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Reqest Form
Company *
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Type of Request
Design
Water Quality Analysis
Membrane Analysis
Pilot Test
Site Inspection
Water Source
Surface Water
Well Water
Wastewater
Seawater
UF/MF Permeate
Other
Application
Drinking
Boiler Feed
Industrial Water
Medical and Pharmaceutical Water
Food Processing Water
Other
Pretreatment
Sandfilter
Media Filter
Softener
Weak Acid
Coagulant
Scale Inhibitor
Acid
CO2 Removal
Other
Capacity
Recovery
Feed Water Quality
TDS Value
SDI Value
Turbidity
Comments
Has feed water analysis been obtained?
Yes
No
Required Permeate Quality
Operating Temperature
Comments
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