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Water System Site Profile Form

View A Brief 1 Minute Video About Our Site Profile Form.

Please complete the form below. Alternatively, you may download the form to print, and fax completed to (678) 835-0057.

*Email is required


Contact Information

 

Customer/Utility Date (mm/dd/yy)
Site or Well Identity/Location Site Contact
Local Engineer/Firm Contact Phone
Other Pertinent Notes Rep Contact
Operator Fax
Target Date for Installation Email*
Treatment Goals

 

System Parameters / Site Specific Info

System Type /Application (utility, school, MHP, other)
Population Served (estimated)
Number of Connections  
Number of Wells to be Treated (# wells to be treated)
Design Flow (GPM) (max design flow rate)
Ave Flow (GPM) (typical demand)
Adedge Sizing Basis (GPM) (sizing basis-Adedge)
Est. Gallons per Day (Av. throughput per day)
Est. Gallons per Year (Best estimate)
Existing Pretreatment or disenfection?
Equipment available for offloading
Pump/Operation Pressure
Electrical Power Availability
Atm Storage Tank Present / Size
Hydropneumatic Tank Present / Size
Building Present
Any Additives ie, phosphates, fluoride
Discharge Options Available

 

Water Analysis

Project Specific Parameters

Codes:
1 = Arsenic
2 = Arsenic, Iron / Mn / S project
3 = Fluoride project
4 = Uranium, Radium project
5 = Nitrate project
6 = General Filtration

(enter all available)

Codes

Parameters

 

Codes

Parameters

All pH units   3, 4, 5 Bicarbonate mg/L HCO3
1, 2 Total Arsenic mg/L As   All Total Organic Carbon mg/L TOC
1, 2 As(III) mg/L (if known)   4, 5 Nitrates mg/L as NO3
All Phosphate mg/L P04   4, 5 Chlorides mg/L Cl
All Alkalinity mg/L @ CaCO3   All Turbidity NTU
All Hardness mg/L @ CaCO3   4 Uranium mg/L U
All Silica mg/L SiO2   4 Gross Alpha pCi/L
All Sulfides mg/L   3, 4, 5 TDS mg/L
All Sulfate mg/L as SO4   3 Fluoride ppm F
All Iron mg/L Fe   All Suspended Solids ppm
All Manganese mg/L Mn   All Temperature degrees F

 

 

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