In order for IST to recommend suitable instruments for your application,please complete and return this form. Fields with red asterisks (_*) are required.

Name	_*
Title	_*
Company	_*
Address	_*
City	_*....State ....Zip
Country	_*
Telephone	_*.....Fax
E-mail	_*

GENERAL INFORMATION:

  Application:

  1. Gases to be monitored and desired ranges (PPM, %LEL, or % by volume)


  2. Interfering gases and possible concentration ranges (PPM, %LEL, or % by volume), if any:

3. Operation temperature range: (optional) at sensor; at instrument.

4. Humidity range: (optional) at sensor; at instrument.

5. Is there an existing gas monitor in use? NO YES

If yes, please indicate manufacturer, model, and any current problems:

6. Type of instrument required:

Portable Desktop Rackmount
Weatherproof or wallmount Explosion-proof

7. Number of sensor points required:

8. Maximum distance from sensor to control room:

9. Line Power: Volts Hertz

10. DC Standby Power: (optional)

11. Additional information and requirements:

In order for IST to recommend suitable instruments for your application,please complete and return this form. Fields with red asterisks (*) are required.

In order for IST to recommend suitable instruments for your application,please complete and return this form. Fields with red asterisks (_*) are required.