Cooling Tower Diagnostic Survey

Warning: Since this form is large, it takes a while to transmit, once you press SUBMIT, so please be patient. An acknowledgement page WILL show up.

Company Name:
Client's E-mail address:
Address:
Telephone Number:
Contact: (Name & title)
AM Distributor
Send instructions/reports to:

System Description

Manufacturer's Name of Tower Chiller , etc

Type of Tower/Chiller:

Mfr's. Name: Compresser and Refrigerant System:

Operation: Hrs/day Days/wk Continuous Intermittent

Rated Tonnage of Tower

Water Recirculation RateGPM

Dimensions of Pan: Width Length Water Depth

Materials of Construction:

Flow Diagram

Site Conditions/Water Source

Draft: Forced Induced Natural

Source of Makeup Water City Well Softened

Amount of makeup used per 24 hours

Makeup line pressure - psi

How is Makeup Controlled? Float Manual

Is there Provision for Bleed? Yes No

If yes above, Rate and Location :

Is a Feeder Present? Yes No

If yes, Type of Feeder: If yes, Location of Feeder:

Results of Analysis: TDS Conductivity(mmho) TH CaH MgH Turbidity M P pH Cl SO4 SiO2 Langelier Index Alkalinity as CaCo3

 

 

Corrosion Monitoring Program:

Condition of Equipment: Towers Condenser Closed System   Chemical Feed System

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:

We usually add all people who inquire about our products to our newsletter mailing list, which is kept for in-house use. We do not ever sell or trade names of our clients, and rarely contact by e-mail more than once a month. Mailing list: YES NO

for original format to print, fill-in with a pen and fax