Fields marked in RED are mandatory.
Company Name
Company Address
City

State/Province
Country
Post Code/Zip
Contact Name
Phone
Fax
Email Address
Project Name
Location
Site contact for additional details
Site Contact Phone
Specify or Estimate the following:  
Lagoon Dimensions
Number of Baffles required
Attachment of Baffle
Aerators Yes No
If yes H.P.
Number and proximity to baffle installation
Flow-through windows Yes No
Flow Rate gph
Slope of Lagoon Banks (i.e. 3:1) or Rise Run
Fluid Description
Temperature pH
Liquid level variation
Time Period
Ambient weather conditions Temp. Max. Min.
Is lagoon lined? Yes No
Synthetic
Other (Specify)
Is there currently or has there been a floating baffle in the lagoon? Yes No
If yes, Manufacturer (if known)
Year installed
Briefly describe any shortcomings or improvements desired:

Additional comment or Requirements
Verification: enter the images you see into the textbox below.


   
 
Elastec/American Marine: 121 Council St., Carmi, IL 62821 USA
Call us at (618) 382-2525 Fax (618) 382-3610 E-mail elastec@elastec.com
Updated December 2003 © Elastec/AmericanMarine All rights reserved.
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