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Media PA 19063  
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Application Data Sheet Sales Office Name Representative Code Phone Number Fax Number Customer Name Contact Name Postal Address Date Email Address Phone Number Fax Number User Name Location Describe process that produces the emission: Volume ACFM  SCFM Location Temperature (°F) Amount of Moisture (% relative humidity) Inlet Dust Loading (#/hour) Average Concentration (grains/ACF) Collector Location Inside  Outside     Elevation Clearance Available H  W  L Materials of Construction Nema Classification Desired Air to Media Ratio # of Shifts Operating Time (hours/week) Compressed Air Pressure  CFM  Dry     Power V  PH  Hz     Static Pressure Ext. to Collector Will discharge be recycled? yes  no     Scrubbing Liquid Available: Source Quantity Recirculate? % Solids in Liquid pH Neutralizer Required Temperature Accessory Items: Final Filter Exhaust Fan Drum Fill Atch Paint Air Mover:      Mfg         Model      HP     Structural Support Access Platforms Rotary Airlock Screw Conveyor Explosion Vents Name of Material Collected: (Attach MSDS if available) Is Material Recyclable? yes  no Particulate Characteristics: Hygroscopic Sticky Dry Oily Fibrous Flammable Explosive Electrostatic Abrasive Toxic/Hazardous Fluffy Powder Corrosive Soluble in Water Particulate Size Distribution: < 1 micron % 1-5 microns % 6-10 microns % 11-20 microns % > 20 microns % Density #/CF