Fume Hood Manufacturer AirClean Systems

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Application Worksheet

The information you provide will ensure the proper safety enclosure is selected for your application. Complete and accurate information is critical for our technical staff to evaluate and recommend the correct safety enclosure. Safety is AirClean® Systems number ONE goal.

1. Describe the application to be completed within the hood.

2. What chemicals will be manipulated inside the hood?

Chemical Name: Concentration: Volume
Evaporated
per day:		 Frequency used in hood:

3. During your application, will any of the chemical(s) be heated inside the hood?

Yes No

If yes, which and explain with volumes and duration of time.

4. Describe the laboratory environment that the hood will be placed in.

5. Do you want the hood to protect:



If both, please explain:

6. Equipment inside the hood can affect containment.
Will any equipment be used inside the hood?

Yes No

If yes, please explain and give dimensions for each.

7. How many linear feet of hood space is required for your application?*

8. Are you interested in:
Please complete all the information below so our technical sales staff can provide you with accurate product information and pricing.
Your Name:*
Company Name:
Address:*
Address (Cont):
City:*
State:*
Postal Code:*
Country:*
Phone*/Ext:
Fax:
Email Address:*
By submitting this application, I warrant that the information provided is complete and accurate. Fields marked with an (*) are requred.