Application Questionnaire

Please, provide as much of the appropriate information in the fields listed below. Click SEND to have your message reviewed by Sciential within two business days.

Full Name:	Company:
Address (1):	Position:
Address (2):	Phone Number (including area code):
City:	Fax Number (including area code):
State or Region:	E-Mail:
ZIP or Postal Code:	Web Site:
Country:

Existing Dissolved Air Flotation Information
Manufacturer:
Model Number:
Year Installed:
Current Condition:	Poor  Marginal  Good
Separation Performance:
Questionnaire
Estimated date of purchase:	(e.g., 10/23/2002)
Required delivery date:	(e.g., 01/01/2003)
Where is the equipment to be shipped?
Is this where it is to be installed?	Yes    No
Who will purchase the equipment?	You, as end user  Engineering Firm  Other
Is equipment for?	Replacement  Expansion  New Plant
Do you have similar equipment?	Yes    No
Site conditions:
Elevation:
Temperature:
Electrical Characteristics:
Volts:
Hz:
Phase:
Please, briefly describe the process in which this equipment is to be used:
Dissolved Air Flotation Thickeners/Clarifiers
Application:
Municipal:
Industrial:
Flow rate (GPM):
Influent:
Design:
Avg.:
Peak:
Influent Concentrations Effluent Concentrations Suspended Solids Concentration  mg/l    mg/l Dissolved Solids Concentration  mg/l    mg/l Fats, Oils & Greases  mg/l    mg/l BOD or COD   mg/l    mg/l Others   mg/l    mg/l Others   mg/l    mg/l Temperature   Fahrenheit   pH
Sludge Loading Rate (lbs/ft²/hour):
Hydraulic Loading Rate (gpm/ft²):
Air to Solids Ratio (lbs of air to lbs of solids):
Sciential standard A/S ratio is 0.02. Some applications require 0.03 to 0.04.
Float Solids Concentration Required (wt %):
Diameter (ft):
Site Water Depth (ft):
Freeboard (ft):
Bottom Floor Slope (in/ft):
Mechanism Type:
Support:	Center column Bridge
Influent Feed Arrangement:	Side Bottom Top
Tank Material of Construction:	Concrete Steel
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