Contact Name
*
Number Of Bags To Be Submitted
Phone
Address
Explain Other
Comments or Questions
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Company Name
*
Problems Experieced
Reason For Test
Failure Analysis
Life Projection
Quality Control
Other
Filter Installation Date
Purchase Order Number
Pressure Differentials (Maximum)
Pressure Differentials (Minimum)
Fabric Specifications
Temperature (Maximum)
Application
LAB TEST REQUEST FORM
Cleaning Procedure
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Temperature (Normal)
Previous Bag Life
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