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Innovative

Contamination
Solutions

Account Needs Analysis

Account Information
Account Manager Name:
Customer Name:
# of Operators:
Cleanroom Classification(s):

Contact Information Product Qualification
Contamination Control Engineer: In-House Testing?
Facilities Maintenance Engineer: Testing Criteria?
Purchasing Mgr: Primary Contact?

Dry Wipes in Use Application
Brand(s): Gownroom Wipedown
PN#(s): Spill Clean-up
Material(s): Environmental Cleaning
Edge Type: Process Cleaning
Size(s): Other?
Approximate Monthly Volume

Presaturated Wipes in Use Application
Brand(s): Gownroom Wipedown
PN#(s) Environmental Cleaning
Material(s): Process Cleaning
Edge Type: Other?
Size(s):
Blend Ratio:
Approximate Monthly Volume

Swabs in Use Gloves in Use
Brand(s): Brand(s):
PN#(s) PN#(s)
Material(s): Material(s):
Approximate Monthly Volume Approx. Monthly Volume

Comments

2150 W. Broadway Rd | Suite 104, Mesa, AZ 85202 USA • 844.309.2376 • Teknipure.com