Evaluation Form English

Please fill out all *Mandatory Fields* filling as many of the following fields as possible, will  will enable our ability to better respond to your inquiry.

**Privacy** Your information is private and will never be sold or shared, and will only be used for the purposes of this inquiry.

Date

Phone (required)

Project Contact (required)

Project Name (required)

Project Contact

Contact Email (required)

Phone (required)

Project Street Address (required)

Project City (required)

Project State (required)

Zip (required)

Country(required)

Engineer (required)

Engineer Phone(required)

Fax number

Name of Buyer (End User of Contact)(required)

Project Classification

Please use \"shift\" for more than one selection

Type of Wastewater Flow

Size GPD/LPD

Hourly Peak Flow GPD/LPD

Elevation (FT) ASL

Hours/Day Plant is Running:

# Of Shifts Per Day

# of Days Per Week Plant Operates

IF PLANT HAS PEAK FLOWS PLEASE DESCRIBE IN FULL DETAIL:WHEN, HOW LONG, HOW MUCH, ETC.

IS THE PLANT SHUT DOWN FOR A LONGER PERIOD OF TIME THAN 24 HOURS?

 yes no

(IF SO DESCRIBE)

DISINFECTION BY:  CHLORINE ULTRAVIOLET DISCHARGE US IRRIGATION STREAM LAKE LAND APPLY OTHER

PROJECT STAGE NOW: PRELIMINARY BUDGET PURCHASE IN 90 DAYS PURCHASE IN 6 MONTHS 

ELECTRICAL SUPPLY: PHASE HZ VOLTS

LOADINGS/CONCENTRATIONS

WASTEWATER CHARACTERISTICS OF INFLUENT AND PARAMETERS TO MEET FOR EFFLUENT

1. BOD\'s mg/1,TO MEETmg/1

1a. Soluble BOD mg/1

2.CODmg/1,TO MEETmg/1

3.TSSmg/1%Volatile,TO MEETmg/1

4.TDS mg/1 text text-152]%Volatile,TO MEETmg/1

5.SETTLEABLE SOLIDS mg/1

6.PH ,TO MEET

7.FOG(fats, Oils, Grease) mg/1,TO MEET

8.TEMPERATURE(FAHRENHEIT)ORCELSIUS

9.TOTAL Nmg/1,TO MEETmg/1

10.TKNmg/1,TO MEETmg/1

11.AMMONIAmg/1,TO MEETmg/1

12.TOTAL P mg/1,TO MEETmg/1

13.POTASSIUM mg/1,TO MEETmg/1

14.CALCIUM mg/1,TO MEETmg/1

15.SULFATE mg/1,TO MEETmg/1

16.DO mg/1,TO MEETmg/1

17.OTHER,TO MEET

NOTE: COMPLETION OF ALL ITEMS ON THIS EVALUATION FORM IS NOT NECESSARY. HOWEVER, WITH COMPLETE INFORMATION AVAILABLE IT DOES HELP US TO SUPPORT YOU BETTER.

ADDITIONAL NOTES

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