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Date Requested

Date Required

Est. Project Closing Date

Client Name (required)

Contact Name (required)

Phone# (required)

Your Email (required)

Project Name/Location(required)

Engineer involved with project (required)
YesNo

If yes Name of Consulting Engineer

APPLICATION TYPE

Residential/Multifamily developments

Number of Homes:

Number of Bedrooms including SQ:

Number of occupants:

Restaurant | Hospitality

Restaurant & Food Type

Hours of operation/#of shifts

#of seats

#of employees

Type of School
DayBoardingOffice

Cafeteria/cooking on site
YesNo

Laundry
YesNo

Hours of operation

#of employees/students

Other activities at the site: E.g Gym, Bakery Laundry

Nursing/Retirement Home/Hospital

Cafeteria/cooking on site
YesNo

Laundry
YesNo

#of beds & employees

Hours of operation

Other Commercial i.e Gas Station,Rest Stops, Shopping Malls

Food Preparation Explain use

Any Additional Comments ie.Specialcircumstances/needs,usingexistingequipmentetc.,siteconstraints,budgetconstraints

Permitted design flow i.e.9,000GPDor34m3/day

Metered flow

Any daily flow fluctuations or variances? Explain

Influent Loadings

BOD
TSS
TKN
FOG
Other

Effluent Requirements

BOD
TSS
TKN
FOG
Other

Electricity Requirements
3-phase1-phase

Reuse application:
IrrigationToilet FlushingAir conditioning coolingDischarge into river, lake, ocean