Request for Lighting Layout, Analysis and Design

The following information is required in order to complete a lighting layout for an indoor or outdoor lighting project. Please provide as much information as possible. If available, send an AutoCAD file of the area with relevant details (NOTE: File must be in either *.dwg or *.dxf format. Microstation or Solidworks users can easily convert drawings to this format using the Save As feature). Otherwise, send a sketch showing room or area size, light fixture locations, etc. Send form and all related info to

lightinglayouts@cooperindustries.com. For Cooper Crouse-Hinds Pauluhn luminaires, send info to crouse.pauluhn@cooperindustries.com

Submitted by: _
Project Name: Project Address: City/State/Zip: Project Description:

Date:_
Contact: Phone: Fax: Email:

Interior Layout - Room Information: (specify feet or meters) Area Classification: (check all that apply) Length: Width: Height: Reflectance: (fill in the color of the following) Ceiling: Walls: Floor: Outdoor Layout - Properties: (specify feet or meters) Length: Width: Fixture Mounting Height: Work Plane Height: Required Light Level (in Footcandles or Lux): Maintenance Factor: (check one) Very Clean Clean Average Dirty Very Dirty
Rev. 01012011

Non-Hazardous Class I, Div. 1 Class 1, Div. 2 Lighting Device Type:

(indicate CCH cat # if known)

Class 2 Class 3

For International use: Write In a d if flame-proof type or e for increased safety type.

Fluorescent Luminaire Compact Fluorescent Luminare Incandescent Luminaire High Pressure Sodium Luminaire Metal Halide Luminaire LED Luminaire High Pressure Sodium Floodlight Metal Halide Floodlight LED Floodlight Working area brief description:

Temperature Class (T-Code): Other Characteristics: