Application Worksheet - AirClean Systems

Fields marked with an (*) are required.

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To expedite your application validation, please provide the most information possible.

Will any chemical[s] be heated inside the hood?
Yes (If yes, be sure to indicate temperature below)
No

Chemical Name: *	Concentration:	Volume Evaporated In 24hrs :	Frequency of evaporation (days per week):	Heated Temperature:

Please describe any equipment to be used inside the hood.

Please describe your hood applications & lab environment.

Please add the two numbers to prove you are a human.

Result *