Date: ________________ Pond Name_______________________________________________________________________________ Client: ______________________________________________________________________________ Address: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Phone: __________________________________________ FAX:____________________________ E-Mail: _____________________________________________________________________________ Service Representative:___________________________________________________________________ |
Surface Area: ______ acres Average Depth: ____ ft. Water Source:__________________________________ Outflow:(as % of total water in lake / pond) _____________% Species Cultivated________________________________________________________________________ Stocking density:___________________% Location:(Describe pond location in words or with a diagram, on the back of this page, for your reference.) |
Offensive odor? no yes How strong? ______ Ammonia? no yes Sulfur? no yes Water color and appearance: __________________________________________________________________________________________ __________________________________________________________________________________________ Runoff: no yes Source:_______________________________________________________________ __________________________________________________________________________________________ Sludge (composition, distribution & thickness): __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Chemicals / pesticides / disease treatments added to pond and when: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Waterfowl:_____________________ Algae:________________________________________________ Aquatic plants:___________________ Recent fish mortalities?_______________________________ Mechanical aeration? _______________ Describe other treatments and when applied: __________________________________________________________________________________________ __________________________________________________________________________________________ |
Dissolved Oxygen - Noon: _____ ppm D. O. Before dawn: ______ ppm pH: ______ @ ______F Alkalinity: ______ ppm Hardness:______ ppm Chloride: ______ ppm Ammonia Nitrogen (NH3):______ ppm Nitrite (NO2): ______ ppm Nitrate (NO3): ______ ppm Carbon dioxide:______ ppm Temperature: ______F |
Copper (total soluble): ______ mg/l Iron: ______ mg/l Lead: ______ mg/l Mercury: ______ mg/l Tributyl tin: ______ mg.l Cyanide:______ mg/l Detergents: ______ mg/l Phenol:______ mg/l Sulfite: ______mg/l Hydrocarbons_____mg/l Pesticides (name chemical tested______________________________________)_______ mg/l FOG_____ mg/l Phosphate:______ mg/l Ammonia Salt (NH4): ______ mg/l BOD:______ mg/l COD: ______ mg/l |
Client Name:________________________________________________________ Name of Pond:______________________________________________________ Water Chemistry Adjustment: ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________
Mechanical Treatment (Aeration, etc.): ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ Alken Clear-Flo® Treatment: ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________
____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ Follow-up and Other comments: ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ |
Draw a sketch of the pond. Be sure to indicate concrete or earthen bottom, location of inflow/outflow, special characteristics: