System Data Survey Please answer the following questions, and tell us about your water treatment needs. NAME(required) EMAIL(required) COMPANY PHONE NUMBER DOES YOUR FACILITY HAVE A COOLING TOWER? Yes No TOTAL SIZE (TONS or USG) WHAT IS THE SYSTEM FLOW RATE (GPM) DOES YOUR FACILITY HAVE A BOILER LOOP? Yes No WHAT IS THE TOTAL WATER VOLUME (USG) HOW OFTEN DOES THE SYSTEM RECEIVE MAINTENANCE? Monthly Semi-Annually Annually Every Few Years Never/ HOW OFTEN DOES THE SYSTEM SHUT-DOWN FOR REPAIRS? Monthly Semi-Annually Annually Every Few Years Never HOW OFTEN DOES THE SYSTEM DISCHARGE (BLOW-DOWN) WATER TO SEWER? Continuously Daily Weekly Monthly Semi-Annually Annually Never WHAT IS THE ESTIMATED TOTAL MONTHLY VOLUME OF SYSTEM WATER LOSS (PURGE, BLOWDOWN, or BACKWASH)? WHAT IS THE PRIMARY INTEREST FOR WATER TREATMENT? Save Water Save Energy Save Chemicals Save Maintenance/Labor Avoid Maintenance/Labor Extend Equipment Life Reduce Operating Costs All of the Above ADDITIONAL NOTES/COMMENTS DOES THIS LOOK FAMILIAR?