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?