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3D SYSTEMS, INC
.
IMPORTANT
You must complete and sign this form before scheduling installation . The information on this form will be used to
determine the necessary time that 3D Systems personnel will need to complete the installation .
In case of multiprinters installation, use 1 x checklist per printer .
Contact name
Phone, email, fax
Phone
Fax
Facility address
COMPANY NAME:
ADDRESS:
ZIP CODE:
CITY:
COUNTRY:
STATE:
Date submitted
Storage Requirements completed
Room Requirements completed
Atmosphere Requirements completed
Electrical Requirements completed
Measured 230 VAC facility power: ________ VAC, ________ Hz
Gas Requirements completed
Compressed Air Requirements completed
Computer and Network Requirements completed
Lifting Equipment Available
Tools Available
Personal Protective Equipment Available
Waste Disposal System Established (Must comply with all applicable regulations)
Fire Suppression Equipment Available
Comments
Signature
FACILITY REQUIREMENTS CHECKLIST - ProX
®
DMP100
SECTION FILLED BY 3DSYSTEMS
# Sales Order (S.O.)
# Serial Number of the printer
3D SYSTEMS RESERVES THE RIGHT TO RECEIVE COMPENSATION FOR NONPRODUCTIVE TIME AND TRAVEL DUE TO FALSE
OR INCORRECT INFORMATION ON THIS FORM .