Doc. No.
ETP-QS
ETP Query Sheet Rev. No 0
Page 1 of 2
General Information
Name of Organization Date:
Address
Name: Designation:
Contact Person Detail
Mobile No: E-mail:
Project Location:
Factory & ETP Information
Factory Category (E.C.R. ’97)
Factory Status
Manufacturing Product
Raw Materials Used
Chemical used
Raw Water Source
Running Hour Factory: ETP:
Weekly Shut Down Factory: ETP:
Yearly Shut Down Factory: ETP:
ETP Installation
Available Space Length: Width: Height: Area:
Effluent Information
Source
Discharge mode from factory Continuous at same rate Continuous at variable rate Batch-wise
Average discharge Rate: m3/hr Duration: hr
Rate: m3/hr Duration: hr
Peak/batch discharge
Frequency times Interval: hr
Discharge rate summary m3/hr m3/day
Full Discharge Zero Discharge
Disposal of the treated effluent Part recycle, Quantity:
Part reuse, Quantity: Use:
River, Name: Local Drain, Type:
Point of treated effluent disposal
Others, Detail:
Sludge Drying Technology natural dry bed screw press filter press
Disposal of Dry Sludge
Checklist for Documents
Master Plan Yes No Test Report of RAW Effluent Yes No
Pics Yes No Sample of RAW Effluent Yes No
Videos Yes No Raw Water Test Report Yes No
Doc. No. ETP-QS
ETP Query Sheet Rev. No 0
Page 2 of 2
Effluent/Water Quality
Sl Source Required water Required water Raw Required
Parameter Unit
No. water for re-cycle for re-use effluent treated effluent
1 Temperature
2 E.Conductivity
3 pH
4 TDS
5 TSS
6 BOD5
7 COD
8 DO
9 Oil & Grease
10 Hardness
11 Bicarbonate
12 Chloride
13 Phosphate
14 Sulfate
15 Free Cl2
16 Iron
17 Arsenic
18 Barium
19 Chromium
20 Zinc
21 Lead
22 Other heavy metal
23
24
25
Scope of Work
Remarks
Signature with date: Signature with date:
Name: Name:
Designation: Designation:
Prepared By Checked By