PERSON TO CONTACT AND/OR ADDRESS RESULTS Facility Owner/Operator/Manager Company Name Street Address City State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Not Listed Zip County/Parish Country Contact Name Position Phone No Fax No email Consulting Engineer: Company Name Street Address City State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Not Listed Zip County/Parish Country Contact Name Position Phone No Fax No email GENERAL PROJECT DATA: TYPE OF PROJECT New Plant? YES NO Upgrade existing facility YES NO Replace Equipment in existing plant? YES NO Other? Type of Waste Municipal? YES NO Describe Industrial? YES NO Describe Combined municipal and Industrial? YES NO Describe Treatment Process Application Aerated Lagoon? YES NO Describe installation Activated Sludge? YES NO Describe installation Equalization Basin? YES NO Describe installation Oxidation ditch? YES NO Describe installation Sludge holding tank/Aerobic Digester YES NO Describe installation Other process? Treatment Objectives Industrial Pretreatment? YES NO Describe objective Improve Winter Operation? YES NO Describe objective Increased Dissolved Oxygen? YES NO Describe objective Algae Control? YES NO Describe objective Odor Control? YES NO Describe objective Mixing Application? YES NO Describe objective Nitrification? YES NO Describe objective BOD Reduction? YES NO Describe objective Project Status: Preliminary Engineering/Design YES NO Budgetary Purposes YES NO Other Status Project Timing Bid date if applicable When will aeration equipment be required on site ? Approximate Budget: Has funding been appropriated for this project? YES NO If yes, specify. YES NO FEDERAL STATE STATE REVOLVING FUNDS SIZING DATA: Influent Flow Select Units of Measure Metric English Design Average Present Average Daily/Hourly Peak Flow and/or Peaking Factor Million Gallons / day Million Cubic Meters / day Million Gallons / day Million Cubic Meters / day Million Gallons / day Million Cubic Meters / day Loadings Specify Sampling Location Is sampling GRAB or COMPOSITE? ITEM INFLUENT PRESENT EFFLUENT PERMIT REQUIREMENTS BOD mg/l COD mg/l TSS mg/l NH3-N mg/l pH
PERSON TO CONTACT AND/OR ADDRESS RESULTS
Facility Owner/Operator/Manager
Consulting Engineer:
GENERAL PROJECT DATA:
Project Timing Bid date if applicable When will aeration equipment be required on site ? Approximate Budget: Has funding been appropriated for this project? YES NO If yes, specify. YES NO FEDERAL STATE STATE REVOLVING FUNDS SIZING DATA: Influent Flow Select Units of Measure Metric English Design Average Present Average Daily/Hourly Peak Flow and/or Peaking Factor Million Gallons / day Million Cubic Meters / day Million Gallons / day Million Cubic Meters / day Million Gallons / day Million Cubic Meters / day Loadings Specify Sampling Location Is sampling GRAB or COMPOSITE? ITEM INFLUENT PRESENT EFFLUENT PERMIT REQUIREMENTS BOD mg/l COD mg/l TSS mg/l NH3-N mg/l pH
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