| 1.0 Name of Institution |
_____________________________ |
| |
|
| 2.0 Institution Point of Contact |
|
| Title |
_____________________________ |
| Address |
_____________________________ |
| Phone Number |
_____________________________ |
| Telefax Number |
_____________________________ |
| |
|
| 3.0 Date RFP Issued |
|
| Proposal Required By |
_____________________________ |
| Pilot Test Startup Desired By |
_____________________________ |
| Pilot Test Completion Desired By |
_____________________________ |
| Report Due Date |
_____________________________ |
| |
|
| 4.0 Facility Industrial Wastewater Discharge Rate |
|
| Average |
_________ gpd _________ gpm |
| Maximum |
_________ gpd _________ gpm |
| |
|
| 5.0 Effluent chemistry resembles the Clinical Incinerator Laundry Research stream
chemistry as provided in Table 2 of this RFP (circle whichever is appropriate). |
|
| |
|
| 6.0 Facility Specific Issues |
_____________________________ |