Water Survey - Culligan of Alabama

At Culligan, we know that the key to providing you with the optimum water treatment system is to first have a thorough understanding of your specific water treatment needs. Please take a few moments to complete this brief survey so that we can better serve you. With this information, we will be able to forward to you (via e-mail, fax or post) more specific equipment information to suit your application. Water testing services and a formal quotation are also available.

Please fill out the survey below::

Your Name:
Company:
Street Address:
City:
State:
Zip:
Phone #:
Email:

What is the general nature of your business? Please specify.


What is the intended purpose for the treated water? Please specify.


What is the source of your current water supply?
City River Cistern Well Lake Other
Please describe the problems and/or symptoms you now experience with your current water supply.
Discoloration Poor Taste Odor Scale Other
How many hours per day will you use the treated water:
8 Hours 12 Hours 16 Hours 24 Hours Other
How many days per week will you use the treated water:
4 Days 5 Days 6 Days 7 Days Other
What is the approximate flow rate of water you will require? (Approximate gallons or litters per minute)

What is the approximate number of total gallons or litters you will require in a 24 hour period?

Which system of measurement do you work with?
U.S. Metric Imperial
Would you describe your treated water flow need as?
"Peak" means you tend to need water fast for a short time such as filling a bucket. "Continuous" means you tend to need a regular stream or flow over a longer time such as a continuous feed to a rinse line.
Peak Continuous
What is the available power source? (Please include voltage)

If you already have water analysis information available, please enter results here.

Please enter any additional comments or questions here:

Site maintained by COMDOC Internet Solutions