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Request A DEFERUM Budget Price

 

This is our basic request form. An advanced request form is available for those with more detailed information and technical knowledge.

Please fill in as much of the following information as you can, but don't worry if you don't have or understand some of the information requested. We can help you gather more detailed information at another time:

* DENOTES REQUIRED FIELD

*Contact Name:
*E-mail:
Office Phone:
Cell Phone:
Home Phone:
Fax:
Company Name:
   
Address:
City:
State / Province:
Country:
Zip / Postal:
   
  What is the status of your water treatment facility?
 
Conceptual / Design Stage
Bidding / RFQ Stage
Under Construction
In Operation
   
  How soon do you need our assistance / information?
 
Today
This Week
This Month
This Year
   
  Which of these actions best describes your immediate need? (choose one)
 
Water Analysis / Performance Testing / Troubleshooting / Service
Budget Estimate / Conceptual Drawings / Literature
Detailed Proposal / Submittal Drawings / Specifications
Pilot Testing / Proof Of Design
   
  What is the average daily water usage (gallons or litres per day / hours per day)?
 
   
  What is the maximum rate of flow at peak usage (gallons or litres per minute)?
 
   
  What is the maximum pressure that the supply system can generate in a "deadhead" condition? (psig)
 
   
  Can you provide any of the water analysis parameters in the water supply?
 
   
  What is the main problem with your existing equipment?
 
   
  What is the main problem with your water quality?
 
   
  How can we best get in touch with you?
 
   
  Any additional comments or questions?
 
 
                    

Home    

|

    What is Deferum?    

|

    Products    

|

    Benefits    

|

    Locations    

|

    Request A Price    

|

    Links    

|

    Log In    

|

    Contact