On-Line Design

Worksheet

Project Name:
Contact Name:
Mailing Address:
City: State: Zip Code:
Phone:
Fax:
Email Address:
Project Description:

Note: If attaching a CAD file, it is not necessary to complete Room Dimension information.

Room Dimensions: Length: Width:   Height:
Color of: Wall:     Ceiling: Floor:   
Fixture Height: Work Plane Height:
Footcandle Level Required at Workplane:   
Atmospheric Condition:
Type of Light:
Wattage:
Area Classification :
If Hazardous classification,
can you identify chemical?
If chemical cannot be identified, please provide "T" rating requirement.
Do you want to send an attachment? (Attachemnts are sent as a separate email)
Other
Comments:

Thank you for your interest in T&B Hazlux Lighting. We appreciate your business.

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