Water Analysis Questionnaire

Please complete the following form and submit with your request for equipment quotation. Print the form using your web browser, and fax it to WGSI at (619) 585-0679.

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CONTACT INFORMATION

Contact Name Installation Location
Company Name Project Name
Address
City/State/Zip
Phone Number Fax Number
E-mail Web Site
Today's Date Need Quotation By (Date)

WATER DELIVERY AND DISTRIBUTION

Feed Water Source Well Municipal/Tap Surface (River/Lake)
Seawater Other
Well Pump Delivery GPM @ psi
Boost Pump Needed? Yes No
Treated Water Storage
Tanks Needed?		 Yes No
Tank Volume Gallons
Product Water
Repressurization Needed?		 Yes No

 

FEED WATER ANALYSIS INFORMATION

Temperature Degree F Degree C
High
Low
pH
TDS
Suspended Solids
Turbidity
Conductivity
Color
Total Hardness

 

WATER ANALYSIS - Ionic - Should Be a Balanced Analysis

Ca++ CO3--
Mg++ HCO3-
Na+ SO4--
K+ Cl-
NH4+ NO3-
Sr++ F-
Ba++ SiO2
Fe++ Other
Mn++ Other
Other Other
Other Other

**** IMPORTANT NOTE: Please indicate if ion is reported in ppm, mg/l, CaCO3, or mEq/L

WGS International San Diego, California USA
Phone: (619) 585-8917 Fax: (619) 585-0679 sales@wgsi.com