Reverse Osmosis Design Request Form

PLEASE NOTE
We will be unable to respond to your request if we do not receive as much data as you can provide below.

Your Contact Information
Please briefly describe your project requirements		*
Please specify the status of this project		Budgetary Only Funding Approved
Company Name		*
Contact Name (First/Last)		First: * Last: *
Street Address
City, State, Zip		City: State: Zip/Postcode: Country:
Phone / Fax		Phone: * Fax:
Email		*
Please detail your existing installations:
Treated Water Requirements (permeate)
Volume per Day:
Volume per Minute:
Hours of Operation of the Unit:
Maximum Demand in Peak Hours:
Usage of the Product Water:
Feed Water Source
Source:
Average Annual Temperature:
Minimum Flow in GPM:
Maximum Flow in GPM:
Feed Water Pressure:
Presence of Free Chlorine:		PPM:
Maximum Space Available for the System
Width: Length: Height:
Energy Source
Voltage: Cycles: Phases:
Maximum Amperes Allowed in the Line:
Additional Information:
Chemical Analysis of the Feed Water
Temperature:		Turbidity/SDI:
Total Solid Residue at 105°C:		at 180°C:
Conductivity:		TDS:
Total Suspended Solids:		Bacteria UFC:
pH:		CO2:
Total Hardness:		Total Alkalinity:
Iron:		Hydrogen Sulfides (SH2):
Calcium:		Carbonates:
Magnesium:		Bicarbonates:
Sodium:		Sulfates:
Potassium:		Chlorides:
Ammonia:		Nitrates:
Strontium:		Phosphates:
Barium:		Silica Oxide (SiO2):
Free Residual Chlorine:
Very Important: Determine the Measuring Unit (mg/l, ppm. CO3Ca, etc.)
Feed Water Pipe Diameter:
Product Water Storage (yes/no):		Yes No
Total Storage Volume (gals/m3):
Distance & Height of the Cistern:
Permeate Re pressurization Required (flow & pressure):		Yes No
Availability of Drainage: