Date:                             
Company:                                                         

Air

Airflow to collector:           CFM or in m³/h @           °F or in              °C

Air condition to collector: Humidity             % or wet bulb temperature           °F/°C

Elevation above ocean level of plant:           ft. or in           m

Total system static pressures:          "WG (extern, duct work, etc. without filter unit)

Inlet loading (grains/ft³): [   ]<1      [   ]1-2      [   ]3-5      [   ]6-12      [   ]>12

Maximum alowable discharge of particles in clean gas air: [   ]mg/m³ or in [   ]grains/ft³

Collector Qualifications:

Describe past dust/fume/mist collection and any problems or issues:







Describe any space constraints:







Provide sketch of process on separate sheet (include all available dimensions).

Recirculation of air:		[   ]Yes	[   ]No
Dust sample sent to DCS?		[   ]Yes	[   ]No
Review and supply customer specifications.	Attached:	[   ]Yes	[   ]No

Review and supply customer MSDS.