Water System Site Profile Form

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Please complete the form below. Alternatively, you may download the form to print, and fax completed to (678) 835-0057.

*Email is required

Contact Information

Customer/Utility		Date (mm/dd/yy)
Site or Well Identity/Location		Site Contact
Local Engineer/Firm		Contact Phone
Other Pertinent Notes		Rep Contact
Operator		Fax
Target Date for Installation		Email*
Treatment Goals

System Parameters / Site Specific Info

System Type /Application		(utility, school, MHP, other)
Population Served		(estimated)
Number of Connections
Number of Wells to be Treated		(# wells to be treated)
Design Flow (GPM)		(max design flow rate)
Ave Flow (GPM)		(typical demand)
Adedge Sizing Basis (GPM)		(sizing basis-Adedge)
Est. Gallons per Day		(Av. throughput per day)
Est. Gallons per Year		(Best estimate)
Existing Pretreatment or disenfection?
Equipment available for offloading
Pump/Operation Pressure
Electrical Power Availability
Atm Storage Tank Present / Size
Hydropneumatic Tank Present / Size
Building Present
Any Additives ie, phosphates, fluoride
Discharge Options Available

Water Analysis

Project Specific Parameters

Codes:
1 = Arsenic
2 = Arsenic, Iron / Mn / S project
3 = Fluoride project
4 = Uranium, Radium project
5 = Nitrate project
6 = General Filtration

(enter all available)

Codes	Parameters		Codes	Parameters
All	pH	units	3, 4, 5	Bicarbonate	mg/L HCO3
1, 2	Total Arsenic	mg/L As	All	Total Organic Carbon	mg/L TOC
1, 2	As(III)	mg/L (if known)	4, 5	Nitrates	mg/L as NO3
All	Phosphate	mg/L P04	4, 5	Chlorides	mg/L Cl
All	Alkalinity	mg/L @ CaCO3	All	Turbidity	NTU
All	Hardness	mg/L @ CaCO3	4	Uranium	mg/L U
All	Silica	mg/L SiO2	4	Gross Alpha	pCi/L
All	Sulfides	mg/L	3, 4, 5	TDS	mg/L
All	Sulfate	mg/L as SO4	3	Fluoride	ppm F
All	Iron	mg/L Fe	All	Suspended Solids	ppm
All	Manganese	mg/L Mn	All	Temperature	degrees F

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ADEDGE TECHNOLOGIES, INC.
5152 Belle Wood Court - Suites A & B - Buford, GA 30518 USA
1.866.8ADEDGE toll free - tel 678.835.0052 - fax 678.835.0057
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