Application Survey

   
         
Complete this Application Survey and we will provide you with a complete and accurate product

quote, based on all your requirements.

 
  (* indicates required field)
 
 

*First Name:

 

*Last Name:

 

*Company:

 

*Address:

 

*City:

 

*State:

         *Zip:  

*Country:

 

*Phone:

 

Fax:

 

*E-mail:

 

*Product Selection:

 
     

Briefly describe your application or process.

If this is a manufacturing process, what are the finished products?

Enter the gas or vapor(s) to be measured.

Select the measurement range:

%Lower Flammable Limit

%Gas or vapor in air

Parts Per Million by volume (PPM)

Parts Per Million Carbon by volume (PPMCv)

Milligrams Carbon per Cubic Meter (mgC/m3)
Sample concentration.

Minimum

Normal

Maximum

 
Sample Temperature.   

F  

C  
 

Minimum

Normal

Maximum

 
Sample pressure.

PSI

 

kPa

 
 

Minimum

Normal

Maximum

 
Sample oxygen content (%).

Minimum

Normal

Maximum

 
Sample water vapor content (%).

Minimum

Normal

Maximum

 
Sample Dew Point.

F  

C  
 

Minimum

Normal

Maximum

 

Does the sample or background contain any of the following?

Bottom

Top

Silicones.

Minimum

Normal

Maximum

 

Halogenated hydrocarbons.

Minimum

Normal

Maximum

 

Organic metallic compounds.

Minimum

Normal

Maximum

 

Corrosive compounds.

Minimum

Normal

Maximum

 

Plasticizers, Plastisols, Resins.

Minimum

Normal

Maximum

 

Condensate.

Minimum

Normal

Maximum

 

Particulate.

Minimum

Normal

Maximum

 

Air Flow/Turbulence.

Minimum

Normal

Maximum

 


Please list all gases and or vapors present.

Gas or Vapor

Minimum

Normal

Maximum


Conditions at the sensor location.

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Top

Total number of sensor points required.

Monitoring method.

Area monitoring of indoor or outdoor space

Process monitoring

Sensor location.

Indoor

Outdoor

Distance from sensor to sample point.

Feet

Area rating required.

Non-hazardous

Hazardous:

Class

Division

Groups

 

Zone

       

Housing rating required.

NEMA 1 general purpose

NEMA 12/13 dust-tight

NEMA 4X water-tight

Ambient Temperature range at sensor site.

F  

C  
 

Minimum

Normal

Maximum

 

Barometer range at sensor site.

mmHg

 

mBar

 
 

Minimum

Normal

Maximum

 

Utilities available at sensor site.

 

Electrical 

Volts

AC

DC

 

Hertz

 

Compressed air

PSIG

 

Instrument air

PSIG

 

Instrument fuels

Propane

Hydrogen

 

Briefly describe the probable sensor location.


Conditions at the operator interface or control monitor location.

Bottom

Top

Control monitor location.

Indoor

Outdoor

Estimated distance between sensor and monitor.

Feet

Monitor and sensor in same location

Area rating required.

Non-hazardous

Hazardous:

Class

Division

Groups

 

Zone

       

Mounting method required.

Panel Mount

Wall Mount

Mounting NEMA rating.

NEMA 1

NEMA 4X

NEMA 7

NEMA 12/13

Temperature range at the operator interface or monitor location.

F  

C  
 

Minimum

Normal

Maximum

 

Barometer range at monitor site.

Minimum

Normal

Maximum

Utilities available at monitoring site.

 

Electrical 

Volts

AC

DC

 

Hertz

Briefly describe the probable monitor location.


Alarms and Outputs

 

Alarms levels settings.

Warning

 

Danger

 

Additional notes and comments.

Top

       

 

"In Accordance with the 1998 Data Protection Act all data is kept as confidential and not passed to any third parties."

 
 
 
 
 
 
 
 
 
 
 
 
 
 

Control Instruments Corporation 25 Law Drive Fairfield, NJ 07004 973-575-9114
Copyright 1998,2002 Control Instruments Corporation. All rights reserved