Evaluation Questionnaire

Contact Information:
First Name: (required)
Last Name:
Phone: (required)
e-mail: (required)
Company:
Address:
City: State: Zip:

General Information:
Model #: Model Name:
Type of Tool:
Evaluation Date: Ship Date:
Evaluation Location:

Evaluation Services Requested:
SEMI S2 {S3, S8, S14, S22, etc...}
CE Marking {Machinery, Low Voltage, ....}
Ventilation Testing {SEMI S6}
Field Labeling {3rd Party Electrical}
Training {Design for Compliance}
Other:

Equipment Details:
1. General equipment description: What does the equipment do?
2. Is the equipment a component, subassembly, or process module of a larger system or host tool?
3. Does the equipment include separate modules?  (e.g., Vacuum Pump, Power Distribution Box, Chiller
4. What is the electrical rating of this system?
Voltage: VAC Phase: Current: amps
5. Overall dimensions of the Equipment:
Length: inches Width: inches Depth: inches
6. Does this system use chemicals or gases during operation or maintenance?
If Yes, please complete the following list: (Note: attach MSDS if available).
Chemical Name Approx. Quantity (Volume, flow rate, etc.)
7. Is exhaust ventilation testing desired for this evaluation?
Note, If yes, an additional Exhaust Ventilation Testing Questionnaire may be required.
8. Does this system use any radioactive materials or isotopes?
9. Does the system or any of its components operate above 10kV?  (i.e., generate X-rays)
10. Does this system use or generate radio frequency (Rf) or microwave (MW) radiation?
11. Does this system use or contain any laser devices?
12. Does this system use or generate any non-ionizing radiation (e.g., UV/IR/visible light lamps, plasma chamber view ports)?
13. Does the system use, contain, or generate any static magnetic fields (e.g., linear motors, or permanent magnets)?
14. Does this system consist of or incorporate any robot devices (i.e., programmable multiaxis robot arms)?
15. Has this equipment, or previous models of this equipment been evaluated for safety (including SEMI S2 analysis)?
If yes, explain:
16. Will Installation, Operations and Maintenance Manuals be available for review?
17. The equipment evaluation typically requires that the system be operational with all facilities (e.g., power, facility gases (N2, CDA), and exhaust operating during the evaluation and testing.  Will the equipment be operational with all facilities including exhaust running?
Please add any additional information that you feel is pertinent to the evaluation: