Spectrum Water Technologies  Commercial Water System Request for Quote

   Date: mm/dd/yy

   Please provide the following contact information:

* NAME:
*ADDRESS:
*CITY:
*STATE:
*ZIP CODE:
*COUNTRY:
* E-MAIL ADDRESS:
*PHONE:
BEST TIME TO CALL:
SHIPPING ADDRESS
ADDRESS  (cont.)

   Request for quote on the following:

           Whole House Filtration
           Drinking Water Filtration 
           Water Purification System
           Ionization System
           Other 

   System Application:

Horticulture
Food Service
Laundry Service
Hospitality
Swimming Pool/Spa
Industrial
Boiler
Cooling tower

   Water Source Conditions:

City   Well     Other

Water TDS (Total Dissolved Solids) or EC (Electrical Conductivity)
Water pH
Water Hardness ppm or gpm CaCO4 (Parts Per Million or Grains Per Gallon)

   Current Conditions:  Select any of the following that apply

Scale Sediment Biofouling Corrosion E-Coli Coliform

Iron Present Manganese Present Hydrogen Sulfide Present Water Analysis Needed  Water Analysis Completed   Date:

  System Specifications:

System Water TDS
System Water pH
System Water Hardness	ppm or gpg CaCO4
Estimated Usage Per Month	Gallons
Total System Capacity	Gallons
Tank / Reservoir	Gallons
Equipment Elevation  Above or Below Water Level	Feet +/-
Plumbing Diameter	Inches
Pump Motor Size In/Out	Inches
Pump Horsepower	HP
Pump Quantity
Pump Voltage	VAC
Circulation Rate	GPM
Circulation Pressure	PSI
Circulation Duration	Hours / Minutes per day

Valves:  Solenoid  Thermostatic  Manual   Pressure Switch   Float Switch

Boiler Blowdown / Cooling Tower Purge Schedule:

Blowdown	Times Per Day / Per week
Duration	Minutes / Hours
% Purge	%

Manual    Auto

System Operation Schedule:

Hours Per Day    Days Per Year

Existing Filtration:  YES  NO

If yes, please fill out as much of the following as possible:

Media Filter
Size	Cubic Foot Media
Type of Filtration Media
Back Flush Schedule	Days / Hours
Micron Filtration	Microns
Flow capacity	GPM

Cartridge Filter
Length & Diameter of  Filter Cartridges	Inches
Micron Filtration	Microns
Flow Capacity	GPM
Carbon Block Filter    Pleated Cartridges

Existing Water Softener:  Yes   No If yes, please fill out as much of the following as possible
Size	Cubic Ft.
Gallon Capacity Per Day	Gallons
Treated Hardness Level	Grains
Salt Type Used	Ns, Cl or KCI

Treatment Goal:

Current Treatment Comments:

Annual Cost of Current Treatment 

Thank you for taking time to complete information.  Please press the SEND button below to e-mail your quote request to us. You may also print this form and fax it or mail it to 

Spectrum Water Technologies 
P.O. Box 97
Arcata, CA 95518 
Phone / FAX (707)25-1770