HVAC VALIDATION INQUIRY FORM

CUSTOMER NAME: - Date :

Contact Person : - Mobile : Email:

A] TEST TO BE CARRIEDOUT:- (√ Tick Mark)

1.Air velocity & ACPH Measurement 6. Differential Pressure Measurement

2.Filter integrity Test 7. Cross Contamination Test
3.Particle count Test 8. Air pressure Balancing
4.Recovery Test 9. Temp. & RH Measurement
5.Air Flow pattern Test

B] AHU Details:-

Description Quantity/Locations/Numbers
Number of AHU
Number of Hepa Filters
Number of Diffusers
No. of Rooms / Area
Air Flow pattern test With Videography
Recovery test Location
Temperature & RH Mapping Points

Particle count No. of Location At Rest No. of Location In operation Sampling time/Volume
ISO 8/100000/Grade D
ISO 7/10000/Grade C
ISO 6/1000/Grade B
ISO 5/100/Grade A

C] Equipments:-
Equipment Name Quantity Total No of HEPA Sampling Time/Volume Test (√Tick Mark)
LAF 1.Air Velocity
RLAF 2.Filter Integrity
Sampling Booth 3.Particle count
Dispensing Booth 4.Air flow Pattern
Isolator 5. Cross Contamination

D] Chemical / Aerosol to be use :- (√Tick Mark)

Test Options Available
Air Flow pattern test Dry Ice Diethylen Glycohol Titanium tetrachloride
Filter integrity Test DOP PAO Parafine

REMARK (if Any):- ……………………………………………………………………………………………………………………………………………………………………………

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