Company Name
:
Address
:
Nature of Industry
:
Area of Operation
:
Safe
Hazardous
Size of Effluents pith / skim pond:
Length
Mts.
Depth
Mts.
Width
Mts.
If you have any trace of detergent, Please give details
:
Flow rate of effluent
:
Mts.
Settling time for effluent
:
Hr.
Ph. of effluent
:
Viscosity of the oil
:
Size of suspended solids
:
P.P.M. of suspended solids
:
Inlet P.P.M. of oil
:
Outlet P.P.M. of oil expected
:
Temperature of effluent oC
:
Inlet / Outlet
It is over flow system
It is under flow system
Inlet Flow
Under Flow
Over Flow
Outlet Flow
Under Flow
Over Flow
Effluent level
Max
Mts
Min
Mts
Person to be contacted in case of clarification required
Name
:
Dept
:
Phone No
:
Fax
:
E-mail
:
This is mandatory.
Comments
:
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