*Indicates required field

Application Parameters

The more information provided will ensure greater accuracy in sizing the proper equipment.

Company Name:

Contact Name*:

City:

State:

Zip:

Telephone*:

Fax:

Email*:

Project Name:

Please provide a brief description of the project and/or application:

Water Analysis

Typically your local water department can furnish a detailed water analysis OR you can send a sample of water to our customer service for analysis.

Total Hardness:

 
as: Grains per GallonParts per million

Total Iron (as ppm):

Total Dissolved Solids (TDS):

Water Temperature (°F):

pH:

Is a Water Analysis Available?
YesNo

This is the minimum required for quoting though a detailed analysis may be requested

Water Usage

The water usage on each project or application varies greatly. We have average water usage guidelines for many applications. Contact technical services if further assistance is needed.

Water Pressure (psi):

Service Hours Per Day:

Estimated GPM (Gallons Per Minute) Flow Rate

Minimum:

Continuous:

Peak:

Estimated Usage:
DailyMonthlyAnnually

Water Source

Treating:
All WaterHot Side Only

Service Pipe Size:
3/4"1"1 1/4"1 1/2"2"2 1/2"3"4"6"8"Other

Other:

Water Source:
MunicipalPrivate WellSurfaceOther

Other:

Equipment Options

CustomCare will recommend the most cost effective water treatment system available based on the information provided unless otherwise noted.

System Configuration Options (pick one):
Single Time ClockSingle MeteredDuplex Parallel Time ClockDuplex Alternating MeteredDuplex Parallel MeteredDuplex Demand RecallTriplex Parallel Time ClockTriplex Parallel MeteredTriplex Alternating MeteredTriplex Demand RecallQuadplex Parallel Time ClockQuadplex Parallel MeteredQuadplex Demand RecallOther Configuration Options

If Other, Please list here:

Additional Information

Please list any additional information that may assist us in providing the correct water treatment system for your project/application: