Sterilizer Requirements Form
Fields marked in Red are mandatory.
Sales Representative
Architect
Customer and/or Facility
Contractor
Address
Project Name
City, State, and Zip
Building/Floor
Phone Number
Fax Number
Sterilizer Chamber Size
Width
Height
Depth
Controls
Push-Button
Micro-Processor
Chamber/Jacket Material
Stainless/Carbon
Nickel Clad/Carbon
All Stainless
Piping
Standard
Stainless
Door Quantity
Double Door Options
Single Door
D-Door Warning System
Double Door
Elect. Door Interlock (MC Only)
Remote Start Switch
Door Hinging #1
Bio-Seal
Wall Thickness
Door Hinging #2
Steam Source
Electric
Direct Steam
Direct Steam
Standard
*min. amount of steam pressure 50lbs
Clean
Dirty
Inlet Filter
Electric Generator
Standard SSR
Voltage
Standard SR
Phase
Stainles Steel SSR
European Plug
Stainless Steel SR
Feed-Water Pump
(required for <45psi)
Other (Over 40kw)
Air Removal Method
Gravity
Vaccum
Vaccum Options
Standard Hi-Vac w/ Water Ejector
Pre-Vac & Post-Vac
Premium Hi-Vac w/ Liquid Ring Pump
Pre-Vac & Post-Vac
Post-Vac Only
Sterilizer Mounting
Cabinet
Reccessed
1 Wall
2 Walls
Shelving Options
Standard Shelving
Extra Cart
Removable Shelves
Extra Carriage
Cart & Carriage
Chamber Tracks
Common Sterilizer Options (Choose at least one)
Sterilizer Loads (Choose at least one)
Automatic Jacket Blowdown
Liquids
Automatic Generator Blowdown
Red-Bags/Waste
Waste Water Cooling System
Wrapped Goods
Load Control Probe
Surgical Utensils
Additional 1/2" Thermo-Couple Port
GlassWare
Chamber Flood Switch
Electro-Polish + Passivated Finish
Reminder, Notes, & Comments:
High-Polish Mirror Finish
Low Temp Controls
Seismic Tie-Down Kit
Installation Notations:
Effluent Decontamination System
DeInstallation
Jacket Condensate Return to Waste?