Milieu-nomics Questionaire
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New Application
DAF System Questionnaire

Name:

Company:

Position:

Address 1:

Address 2:

City: State:

Zip code:

Country:

Phone: Fax:

E-mail address:

Describe Process

 Please describe the process which is the source of the wastewater / effluent stream. If you have more than one process stream or type of wastewater, but they are ultimately combined (at present) in your facility prior to treatment or discharge, please describe them individually.

For each effluent stream please provide the following information:

Effluent Flow Rate: Minimum
Maximum:
Average:
Hours of Operation: Hrs/Day:
Days/Week:
Temperature: Minimum:
Maximum:
pH: TDS:
Conductivity:
TSS:
BOD: COD:
TOC: FOG:
Do you have Ionic analysis? Yes No
Other pertinent information such as the presence of solvents, oxidants, etc.:
Do you currently treat this effluent in any way?: Yes No

If Yes, please describe

Objectives
Current Water Costs:
Current Sewer Costs:
Target Quality:
Regulatory Compliance
Is water reuse desirable?: Yes No

Critical impurity levels
Reduce Water and/or Sewage Costs
Type of process producing waste stream

Other Comments or Questions

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