ITL Photometry Order Form

Independent Testing Laboratories, Inc. Photometry Order Form Photometry, lamp, electrical, ballast, fluorescent, compact fluorescent, incandescent, LED, special testing.

THE FOLLOWING INFORMATION MARKED WITH AN * AND IN BOLD TYPE IS CRITICAL. IF THIS INFORMATION IS NOT INCLUDED ON YOUR ORDER FORM, IT MAY RESULT IN SLOWER PROCESSING OF YOUR ITL TEST(S).

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*Contact Name

Billing Address: E-mail address:

*Telephone:

Fax Number:

P.O. Number:

Shipping address same as Billing address Yes No (if no, add shipping address at bottom of form)

*Company name (as it is to appear on ITL report)

*Catalog Number(s)

Luminaire Description

Number of lamps Watts per Lamp *Lumens per lamp

Has this hardware (either in part or full) been tested previously by ITL?
If so, please list test number(s)

FOR LAMP(S), INDICATE ALL THAT APPLY:

Metal Halide: Clear Phosphor-Coated HQI Sketch of Luminaire Orientation for Test

High Pressure Sodium: Clear Diffuse Please e-mail or FAX a sketch of the luminaire indicating orientation of fixture and lamp.

Mercury: Clear Phosphor-Coated

Incandescent: A-19 A-21 Clear Inside Frost Quartz
Other, describe:

Other: LED Induction Other:

Envelope Style (i.e. BT-28, E-18):

*Lamp Position Horizontal Vertical-Base Up Vertical-Base Down

Other (describe, provide a sketch if necessary)

Fluorescent: T12 T8 T5 U-lamp Compact Biaxial

Color Temp. Other:

* If you require a specific lamp type please specify, otherwise ITL may use a substitution (i.e. color temperature, make):

INDICATE TYPE OF PHOTOMETRIC REPORT DESIRED

Indoor Report:

VCP table (extra cost)?YES
Cone of Light (extra cost)?YES Beam Spreads (extra cost)?YES

Roadway/Area Report: Mounting Height for Isofootcandle Plot:

Floodlight Report:

NOTE: For LED luminaires, please select desired photometric test report type above. LED tests will be performed in accordance with IESNA LM-79 unless otherwise specified by customer. If color measurements are desired, select box below.

Include LM-79 Color Measurements for LED Testing (CRI, CCT, DUV and X,Y Coordinates), extra cost.

Include Spectral Distribution (SPD) on Color report for LED Testing (not included with above checkbox), extra cost.

* Light measured in: Upper hemisphere Lower hemisphere only Both Upper & Lower hemisphere

* If you do NOT want us to drill holes in your samples, check here! (If we cannot drill holes in your samples, there may be additional charges for producing a structure to support your samples on our test apparatus.)

* Estimated date test samples to arrive at ITL:

*SELECT ONE:

PRIORITY SCHEDULING (40% surcharge applies) Yes (call for current priority turnaround time.)

E-mail to another address? Yes E-mail address:

Special Instructions:

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Choose these options before filling out the ITL Photometry Order form if you desire. You will lose any information typed in if you choose these options now!

E-mail: itl@itlboulder.com

Independent Testing Laboratories, Inc.

3386 Longhorn Road, Boulder, CO 80302

Tel: 303.442.1255

Fax: 303.449.5274

Metal Halide:	Clear	Phosphor-Coated	HQI	Sketch of Luminaire Orientation for Test
High Pressure Sodium:	Clear	Diffuse		Please e-mail or FAX a sketch of the luminaire indicating orientation of fixture and lamp.
Mercury:	Clear	Phosphor-Coated

Incandescent:	A-19	A-21	Clear	Inside Frost Quartz	Other, describe:
Other:	LED	Induction		Other:
Envelope Style (i.e. BT-28, E-18):

*Lamp Position		Horizontal		Vertical-Base Up		Vertical-Base Down
Other (describe, provide a sketch if necessary)

Indoor Report:
VCP table (extra cost)?YES	Cone of Light (extra cost)?YES	Beam Spreads (extra cost)?YES
Roadway/Area Report: Mounting Height for Isofootcandle Plot:
Floodlight Report:

NOTE: For LED luminaires, please select desired photometric test report type above. LED tests will be performed in accordance with IESNA LM-79 unless otherwise specified by customer. If color measurements are desired, select box below.
Include LM-79 Color Measurements for LED Testing (CRI, CCT, DUV and X,Y Coordinates), extra cost.
Include Spectral Distribution (SPD) on Color report for LED Testing (not included with above checkbox), extra cost.

* Light measured in:	Upper hemisphere	Lower hemisphere only	Both Upper & Lower hemisphere
* If you do NOT want us to drill holes in your samples, check here! (If we cannot drill holes in your samples, there may be additional charges for producing a structure to support your samples on our test apparatus.)