Dust Collectors Questionaire
Submitted By:  Job Title:  Date: 
Company Name:  Phone Number: 
Address: 
City:  State:  Zip: 
Type of Dust: 
Collector Make:  Model No.:  Size(CFM): 
No. of Bags:  Operating Temp.:  Air-to-Cloth Ratio: 
Collector Age:
(years)		 Avg. Bag Life:
(months)		 Est. Date of
Next Replacement:
Reason For Replacement: 
Fabric Currently in Use Fabric Finish Fabric Weight
polyesterpolypropylene
acrylicnomex
nyloncotton
other
glazedsinge
feltwoven
knittedteflon coated
other
oz./sq. yard
Clean Air Permeability
cfm/sq.ft.@1/2" W.G.
Bag length:  Bag Diameter:  or Flatwidth: 
Maint. Performed by:  company employee   local contractor   other
current or future
repairs needed on collector: 
past repairs
made to collctor: 
check the appropriate
end configuartion:









check the appropriate
bag style:










 





   5340 East Road P.O. Box 1186, Baytown,Tx 77522-1186   Tel: 1.800.299.2247   Fax: 281.421.5993   sales@worlwidefiltration.com