NOTE: Required fields are marked with a *.
Facility Name: *
Contact Name: *
Email Address: *
Address Line 1: *
Address Line 2:
City: *
State/Province: *
Zip/Post: *
Country: *
Telephone: *
Fax:
Facility Type:
Plant Name:
WASTEWATER CHARACTERISTICS
1.
Is the spill contained or in open water?
Contained Open water
2.
How thick is the contamination on top of water?
Feet:
Inches:
or Meters:
Millimeters:
3.
How old is the spill?
Days:
Weeks:
Months:
4.
Estimate the size of the zone of contamination:
Indicate whether ft3 or m3 below
Enter the length
Enter the width
Enter the depth
ft3 m3
5.
Type of Water:
Saltwater:
Freshwater:
Contained Water:
Other
If Other, Describe:
6.
Salinity of water in %:
7.
pH of Water:
8.
Alkalinity of Water:
mg/L
9.
Temperature:
Air:
°C
°F
Water:
10.
Source(s) of Contamination (please describe ranges and types of compounds encountered)
a)
b)
c)
d)
e)
11.
Current range of TPH (Total Petroleum Hydrocarbons) in ppm:
TPH: ppm
12.
Current range of PAH (Poly Aromatic Hydrocarbons) in ppm:
PAH: ppm
13.
Current range of BTEX (Benzene - Toluene - Ethylbenzene - Xylene) in ppm:
Benzene:
ppm
Toluene:
Ethylbenzene:
Xylene:
Total BTEX:
14.
Current range of asphaltenes in ppm:
Asphaltenes: ppm
15.
What is the current level of heavy metals in ppm?
Heavy Metals: ppm
16.
Measure the following C:N:P levels in ppm or mg/L:
Carbon:
ppm or mg/L
(T.O.C)
Nitrogen:
(NH3-N)
Phosphorous:
(Total)
17.
Is a boat boom spraying system or aircraft available to spray application onto the contaminated water?
Yes No
If yes, above, which mechanical application is available?
Boat/Boom Spraying System Aircraft/Aerial Spraying System
18.
How often is it practical for you to mechanically spray and treat the water?
Daily Weekly Bi-weekly
19.
Do you have a portable spray rig system available for applications to the contaminated water? (for contained spills)
20.
If you do not have one of the two application systems above, are you willing to set up such a mechanized application or system?
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