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Water Purification Questionnaire

Water purification to make safe, clean drinking water can sometimes be a challenging process.  To make sure we are providing the best possible solution for your situation, please complete as much information as you can in this questionnaire.

* = required information

Water Source To Be Purified * Deep Well Over 50 Meters or 164 Feet
Shallow Well Less Than 50 Meters
     or 164 Feet
Lake
Spring
Pond
Municipal Water Source
Unknown
If from a well, static and total depth
or well in feet or meters
Type of Water * Fresh Brackish Salt
Purified Water Needed Per 24 Hours *
Water Needed Unit of Measurement * Gallons Liters Cubic Meters
Minimum Flow Rate Needed *
Flow Rate Unit of Measurement * Gallons Liters Cubic Meters
Minimum Water Pressure *
Pressure Unit of Measurement * PSI Bar
Maximum Water Pressure *
Pressure Unit of Measurement * PSI Bar
Power Source, check all that apply  
Solar
Generator
Grid
Gravity
Voltage
Frequency Hz
Phase 50 Hz 60 Hz
Maximum Current Amps
Feedwater Characteristics  
Color *
Suspended Matter mg/liter
Water Temperature Minimum
Water Temperature Maximum
Water Temperature Unit of Measurement * Degrees F Degrees C
Cations Present  
Calcium
Magnesium
Sodium
Potassium
Anions Present  
Bicarbonate
Carbonate
Hydroxide
Phosphate
Chloride
Sulphate
Nitrate
Solids and Hardness  
Total Dissolved Solids
Total Hardness
Carbonate Hardness
Non Carbonate Hardness
Alkalinity p
Alkalinity m
Free Chlorine Cl2
Iron Suspended
Iron Dissolved
Silica
Copper
Zinc
Manganese
Fluorine
Your Contact Information  
Your Name *
Company or Organization
Address *
Additional Address
City *
State, Province, Prefecture *
Country *
Postal Code
Telephone *
Email Address *
Additional Information
Delivery Date Needed *
Verification *

   

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