ULTRA-SEP®
APPLICATION DATA SHEET

Company/Organization:

Date:

Address:

Contact(s):

Address:

Customer Project#:

State/Province:

Sales Rep Code:

Country:

Phone:

Mail/Postal/Zip Code:

eMail:
Application Check Appropriate Category
  • Metal Finishing
  • Chemical Process WW
  • Aircraft Maintenance
  • Ground Remediation
    		•
  • Machining Coolant Recovery
  • Bilge Water Treatment
  • Vehicle Maintenance
  • Landfill Leachate Treatment
    		•
  • Refinery Wastewater
  • Oil Production Washdown
  • Ind. Oily Water Separation
  • Others:(Please specify)
    		•
    Project Requests Enter Objectives - Expectations:

    Customer Requests
     Check
    if Needed    		Date RequiredDescription:
    Budget Estimate
    Formal Proposal
    CWWS Bench Test
    Pilot Test onsite
    Technical Presentation
    Additional Literature

    Technical Information Requests
     Quantity NeededDate Required Description:
    Dimensional Dwgs.
    Flow Diagrams
    Spare parts list
    I.O.M. Manual
    Electrical Schematic
    Other:(Specify)

    Application Description
    Feed type Oil/Grease
    Process Volume Flow Suspended Solids
    Temerature (normal) Total Solids
    High/Low BOD
    pH Range COD
    Solvents Other

    Discharge Guidelines/Targets
    Oil and Grease TS
    BOD Color
    COD Ph Range
    Other(Specify) Other(Specify)
    Is future treatment required?

    Reject or Concentrate Limits
    Total Solids
    Oil and Grease
    Concentration Factor
    Is future treatment required?

    Additional System Information
    Daily Hours of Operation Number of Days per Week
    Batch Process Level of Automation
    Continuous Operation External Alarms
    Level Control Other:
    Other Details
    Current Treatment
    Disposal Costs (Current)
    Other: