[vc_row][vc_column]
Sales Consultant
Customer Name
Physical Address
Email Address
Contact Number
Enquiry Date
Where did you hear about us? FacebookGoogleOLXReferralOther
Have you already tested your water? YesNo
If yes, please attach results
No water test? Book a site visit / water sample collection YesNo
Deliver your water sample to us YesNo
What type of water system are you contemplating? Water SofteningReverse OsmosisDesalination SystemsIron RemovalOzone GeneratorsWellpoint DrillingUltra FiltrationRainwater HarvestingGreywater ReuseGroundwater BackupMunicipal BackupNot Sure
What is the water source? MunicipalNon-MunicipalBoreholeRainwaterWellpointRiver/Dam
If non-municipal, describe source
Does the water come directly from the source or into a tank first?
If tank first, is there a booster pump? YesNo
Existing filtration or pre-treatment?
Existing Equipment (Pumps, Tanks, Filters, Plumbing)
What will the water be used for? HouseholdDrinking/PotableSwimming PoolIrrigationManufacturing
Amount of purified water required
Are there any specialized water pressure requirements? (e.g. specialized taps)
How far is the water source from the house or usage point?
Site Assessor
Date
Time [time site-time]
Confirmed By (Internal)
Confirmed With (Customer)
Specialized Entry Notes / Instructions
Critical – 7 to 10 daysUrgent – 10 daysImportant – 14 daysJust browsing
