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Customer Information
Name:
*
Company:
Address:
Suite/No.:
Phone:
(
)
-
Ext.
*
E-Mail:
*
Building Information
Type:
Please select...
Concrete
Steel
Quantity:
Dimensions:
Please include measurement units. Example: 10'6"
Length (Outside):
Width (Outside):
Height (Inside):
Number of Rooms:
Floor Extension:
Extended Slab™
Yes
No
Interior Finish:
Please select...
FRP
Sheetrock
Plywood
Steel
Other
Exterior Finish:
Please select...
Exposed Aggregate
Concrete Façade
Steel
Other
Floor Finish:
Please select...
VCT standard
VCT anti-static
Slip-Resistant Coating
Other
Mechanical Information
Door:
Dimensions:
Please select...
3' x 7'
3'-6" x 7'
4' x 7'
4' x 8'
6' x 7' Double
Quantity:
1
2
Type:
Please select...
Galvanized and Painted Steel
Aluminum
FRP
Stainless Steel
Bullet Resistant:
Yes
No
Door Hardware:
Standard:
Deadbolt lock with pick guard
N-R-P stainless steel hinges
V-wedge closures with pull handles and padlock hasp
Magnetic weather stripping
Aluminum threshold
Hold open hook
2" aluminum threshold
Comments:
Waveguide Entrance Panel:
Quantity:
Type (Make):
Please select...
Microflect
Polyphaser
Roxtec
Number of Ports:
Port Diameter:
(4" is standard)
Cable Tray:
Cable Tray Needed:
Yes
No
Length (Linear Feet):
Width:
Please select...
6"
12"
18"
24"
Type:
Please select...
Steel - Telco Grey
Steel - Gold Chromate
Aluminum (please describe)
Comments:
Bulkhead:
Bulkhead Needed:
Yes
No
Quantity:
Dimensions:
Type:
Please select...
Galvanized and painted steel
Aluminum
Stainless Steel
Electrical Information
Power:
Voltage:
Amperage:
100A
200A
300A
400A
Phase:
Single
Three
Generator Receptacle:
Yes
No
(Appleton is preferred mfg.)
Generator:
Make:
Please select...
Onan
Kohler
Generac
Size (KW):
Please select...
25KW
35KW
50KW
75KW
100KW
Fuel:
Please select...
Diesel
Lp Vapor
Natural Gas
Location:
Please select...
Interior
Exterior
Installation:
Please select...
Factory Installed
Site Installed
Extended Slab:
Yes
No
Generator Room:
Yes
No
Generator Transfer Switch:
Manual
Automatic
Main AC Disconnect Switch:
Interior
Exterior
Main AC Distribution Panel:
Yes
No
Positions:
Breakers:
Secondary AC Distribution Panel:
Yes
No
Positions:
Breakers:
UPS Distribution Panel:
Yes
No
Positions:
Breakers:
Surge Arrestor:
Yes
No
Interior Grounding Halo:
Stranded or Solid:
Please select...
Stranded
Solid
Insulated or Bare:
Please select...
Insulated
Bare
Number of Drops:
R-56 Compliant:
Yes
No
Ground Bar:
Quantity:
Please select...
0
1
2
3
Size:
Receptacles - Interior:
Quantity:
Type:
Please select...
Duplex
Quadplex
Location:
Please select...
Wall
Ceiling/Tray
Both
Receptacles - Exterior, GFCI:
Yes
No
Quantity:
Equipment Circuits:
Yes
No
Quantity:
Lighting - Interior:
Quantity:
Control:
Please select...
Switch
Timer
Motion
Type:
Please select...
Fluorescent
Incandescent
Lighting - Exterior:
Quantity:
Type:
Please select...
HPS
Incandescent
HVAC:
Quantity:
Type:
Please select...
Wall
Roof
Other (please specify)
Tonnage:
Please select...
1
2
3
4
5
6
Heat:
Please select...
5kw
10kw
Comments:
Ventilation:
Yes
No
Size (cfm):
Please select...
100
350
600
1200
Comments:
Alarms
Door intrusion:
Yes
No
Generator:
Yes
No
High / Low Temp:
Yes
No
Humidity:
Yes
No
HVAC:
Yes
No
Power Fail:
Yes
No
Tech-On-Site:
Yes
No
Hydrogen Detector:
Yes
No
Mounting Board:
Yes
No
Please include measurement units. Example: 10'6"
Length:
Width:
Safety Information
Automatic Fire Suppression:
Yes
No
Eye Wash:
Yes
No
First Aid Kit:
Yes
No
Fire Extinguisher:
Quantity:
Type:
Please select...
CO2
Dry Chemical
Size:
Please select...
10#
20#
Integration of Customer Furnished Equipment
Please give instructions, if any:
Delivery
Transportation:
Yes
No
Address:
Crane Service:
Yes
No
Field Technician:
Yes
No
Site Work
Clearing and Grading:
Yes
No
Site Dimensions:
Please include measurement units. Example: 10'6"
Length:
Width:
Site Plan Available:
Yes
No
Exterior Ground Ring:
Yes
No
Weed Mat and Gravel:
Yes
No
Perimeter Fence:
Yes
No
Commercial Power:
Yes
No
Foundation:
Slab
Perimeter Beam
Piers
Gravel
Pre-Fabricated Concrete Pads (requires local review and approval)