Please fill out the following form. This will help us give you the best suggestions for what equipment will work best your application. Name of Bussiness * Name of Contact Person * Phone Number * State or Country You Will Be Treating In * Email Address * Type of room or rooms you will be treating * Studio 1 Bedroom 2 Bedroom 3 Bedroom Multi Level Apartment High Rise Other What is the square footage of the room(s) or apartment you will be treating? * What Amp Are the 120 volt Circuits In the Apartment * 15 amp 20 amp Both Other What Amp Are the 240 volt Circuits In the Apartment * 20 Amp 30 Amp 40 Amp 50 Amp Other Is there a electric stove? * Yes No Is the electric stove hardwired? * Yes No Is there a 220 volt 20 amp AC or PTAC in the room? * Yes No Is the AC or PTAC Hardwired * Yes No Do you have any “exposited” concrete (or similar material) * Yes No Please give us a brief description of area(s) you want to treat