Email: contact@nancylitchfielduv.com.au Ph: 61 - 03 9727 0977   Fax: 61 - 03 9727 0277

	UV Lamp Quote Request Form
	To help us identify the correct UV lamp you require please submit as much of the information below as possible. However, if most of this information is not available, you can take the easier option which many customer choose, which is to loan us either a new lamp or a lamp that you have used, (as long as it can still "boot up" and has some life left in it), our manufacturer can measure the electrical specifications from it. We will send it off and return it in about 3 weeks and then we will be able to supply with with a quote and availability.
	Lamp Manufacturers Name ?
	Lamp Ref./Part Number ?
	Equipment Lamp used in ?
	Lamp Operating Voltage ?
	Lamp Operating Current/Amps ?
	Lamp Start up Voltage ?
	Lamp Start up Current/Amps ?
	Lamp Wattage ?
	Lamp Output (w/inch) or (w/cm) ?
	Spectral Output Requirements in nanometers Eg. Metal Halide , Gallium, Iron etc. ?
	Ozone Producing or Ozone Free ?
	Lamp Drawing Physical Dimensions
	1) Total Overall Length ?	mm
	2) Arc Length ?	mm
	3) Lamp Outside Diameter ?	mm
	4) Cable Length ?	Side A mm Side B mm
	5) End Cap ?	Metal mm Ceramic mm
		a) mm b) mm
		c) mm d) mm
	Cable Connector Ring ?	Metal (diameter) mm Other mm
	Your Name ?
	Title ?
	Company Name ?
	Company Mailing Address ?
	Phone Number ?
	Fax Number ?
	Email Address ?
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