QUESTIONNAIRE FOR WASTE WATER APPLICATIONS




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

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 

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


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!