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Dust Control Solutions
P.O. Box 71
Bloomsbury NJ 08804
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Process Summary -- Page 1 of 2

Date:                                      
Customer's Company Name:                                            
Customer's Contact:                                                           
Customer's Phone:                                            
Customer's Fax:                                            
Customer's Address:                                                            


Process:

Describe process generating dust/fume/mist:                                                                              
Chemical or common name of dust/fume/mist:                                                                            

Characteristics - Check all that apply:

[   ]Abrasive

[   ]Agglomerate

[   ]Corrosive

[   ]Hygroscopic

[   ]Toxic

[   ]Fibrous

[   ]Fire Hazard

[   ]Explosive =     & Pmax:    bar Dust: St1, St2, St3?

If explosive, the distance from outside wall, if unit will be inside, is        ft.
Collector will be:     [   ]indoors    or    [   ]outdoors?
Density of dust:       lbs/ft³
Size distribution (assign 0-100%, by weight):
      < 1 um      1-5 um      6-10 um      11-50 um      51-100 um      > 100 um

Operation:

Operation hours per day:   [   ]0-4 hrs [   ]5-8 hrs [   ]9-12 hrs [   ]13-16 hrs [   ]17-23 hrs [   ]24 hrs Operation days per week:        days

Electrical and design data for unit:

- Power Supply for unit available:
[   ]460 VAC/60HZ or [   ]575VAC/60HZ

Discharge of unit: Fan for unit: Silencer for unit:

[   ] Dust bin(s)

[   ]Yes [   ]No

[   ]Yes [   ]No

-Solenoid valves for Unit in:
[   ] VDC or [   ] 110 VAC/60HZ

[   ] Rotary valve

<        dB(A)@5ft

[   ] Screw conveyor

Protection:      [   ]NEMA 12    or    [   ]NEMA 4    or    [   ]NEMA 4X - Enclosure for timer board on electrical panel?

Collector build out of:

-Carbon steel

[   ]Yes   or   [   ]No

-Stainless Steel

[   ]only raw gas section in stainless steel?
[   ]raw gas section and clean gas section in stainless steel?
[   ]compressed air tank in clean gas section in stainless steel?