Spectrum Water Technologies Residential 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
Drinking Water
Laundry Service
Whole house
Swimming Pool/ Spa
Pond / Fountain

   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

Lime Scale Sediment Problems Corrosion Problems E-Coli Present Coliform Present

Iron Present (red staining) Manganese Present (black staining) Hydrogen Sulfide Present (rotten egg smell) Water Analysis Needed  Water Analysis Completed      Date:

System Specifications:

Estimated Usage Per Month	Gallons
Pool, Pond or Reservoir Information:
Capacity	Gallons
Equipment Elevation  Above or Below Water Level	Feet +/-
Plumbing Diameter	Inches
Pump Horsepower	HP
Pump Voltage	VAC
Circulation Rate	GPM
Circulation Pressure	PSI
Circulation Duration	Hours / Minutes per day

Valves:  Solenoid    Manual   Pressure Switch   Float Switch

Existing Filtration:  YES  NO

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

Media Filter
Size	Cubic Ft. 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 Cardridges

 

Existing Water Softener:  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 this information.  Please press the SUBMIT button below to e-mail your quote request to us. You may also print this form and fax it and mail it to: Spectrum Water Technologies P.O. Box 97 Arcata, CA 95518 Phone / FAX (707)825-1770 All information is kept strictly confidential by Spectrum Horticulture.  Additional information may be required to accurately size your system.  If so, you will be contacted by your preferred method of contact.