This document contains a questionnaire about a client's cooling water system and current water treatment situation. It requests information on the cooling tower type, water volumes and flows, temperature data, water quality parameters, number and details of water coolers, existing water treatment contractor and equipment, problems, and costs. The client is asked to provide additional details, drawings, and reports to help develop a tailored water treatment proposal.

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SINOMGREEN QUESTIONARY
CLIENT INFORMATION
Client name:
Contact person: Tel: Date:
Address:
COOLING WATER SYSTEM DATA
Item Unit Normal Max. Min. Item Unit Qty Remark
Cooling tower type
 tap water  well water
 river water / lake water
Total volume of cooling
tower water channel/cistern
M3
Total flow of cooling
tower
M3
/h
Cooling tower maintenance
intervals
Additional total volume
of water channel/cistern
+ piping volume
M3
Designed treatment capacity
of each cooling tower
M3
/h
Cooling water temp.
Inlet of tower
℃
The numbers of cooling
tower
set
Cooling water temp.
Outlet of tower
℃
Annual average temp.
locally
℃
Cooling water temp.
Difference between inlet
and outlet of tower
℃
The material of water
channel/cistern
MAKE-UP WATER PARAMETER
Item Unit Normal Max. Min. Item Unit Normal Max. Min. Remark
Make-up water
type
Total dissolved
solids (TDS)
mg/L
PH value
Total suspended
solids (TSS)
mg/L
Specific
conductance
μS/cm Silica content mg/L
Total hardness
(CaCO3)
mg/L
Chemical oxygen
demand (COD)
mg/L
Total alkalinity
(CaCO3)
mg/L
Copper ion
content
mg/L
Chlorine ion
content
mg/L Iron ion content mg/L
CIRCULATING WATER QUALITY PARAMETER
Item Unit Normal Max. Min. Item Unit Normal Max. Min. Remark
PH value
Total dissolved
solids (TDS)
mg/L
Specific
conductance
μS/cm
Total suspended
solids (TSS)
mg/L
Total hardness
(CaCO3)
mg/L Turbidity NTU
Total alkalinity
(CaCO3)
mg/L
Chemical oxygen
demand (COD)
mg/L
Chlorine ion
content
mg/L
Total bacteria
reading (SPC)
cfu/ml
Iron ion content mg/L
Copper ion
content
mg/L
Concentration
multiple
WATER COOLER DATA
Item Content Item Content Remark
The numbers of water
cooler
Water cooler material (the
material that contact with
cooling water)Water cooler type

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WATER COOLER DATA
Item Content Item Unit Content Remark
Water cooler maintenance
intervals
Water cooler heat
exchanging strength
W/m2
Water cooler special
requirement
Water cooler water flow
speed
m/s
Note: It is better to furnish the detailed parameters for each water cooler by attachment way. To ensure the proposal
pertinence, please try to furnish the more details.
CURRENT WATER TREATMENT SITUATION AND CONDITION
Item Unit Content Item Unit Content Remark
Water treatment
contractor
Whether erected drain-off
system
Specific conductance
control range
μS/cm Existing problems
Make-up water rate m3
/day
The used chemical agents
cost annually
Running time hours/day
Whether erected bypass
filtering system
The price of make-up
water
usd/ton Filtering system type
The price of electricity
locally
usd/kWh
Filtering system treatment
capacity
m3
/h
Others: Also may furnish site photos, related drawings, water quality report etc. by attachment way.
Preparer:________________