Fill out our Dredge Application form and automatically submit it to SRS Crisafulli

Manufacturers of reliable Crisafulli products Pumps – Dredges – Power Units — Custom or Standard supported by superior service Headquarters & Operations: PO Box 1051 • 1610 Crisafulli Drive • Glendive MT 59330-1051 • USA Phone: 406-365-3393 • Toll-free: 1-800-442-7867 • Fax: 406-365-8088 www.crisafullipumps.com • srsc@crisafulli.com Corporate office: PO Box 617 • Old Greenwich CT 06870 • USA • Phone: 203-637-5494 DREDGE APPLICATION QUESTIONNAIRE Date: Company: Your Name: Title: Company Address: Company Address 2: City, State and Zip: Country: Phone: Cell: Fax: Email: Please complete the following thoroughly and accurately. The information you provide will help the selection process go smoothly. Drawings, maps and photographs of the site are also useful. Call us at 800-442-7867 if you need further assistance or information not covered in this questionnaire. 1. Dimensions of dredging area (L,W,D)? 2. Amount of material to be removed? 3. Depth of material to be dredged? 4. Depth of water on top of the material? 5. Description of type of material to be dredged & process which created this material? 6. Is the material compacted in any way? 7. Percent of solids of material in situ- By weight? By volume? 8. Specific gravity of material? 9. Viscosity of material? Manufacturers of reliable Crisafulli products Pumps – Dredges – Power Units — Custom or Standard supported by superior service Headquarters & Operations: PO Box 1051 • 1610 Crisafulli Drive • Glendive MT 59330-1051 • USA Phone: 406-365-3393 • Toll-free: 1-800-442-7867 • Fax: 406-365-8088 www.crisafullipumps.com • srsc@crisafulli.com Corporate office: PO Box 617 • Old Greenwich CT 06870 • USA • Phone: 203-637-5494 DREDGE APPLICATION QUESTIONNAIRE CONTINUED: 10. Is material unusually warm cold If so, temperature range? 11. Does the material tend to emulsify? 12. Is material caustic, acidic, corrosive, or hazardous in any way? Yes No a. If yes, please provide PH and chemical composition: 13. Is material abrasive? (describe) 14. Any obstructions in pond? (describe) 15. Any debris in pond such as rocks, branches, metal scraps, etc.? (describe size and quantity) 16. Any aquatic growth in the pond? (describe) 17. Does the pond have a liner? (what type) 18. Any special safety precautions required at site such as fire retardant clothing, chemical resistant equipment, etc.? 19. Maximum distance from dredge to discharge site? 20. Maximum distance of floating line required? 21. Vertical Lift from dredge to discharge site (highest point between)? 22. Desired pipe size or existing pipeline diameter and type? 23. Solids size (typical, max., distribution)? 24. Power available (electric, hydraulic, diesel, voltage and phase)? 25. Will inclement weather present any problems? Yes No Sometimes 26. Flow required: 27. Are there special precautions or conditions that we should be aware of? Manufacturers of reliable Crisafulli products Pumps – Dredges – Power Units — Custom or Standard supported by superior service Headquarters & Operations: PO Box 1051 • 1610 Crisafulli Drive • Glendive MT 59330-1051 • USA Phone: 406-365-3393 • Toll-free: 1-800-442-7867 • Fax: 406-365-8088 www.crisafullipumps.com • srsc@crisafulli.com Corporate office: PO Box 617 • Old Greenwich CT 06870 • USA • Phone: 203-637-5494 DREDGE APPLICATION QUESTIONNAIRE CONTINUED: 28. I need this information Immediately For a purchase decision in months For a project that I’m bidding on. Date: For a project that I’m specifying. For my files. Additional Comments: Please provide any drawings, sketches, or pictures of the area to be dredged (with side elevations). Also include any notes about your application that are relevant to the dredge selection. Thank you for your time and cooperation in answering our questions. We look forward to working with you. administratorTypewritten TextadministratorTypewritten Text Date: Company: Your Name: Title: Company Address: Company Address 2: City State and Zip: Country: Phone: Cell: Fax: Email: 1 Dimensions of dredging area LWD: 2 Amount of material to be removed: undefined: 4 Depth of water on top of the material: undefined_2: Is the material compacted in any way: By weight: By volume: undefined_3: undefined_4: If so temperature range: 11Does the material tend to emulsify: 12 Is material caustic acidic corrosive or hazardous in any way: Yes: a If yes please provide PH and chemical composition: undefined_5: 14 Any obstructions in pond describe: 15 Any debris in pond such as rocks branches metal scraps etc describe size and quantity: 16 Any aquatic growth in the pond describe: 17 Does the pond have a liner what type: resistant equipment etc: 19 Maximum distance from dredge to discharge site: undefined_6: 21 Vertical Lift from dredge to discharge site highest point between: 22 Desired pipe size or existing pipeline diameter and type: undefined_7: 24 Power available electric hydraulic diesel voltage and phase: 25 Will inclement weather present any problems: Yes_2: No: Sometimes: 27 Are there special precautions or conditions that we should be aware of: For a purchase decision in: For a project that Im bidding on Date: Additional Comments: Check Box4: Check Box5: Check Box6: Check Box7: Check Box8: Check Box9: Check Box10: Email Form Now: Check Box1: Check Box2: