Filtracheck™ Form

NAME: ADDRESS:
COMPANY: CONTACT NUMBER:

Type*: ☐ Ducted ☐ Ductless *Note: Please choose your preference. The correct tType will be recommended based on the application and information provided below.
Frequency of Work
Type of work Quantity of Duration of
No. Temperature of Per Day (PD)
Name Concentration (%) (e.g. Distillation, Open or covered chemical used (mL, handling
handling (°C) Per Week (PW)
Transfer etc.) L, or g) (mins, hours)
Per Month (PM)

ADDITIONAL REQUIREMENTS
Are you going to place any apparatus inside the fume hood?
☐ Yes, please specify: What are your requirements for Accessories / Service Fixtures? (May vary depending on
☐ No the recommended fume hood model type)
☐ Faucet ☐ Sink/ Drip Cup ☐ SF- Gas ☐ SF- Water
☐ Others, please specify:

Filtracheck™ Notes
 Filtracheck™ Form
Chemicals

 Name: The name of the chemical used in the fume cabinet (e.g. Toluene). For trade name, please provide material safety data sheet.
 Concentration: Indicate the concentration of the chemical (in % volume for fluids and % mass for solids).

Application

 Type of Work: Provide method used, technique or other details on the nature of the work / process being carried out (e.g. Distillation, Transfer etc).
 Open/Covered: Mention whether the process is being carried out open or covered.
 Temperature: The temperature at which the work / process is being carried out. This is especially important in case the process requires the chemical to be heated.
 Frequency: Specify how frequently the concerned work / process is carried out (e.g. 2xPD, 1xPW).
 Quantity: Quantity of chemical (in ml. or gm.) used during the process.
 Duration: Time taken for carrying out the process