Data collection sheet for recommendation
Cooling Water Treatment Program

New Client/ New Application
S.No. Description Details
1 Client name with full postal address and pin code
  Phone
  Fax
  Email
2 Attention to whom
Name
Designation
3 Subject
4 Our sales Person (s) involved
5 Discussion over Phone  / Direct  Site Visit Phone Direct Site Visit
6 Discussed with whom
Name
Designation
7 Offer to be sent by Fax / Courier : If fax : Fax Number Courier Fax         Fax No.
8 Copies to be sent to ( ie CC to )
Name
Designation
9  No.of Cooling Towers Working        Standby      
10 Type of System
11 Type of cooling tower
12  Recirculation Rate in m3/hr
13 No.of Pumps working
  a) HP of pump
  b) Head in Mtrs of Pump
  c) Working Pressure of the pump
14 Difference in Temperature (ΔT) in Degree C   Inlet  Outlet   ΔT
15 Holdup Volume of sump in m3
16 Hold up Volume of the system including sump, pipelines, heat exchangers and condensors
17 Cycles of concentration (COC) at present
18 Evaporation Loss at present m3/ hr
19 Bleed off at present m3/ hr
20 Makeup water quantity  at present m3/ hr
21 Type of make up water
22 Residual free chlorine level maintained in recirculation water
23 Avaliability of corrosion test rack Yes  No 
24 Whether cooling towers are interlinked Yes    No 
25 Type of external treatment (Filter / Softener / Dealkalizer/ RO Plant)
26
Water Characteristics
 Raw Water Cooling Tower – Make up Water Cooling Tower – Recirculation Water
TDS ppm
PH
Level of SRB
Level of TBC
Total Hardness ppm
P.alkalinity ppm
M.alkalinity ppm
Chlorides ppm
Iron ppm
Silica ppm
Sulphates ppm
Product residuals like Organo Phosphonate, Phosphate, Zinc, azole etc.
 
27 Whether any acids like Sulfuric acid (or) Hydrochloric acid is being dosed in the recirculation water. If so please give the details Yes    No
28 Whether Chlorine gas (or) Sodium hypochlorite (or) Calcium hypo chlorite is being dosed in recirculation water.  If so please give the details Yes    No
29 Whether side stream filter is there in the system? Yes    No
30 Corrosion rate in MPY at present for the metals in your cooling tower system
  Recommended product (s)
  Dosage
  Price
  Special Instruction(if any)
  Date of visit by you
  Offer sent Date to client