Air Inlet Screen Panel Survey Form

(Please include units when specifying sizes. e.g. ft., in.)
1) Frame size: Width x Height

2) Width of outside frame:
   Top Sides Bottom

3) What is frame made of? Sheet metal Other

4) Are there obstructions in the area that need to be described?
   

5) Screen mesh: Course 12 mesh stainless Fine 30 mesh stainless

6) Should this be fixed or easily removeable? Fixed Removeable

Required *
Company Name *
 PO Number
Phone *
 Fax *
Address *
City *
 State *
 Zip Code *
Prepared By *
 Quantity *
 Date Required *
Email *
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