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| DOE-STD-3025-99
APPENDIX 3 - HEPA FILTER PENETRATION AND RESISTANCE TEST RESULTS
FTF Name
FTF Address
INSPECTION AND TEST REPORT
MANUFACTURE
P.O.
DATE
DATE
NO.
FILTER
SIZE-CFMTEMP.HUM.TESTED BY
NO.
REC.
TESTED
FILTERS
MODEL
FILTER
RES. IN
DOP PENETRATION %
REMARKS
SERIAL NO.
OK
NG
W.G.
100%
20%
We certify that the filters listed by identifying number have been tested and inspected and that the above readings are
true and correct.
25
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