DATA FORM

RAW WATER INFORMATION

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Your Name

Your Email Address

Your Phone Number

CONDUCTIVITY MMHOS

CONDUCTIVITY RANGE

PH

PH RANGE

TOTAL ALKALINITY as CaCo3

TOTAL ALKALINITY RANGE ppm

CHLORIDES as C1

CHLORIDES RANGE ppm

SULFATES as SO4

SULFATES RANGE ppm

SILICA as SIO2

SILICA RANGE ppm

SODIUM as Na

SODIUM RANGE ppm

CALCIUM as Ca

CALCIUM RANGE ppm

MAGNESIUM as Mg

MAGNESIUM RANGE ppm

TOTAL HARDNESS as CaCo3

TOTAL HARDNESS RANGE ppm

IRON as Fe

IRON RANGE ppm

NITRATES as NO3

NITRATES RANGE ppm

POTASSIUM as K

POTASSIUM RANGE ppm

BROMIDE as Br

BROMIDE RANGE ppm

SUSPENDED SOLIDS

SUSPENDED SOLIDS RANGE ppm

Source of Water

Well Water
Surface Water
City Water

Other

Variation

IS WATER SUPPLY CONSISTENT THROUGHOUT YEAR?

YES
NO

COST OF SOURCE WATER PER 1,000 GALLONS $

COMMENTS: LIST ANY INFO THAT WOULD BE OF VALUE TO TREATMENT OR INFLUENCE TREATMENT

TOTAL USAGE

TOTAL GALLONS USED PER YEAR FOR COOLING SYSTEM(S)

TOWER WATER SUPPLIES COOLING WATER TO:

CHILLERS
SHELL & TUBE HEAT EXCHANGES - LOWEST WATERSIDE V
PLATE AND FRAME HEAT EXCHANGES
OTHER TYPE OF HEAT EXCHANGERS

COOLING SYSTEM INFORMATION

SYSTEM #

I.D.

TOWER MAKE

MARLEY
B.A.C.
EVAPCO
CERAMIC

OTHER

TOWER TYPE

CROSSFLOW
INDUCED DRAFT
COUTERFLOW
FORCED DRAFT

OTHER

FILL TYPE

SPLASH
THIN FILM

OTHER

MATERIAL TYPE

WOOD
CERAMIC
FIBER
PLASTIC

OTHER

TOWER STRUCTURE

WOOD
GALVANIZED
CEMENT

OTHER

BASIN STRUCTURE

WOOD
GALVANIZED
CEMENT

OTHER

RECIRCULATION RATE GPM

TOTAL SYSTEM WATER VOLUME GALLONS

MAXIMUM LOAD TONS/DAY

SEASONAL LOAD HOURS AT MAXIMUM LOAD/YEAR

OPERATION

CONTINUOUSLY OPERATED
DISCONTINUOUSLY OPERATED

HOURS/DAY

HOURS AT MAXIMUM LOAD/YEAR

METALLURGY THROUGHOUT SYSTEM

MILD STEEL
COPPER
GALVANIZED
BRASS

OTHER

HOTTEST SKIN TEMP ON WATER SIDE FOR A HEAT TRANSFER SURFACE IN COOLING SYSTEM FAHRENHEIT

HOTTEST RETURN WATER TEMP FAHRENHEIT

CURRENT CYCLES OF CONCENTRATION

CURRENT TOWER CONDUCTIVITY LIMIT MMHOS

AVERAGE MAKEUP WATER RATE GPM

AVERAGE BLOWDOWN WATER RATE GPM

WINDAGE LOSS (DESIGN OF TOWER) % OF RECIRC RATE

CURRENT TREATMENT

SCALE INHIBITOR(S)

CORROSSION INHIBITOR(S)

BIOCIDES

OTHER

BACKGROUND INFORMATION

COST OF SEWAGE/DISCHARGE OF WATER PRICE/1000 GAL

COST OF TOTAL CHEMICAL TREATMENT (INCLUDING ACID, BIOCIDES, ETC) PER YR

ESTIMATE OF MANUAL LABOR COST TO RUN COOLING PROGRAM: (INCLUDING TESTING, ADJUSTMENTS TO CHEMICAL ADDITION, TOWER BASIN CLEANING, ETC.) PER YR

TO INDICATE ORDER OF IMPORTANCE FOR YOUR WATER TREATMENT, NUMBER THE FOLLOWING LIST SHOWN BELOW FROM 1-10. (1 BEING MOST IMPORTANT)

ENVIRONMENTAL CONCERNS/COMPLIANCE

OVERALL COST REDUCTION

PROGRAM PERFORMANCE/IMPROVEMENT

WATER CONSERVATION

REDUCTION OF SAFETY HAZARDS

REDUCTION OF MANPOWER REQUIREMENT

EASE OF OPERATION

COMPUTERIZED AND/OR REMOTE MONITORING

DISSATISFIED WITH CURRENT TREATMENT VENDOR

COMPLETE SERVICE PROGRAM

AT WHAT LEVEL OF CONFIDENCE DO YOU BELIEVE OZONE TREATMENT CAN BE OF BENEFIT TO YOUR PROCESS. (SCALE 1-100%) % CONFIDENT