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Name

Company

Email

Phone

Address

City/State

Zip Code

What product(s) do you want to vacuum?

Is it explosive?

Is it toxic?

• Ordinary Location
• Division I
• Division II

How long will you use the vacuum? (Time of operation. Per day, per week.)

What collection capacity are you looking for?

Do you have compressed air available? (If so, what diameter and cfm is available.)

If Electric, what voltage is available?

• HEPA Plus*
• ULPA

What diameter and length of Suction Hose is Required?

What accessories are required?

Additional Information: