' Milieu-nomics Upgrade Questionnaire

Upgrade Questionnaire

Name:

Company:

Position:

Address 1:

Address 2:

City: State:

Zip code:

Country:

Phone: Fax:

E-mail address:

Current DAF System Information

Manufacturer:

Model Number:

Year Installed:

Satisfaction

High: OK: None:

Describe Process

Performance of System

Flow / Day-gallons:

Hour / Days:

Days / Week:

Peak Flow - GPM

Avg. Flow

Is Recycle Used? Yes No

If yes, specify % or GPM:

Total Flow to Clarifier (Feed Flow + Plus Recycle) = GPM

Clarifier Geometry

Round Rectangular Square Other Shape

Clarifier Dimensions - Width:

Clarifier Dimensions - Length:

Clarifier Dimensions - Depth:

Feed Pump Make & Model

Make:

Model:

Total HP (water) used:

Air Flow To System:

Total HP (air) used:

Chemical Use

Process Step	Chemical Name	ppm Used	$/Day
pH Adjust
Precipitation
Coagulation
Flocculation
Other

Objectives

High Quality Effluent:

Reduce Energy Costs: $KWH

Lower Maintenance Costs: Reuse Water:

Reduce Chemical Use: Increase Capacity of System:

Automate existing System: Expand Capacity:

Timeline for Upgrade

Hurry, We are ready now!

Budgeting for next year

3 Months:

6 Months:

6 to 12 months:

Collecting Information for future needs: