USP797 Compliant Clean Room Worksheet

Please fill out this form as completely as possible so that we are better able to help you. If you need help with this form or prefer to discuss your cleanroom needs directly with us, call 1-800-815-2726. This information is used only to contact you and will not be sold or redistributed.

General Information
Cleanroom Dimensions	(W x L x H)
Gown/Ante Room Dimensions	(W x L x H)

Temperature and Humidity Requirements
Will this cleanroom need air conditioning?	Yes No

Electrical Requirements
How many electrical receptacles?	Not sure
How many 208 volt receptacles?	Not sure

Other Needs
Laminar flow hoods, furniture, sinks, etc.

Contact information
Please include your name and at least one way for us to contact you. Or, print this worksheet, fill it in and fax it to 972-513-1877. This information is used only to contact you and will not be sold or redistributed.
Full Name
Phone Number
E-mail Address
Fax Number