Project Data Sheet

Information Requested

Type of information requested

Date by which you need this information

Date by which the system must be delivered

Date by which the system must be operational

Contact Information

Name

Title

Company

Work Phone

Cell Phone

Mailing Address

Physical Address

Email

Location

The project is

Specific location if available

The system

The site has or may have permafrost

Yes No

The system will be on an ice pad

Yes No

Project Background

Please provide a brief description of the project

Instructions

Fill in data for applicable sections - Work Camp, Hotel / Lodge, Village, or Residence

Camp

Total # Beds

Max # People

Average # People

Estimated water use in gallons per person per day

Camp will be

Mode of transport will include (check all that apply)

Truck / trailer on public road

Hercules aircraft

Other fixed wing aircraft - specify aircraft below

Helicopter - specify max allowable weight below

Barge

Transportation Comments

The system will

Operating Period

Hotel / Lodge

Max overnight guests

Average overnight guests

Max day visitors

Average day visitors

Max staff

Average staff

Operating period

Village

Village population

Total houses

Max gallons per day to be treated

Average gallons per day to be treated

Water supply

Residence

Max number of residents

Total bedrooms

Water use in gallons per bedroom per day

Water supply

Effluent Discharge

Treated sewage effluent will be discharged to this environment

Name of waters affected

We already have a discharge permit

Sludge Treatment & Disposal

Sludge can be removed from the system by means of a commercial vacuum pumper or a village pumper truck We will need a sludge dewatering system Please tell us about sludge because we are unsure if we need a sludge dewatering system

Drinking Water

Drinking water will come from

An onsite well A piped water system An onsite storage tank after being hauled to the site

If drinking water comes from an onsite storage tank please check its corresponding location

Indoors Above ground outdoors Below ground outdoors

Describe proposed (or actual) drinking water source

Describe proposed (or actual) drinking water treatment

Backwash water or other material from water treatment plant will go to the sewage treatment plant

Drinking water backwash explanation

If you need assistance with drinking water supply or treatment please explain below

Project Priorities

Your priorities in purchasing a sewage treatment plant could be stated as follows (please check all that apply)

We need the best quality effluent all the time (we cannot afford to have any permit violations)

We want the system to be Internet accessible (so that it can be remotely monitored and possibly controlled making it easier for Lifewater to provide support to the operator)

We want the simplest treatment technology with minimal operation and maintenance requirements that will give us acceptable quality effluent

Long term value is important to us

The lowest purchase price is our biggest concern

We prefer to lease rather than purchasing a system

We would consider leasing rather than purchasing a system

Other (please explain below)

Other explanation

Other

Please provide any other information you think is pertinent

Please upload any additional documentation

Choose a file

Max. size: 512.0 MB

Information Requested & Contact Information

Location & Project Background

Type & Size of Facility to be Served

Effluent Discharge, Sludge Treatment, Drinking Water & Project Priorities

Information Requested

Type of information requested

Date by which you need this information

Date by which the system must be delivered

Date by which the system must be operational

Contact Information

Name

Title

Company

Work Phone

Cell Phone

Mailing Address

Physical Address

Email

Location

The project is

Specific location if available

The system

The site has or may have permafrost

The system will be on an ice pad

Project Background

Please provide a brief description of the project

Instructions

Camp

Total # Beds

Max # People

Average # People

Estimated water use in gallons per person per day

Camp will be

Mode of transport will include (check all that apply)

Transportation Comments

The system will

Operating Period

Hotel / Lodge

Max overnight guests

Average overnight guests

Max day visitors

Average day visitors

Max staff

Average staff

Operating period

Village

Village population

Total houses

Max gallons per day to be treated

Average gallons per day to be treated

Water supply

Residence

Max number of residents

Total bedrooms

Water use in gallons per bedroom per day

Water supply

Effluent Discharge

Treated sewage effluent will be discharged to this environment

Name of waters affected

We already have a discharge permit

Sludge Treatment & Disposal

Drinking Water

Drinking water will come from

If drinking water comes from an onsite storage tank please check its corresponding location

Describe proposed (or actual) drinking water source

Describe proposed (or actual) drinking water treatment

Backwash water or other material from water treatment plant will go to the sewage treatment plant

Drinking water backwash explanation

If you need assistance with drinking water supply or treatment please explain below

Project Priorities

Your priorities in purchasing a sewage treatment plant could be stated as follows (please check all that apply)

Other explanation

Other

Please provide any other information you think is pertinent

Please upload any additional documentation