Date: ________________
Client's
Name:
Address:
Phone: _______________________
FAX: _________________________
E-Mail: ________________________
Send Instructions and/or Reports to:
Send copies of Instruct/ Reports to:
Service Representative:
System Description
Manufacturer's Name of Tower/Chiller, etc._____________________________Type:___________
Mfr's. Name: Compresser and Refrigerant
System:
Operation: Hrs/day___Days/wk___Continuous___Intermittent_____________
Rated Tonnage of Tower_______________Water
Recirculation Rate_____GPM
Dimensions of Pan: Width_________Length_________Water
Depth________________________
Materials of Construction:
System Flow Diagram (attach)
Site Conditions/Water Source
Draft: Forced__________________Induced______________Natural________________________
Source of Makeup Water (City, Well, Softened, etc.):
Amount of makeup used per 24 hours_______________
Makeup line pressure (ps__________________________
How is Makeup Controlled? Float__________________Manual____________________________
Is there Provision for Bleed?_____Rate and
Location_____________________________________
Is a Feeder Present?______Type__________Location___________________________________
Results of Analysis: TDS____ Conductivity____
(mmho)____ TH____ CaH____
MgH____ Turbidity____ M____ P____ pH____ Cl____
SO4____ SiO2____
Langelier Index____
Current Treatment Program:
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Manufacturer |
Formula |
Lbs/day |
Cost/lb |
Feeding Point |
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Current Chemical Control Testing
| Control Tests |
Frequency of Plant Tests |
Limits of Plant Tests |
Open Recirculation Tests |
Closed Recirculation Tests |
Once Through Tests |
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Corrosion Monitoring Program:
Condition of Equipment:
- Towers
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- Condenser
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- Closed System
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- Chemical Feed System
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How will Alken-Murray treatment
be fed into the system?
What is Cooling Water Used For?
Present Condition of System (Scale, Slime, Mud, etc.)
Temperature of influent water (water to tower)______F.
Temperature of effluent water (water leaving the tower)____F.
How Frequently is the System Cleaned - (Method)?
Effluent Disposal
Is an NPDES Permit in Effect? Yes No
Receiving body
Pre or Post Treatment
Restrictions/Permit Effluent Limits:
Dilution Water Available:
Miscellaneous Notes
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