| Please briefly describe your project requirements |
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| Company Name |
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| Contact Name (First/Last) |
First:
Last:
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| Street Address |
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| City, State, Zip |
City:
State:
Zip/Postcode:
Country:
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| Phone / Fax |
Phone:
Fax:
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| Email |
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| Industry Description |
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| Project Location |
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| Wastewater discharged by |
Gravity
Pumps
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| Pressure of head of water |
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| Nature of existing waste water discharge system |
Collecting Pit
Pipe Line
Sewer
Gutter
Other
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| Existing control equipment in feed system |
Valves (state pipe)
Blends
Reducers
Chokes
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| Minimum flow, normal flow, maximum flow |
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| Continuous operation / batch operation |
Continuous
Batch
; Operation
Hours |
| Average period of batch flow |
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| Frequency of batches |
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| Quantity of waste water per batch |
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| Appearance |
Color
Turbidity
Odor
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| Temperature |
Minimum
Normal
Maximum
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| Are soaps, detergents or their surface active agents present in the waste water |
Yes
No
Please Specify
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| Are fibers, hair, etc. present in the waste water |
Yes
No
Please Specify
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| Are air or gases present in the wastewater |
Yes
No
Unsaturated
Saturated
Super Saturated
Entrained Bubbles
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| Quantity of materials settling out |
mg/l |
| Density and settling velocity of materials |
m/h |
| Quantity and nature of floating material |
mg/l |
| Size distribution of the solids present if known |
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| pH |
Avg
Min
Max
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| TSS (Total Suspended Solids) |
mg/l |
mg/l |
| TDS (Total Dissolved Solids) |
mg/l |
mg/l |
| COD (Chemical Oxygen Demand) |
mg/l |
mg/l |
| BOD (Biochemical Oxygen Demand) |
mg/l |
mg/l |
| TOC (Total Organic Carbon) |
mg/l |
mg/l |
| Ammonia nitrogen |
mg/l |
mg/l |
| Albuminoid nitrogen |
mg/l |
mg/l |
| Phosphates |
mg/l |
mg/l |
| Orthophosphates or polyphosphates |
mg/l |
mg/l |
| Mineral, animal, vegetable |
Mineral
Animal
Vegetable
Concentration:
mg/l |
mg/l |
| Method of analysis used to obtain the figures |
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| Specify gravity |
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| Viscosity (State method and units used) |
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| Oil droplets diameter |
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| Oil droplets size distribution |
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| Nature of fats |
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| Concentration |
mg/l |
mg/l |
| Iron |
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| Concentration |
mg/l |
mg/l |
| Emulsified Materials |
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| Calcium and Magnesium salts |
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| Alkali metal salts |
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| Carbonate and bicarbonate |
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| Sulphate |
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| Others, please specify |
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| Do legislative standards apply to your waste effluent discharge |
Yes
No
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| Which standards |
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| Is a copy available |
Yes
No
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| Visual appearance of the waste effluent |
Color
Turbidity
Jackson Turbidity Units
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| The treated water will be |
Discharged
Re-used
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| In case of re-use, please give the specification for the water to be re-used |
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| Are the impurities to be recovered |
Yes
No
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| In case of recovery, please specify any chemicals that may not accompany the material to be recovered |
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| Situation |
Above ground
Sump
Others
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| Material(s) of construction |
Concrete
Sump
Others
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| Installation location relative to water source |
Indoors
Outdoors
Off-shore
Other
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| Is electricity available |
Yes
No
Phase
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| Maximum starting load permitted |
Kw |
| Is compressed air available |
Yes
No
If Yes, please give details
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| Is clean fresh water available |
Yes
No
If Yes, please give details
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| Is steam available |
Yes
No
If Yes, please give details
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| Is an offer required |
Yes
No
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| If Yes, what is your timeframe |
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| Scheduled date of start-up |
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| Plant location well accessible |
Yes
No
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| Are there any obstacles for transport |
Yes
No
If Yes, please give details
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