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Contact name/Position*: Company/Facility*:
Address*: City, State, Zip*:
Date: Phone number:
Fax: Mobile Phone:
Email*:
Type of Body Facility Temperature
Water Surface Area (Sq. Ft.) Is this a newly plastered pool?
Pool Volume - Gallons If Yes, Estimated date (to be) Plastered?
Bather Load: MAXIMUM for 24 hour period Does Pool Have Gutters?
Facility Open: # Hours Per Day Flow Rate - GPM & Return Pipe Size (Diameter in Inches)
Facility Open: # Days Per Week Existing Automation / Controller? if so: make model, install date
Indoor / Outdoor Have Installation Capability?
Pump Room Voltage Cost of Monthly Membership
Family: Single:
Water Feature Description ROI - Annual Chlorine Costs (Previous 12 months)
Combined Chlorine Level (ppm) Combined Chlorine In Fill Water (ppm)
Give us a brief description of what you are looking for.