Improve Water Quality- Water Questionnaire- Clean-Flo

Name of Waterbody:*

Full Name:*

Email Address:*

How did you hear about us?*

Phone Number:*

Street Address*

Zip:*

Shape of Waterbody*

Surface Acres*

Maximum Depth*

Average Depth*

Quick Questions:

Is the water used for irrigation?

Yes
No

If so, please describe the amount and frequency:

Does the water run through continuously?*

Yes
No

Which months?*

Hold control to select more than one month

Does water run through when it rains?

Yes
No

How much? (in gallons/minute)

Objectives for Waterbody Improvement:

Bad Odor:*

Yes
No

Murky Water:*

Yes
No

Fish Kills:

Yes
No

Is muck removal one of your objectives:

Yes
No

Weeds and Algae

What problem weeds are present?*

Bladderwort
Watersheild
Water Meal
Water Lilies
Pond Weed
Coontail
Milfoil
Other
None

Please check all that apply

What type of algae is present?*

Filamentous
Blue-Green
Green Planktonic
Nitella
Chara
Other
None

Please check all that apply

Please provide an overall assessment of the weed and/or algae problem:

Additional Information

If available, please provide a depth profile for the water body. If not, please indicate below.

Do you have a depth profile?

Yes
No

Please provide any additional information in the box below, and please E-mail, fax or mail the following information.

- Please send any studies, photos, or aerial photographs that have been made in the past 10 years.
- Please list any URL describing the water body.

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Water Questionnaire

Quick Questions:

Objectives for Waterbody Improvement:

Weeds and Algae

Additional Information

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