QUESTIONNAIRE FOR WASTE WATER APPLICATIONS

For Clean-Flo International to properly evaluate your project and do the best job possible in improving it, we need answers to the following questions. Please answer them as completely as possible. If the information is not immediately available please answer as many as possible and a Clean-Flo representative will evaluate the information and contact you with further questions.

Project Name
Project Location
How did you hear about us?
         

PERSON TO CONTACT AND/OR ADDRESS RESULTS

Facility Owner/Operator/Manager          

      
Company Name       
Street Address         
City

 State

 Zip

    
County/Parish Country  
Contact Name Position  
Phone No 

 Fax No  

 email 

    
         
Consulting Engineer:      
Company Name       
Street Address         
City 

 State 

 Zip 

    
County/Parish Country  
Contact Name Position  
Phone No 

 Fax No  

 email 

    
         
TYPE OF PROJECT      
GENERAL PROJECT DATA: YES NO  
New Plant?  
Upgrade existing facility  
Replace Equipment in existing plant?  
Other?  
         
TYPE OF WASTE      
Municipal?    
Describe
Industrial?    
Describe
Combined municipal and Industrial?  
Describe
         
Treatment Process Application      
Aerated Lagoon?  
Describe installation
Activated Sludge?  
Describe installation
Equalization Basin?  
Describe installation
Oxidation ditch?  
Describe installation
Sludge holding tank/Aerobic Digester  
Describe installation
Other process?  
         
Treatment Objectives      
Industrial Pretreatment?    
Describe objective
Improve Winter Operation?    
Describe objective
Increased Dissolved Oxygen?    
Describe objective
Algae Control?    
Describe objective
Odor Control?    
Describe objective
Mixing Application?    
Describe objective
Nitrification?    
Describe objective
BOD Reduction?    
Describe objective
         
Project Status:      
Preliminary Engineering/Design  
Budgetary Purposes  
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?		  
If yes, specify.
         
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
Fats, oil & grease
TKN
TOC
Total PO4
YES NO
Are quaternary amines used for disenfecting at this facility?
Indicate Toxic Materials
Any peculiarities in waste
PRETREATMENT FACILITIES
EXISTING
YES NO
PLANNED
YES NO
Equalization Basin
Grit Removal
Screening (type and size)
Comminutor
Primary Clarifier
None
Aerated Basin Type & Sizes
TYPE of BASIN SIDE SLOPE RATIO L X W X D Side Slope Volume Units
Feet

Meters
Feet

Meters
Feet

Meters
Feet

Meters

Please describe materials of construction for each basin, eg. concrete, earthen lined, clay lined, fabricated liner, etc.

DESIGN TEMPERATURE RANGE Summer Winter
Basin Liquid Temperature


º F

º C


º F

º C
Air


º F

º C


º F

º C
Elevation: above sea level

Feet

Meters

Alpha and Beta Factors a

 b
If none are given textbook values will be assumed
 
Basin(s)where aeration is to be considered
Type of existing aeration equipment (HP/KW and type of
mechanical or diffuser system)
Number
Brand Name
Power Consumption
HP

KW
Company Name

Electrical Service Available:

Volts Phase Hertz Amperes KW

Operational considerations that will affect the design of the
system

 
Fluctuating water level Describe
Intermittent loading
Present time of aeration operation
HRS/DAY DAYS/WK
Seasonal Operations
Other Considerations
Please indicate if discharges are spray irrigation or lake, river,
stream etc.  Also any other relevant information.


Please send us any Questions or Comments below.

Please forward all data and reports available. THANK YOU!