Price Quote Request
...
Refrigerant Leak Detection and Monitoring Systems...
Contact
Information
Title
Mr.
Ms.
Mrs.
Dr.
First Name
Last Name
Business
Information
Business Name
Street
City
State
ZIP Code
Telephone
Fax
Project
Information
Location / Project Name
Project Bid Date
MONTH
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YEAR
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2003
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2005
Projected Installation Date
MONTH
January
February
March
April
May
June
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September
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November
December
DAY
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YEAR
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2005
Specifications
If you have a written specification, please FAX it to
770-667-3857
.
Otherwise, please complete the following before submitting.
Project
Determination
Criteria
What refrigerant gases
are to be monitored?
Is chiller to be in
an enclosed area?
Yes
No
Are possible contaminants
nearby? (i.e. cleaning fluids,
ammonia or other hydrogen
or chlorine sources)
Yes
No
Number of chillers?
Distance between chillers
Size of room?
cu.ft.
Goal
Conservation
Safety
Options
Desired
Check all
that apply
Local Horn
Remote Horn
Local Strobe
Remote Strobe
Remote Horn/Strobe Combo
Multiple Sensing Points
If so, how many (up to 24) ?
Battery Backup
Calibration Kit
Analog Output
SCBA & Wall Case
Comments
Please include
any additional
information you
believe relevant
Your
E-mail Address
Required to
process request
