Waste Water Questionnaire
Name:
Company
Address:
City:
State/Province:
Postal/Zip:
Phone:
Email:
Date
1. Waste Water Flow
Average Flow:
lph
gph
Peak Flow:
lph
gph
Hours/Days of Operation:
Total Daily Waste Water:
2. Waste Water Description
a. Industry
b. Origin of Flow
(i.e., source of waste water
such as plant effluent)
c. TSS
(Total Suspended Solids)
Normal
Maximum
%
ppm
Size Range
mm
Microns
Specific Gravity
d. Temperature, Normal
Maximum
Deg. F
Deg. C
e. Ph, Normal
f. BOD, Normal
Maximum
ppm
g. COD, Normal
Maximum
ppm
h. Hydrocarbon type
Volume
i. Fat, Grease, Oil Content
(Food Industry), Normal
Maximum
ppm
3. Discharge Objectives
Hydrocarbons
ppm
TSS (Total Suspended Solids)
ppm
COD
ppm
BOD
ppm
4. Project Schedule
1 month
3 months
6 months
1 year
Future
Budget
Other comments