Aqua Alternatives
Dean Petrich
2131 E. Middle Drive
Freeland, WA 98249-9516
(360) 730-7992
petrich@whidbey.com
SURVEY SHEET
NAME _________________________________________________________
ADDRESS _____________________________________________________
CITY & ZIP ___________________________________________________
HPHONE: ______________________
WPHONE: ____________________
Date:________________________
pH_____________________________
# houses________________________
total iron________________________main
pipe size_____________________
sulphate_______________________
pressure tank______________________
manganese______________________
separate irrigation line: Y / N
tannin & lignins_________________
PUMP: gpm_____________gpd________
coliform bacteria_________________
Hp
; voltage: 110 / 220
nitrates_________________________
submersible / shallow well / deep jet
turbidity________________________
geothermal (heat pump): Y / N
clay or colloids___________________
chlorinated: Y / N
hardness________________________
backwash / replaceable filters
TDS (for RO)___________________
psi at location (for RO)
REMARKS: