CONTACT DETAILS
Company Name
Company Address
Post Code
Telephone
Fax
E-Mail
Contact Name
Job Ref.
Site Address
Site Post Code
Application:
Domestic:
Commercial:
Other:
If other, please state
PROPERTY SPECIFICATIONS
Number of Properties
Please select
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Total Number of Bedrooms
Are additional gravity
drained toilet facilities
available?
Yes:
No:
Special Requirements
e.g. swimming pool, laundry etc
Please indicate daily flow rate for special requirements
(if known):
Please select
litres per second
litres per minute
cubed metres per hour
Is surface water to be combined with
the foul water pumping station?
Yes:
No:
If a separate surface water pumping
station is required, please indicate below:
(A) Depth from ground level to lowest
invert level (in metres)
(B) Difference in level between lowest
invert level and discharge level into outfall chamber (in metres)
(C) Total distance from pump chamber
to outfall chamber (in meters)
If there is a high point between the pump discharge
and outfall chamber, please state the distance: (in metres)
Rising Main
New:
Existing:
If existing, please state main material
Please select
MDPE
HDPE
Cast Iron
Ductile Iron
Internal diameter of rising main (in mm)
Inlet size
Please select
100 mm
150 mm
200 mm
250 mm
Number of Inlets
Electrical supply available
Please Select
240v Single Phase
415v Three Pahse
Distance from control panel to pump station (in
metres)
Will pumping station be located in a hazardous
area, and as such require explosion proof pumps?
Yes:
No:
All control panels come complete
with the following as standard: Direct on line start, IP54 Enclosure,
Overload fitted to suit particular pump motor, Hand/Off/Auto
selector
switch (es), High Level Audible alarm with mute button, Door
locking isolator, Visual indication for: ‘pump(s) running’, ‘pump(s)
tripped’, ‘high level’, 24vAC output connection
for remote beacon (to indicate high-level), Klixon connections.
(All control panels offered in 3 or 4 float setup).
If there are any imposed flow limits into the outfall
chamber, please state maximum outflow:
Please select
litres per second
litres per minute
cubed metres per hour
Must the total storage
capacity be confined to the pumping chamber?
Yes
No
If No, please state available
capacity upstream from the pumping chamber. (in litres)
If the pumping station will be adopted
please state the adoptive authority.
Time Frame:
Please select
0 - 4 weeks
4 - 12 weeks
12 plus weeks
Notes: