Project Name: (as permitted)
Project Location: (Street, City, Location)
Project Owner's Name:
Project Engineer's Name:
Engineer's Email Address:
Engineering Firm:
Firm Address: (Street, City, Location)
Firm Phone Number:
Firm Fax Number:

Please describe in detail the type of facility, with the description of facility services (including square footage), which the pump station will serve (Ex: food handling, car washes, number of rest rooms). If residence, please include a complete description (single family, multi-family, attached, detached) and include number of units, sq. footage, and number of bedrooms per unit.


Please indicate the running length of force main in feet, including any aqueous crossings, the number of, and degree of turns, and any type of above-surface crossings:


Please indicate how the wastewater is being discharged; if the wastewater is discharging into a manhole, gravity line, force main, etc:


If wastewater is being discharged into a force main, what are the static pressures of the force main? Please indicate: (enter N/A if not applicable)
Low Pressure:      
High Pressure:     

Please list below the elevations of your application:

25 year flood elevation (FEMA) [if known]:  
100 year flood elevation (FEMA):               
Influent pipe elevation:  
(Required)
Station grade elevation:
(Required)

Highest grade elevation between pump station
and the force main discharge point:

Identify Available Power:
115 Volt 1 Phase
208 Volt 1 Phase
230 Volt 1 Phase
208 Volt 3 Phase
230 Volt 3 Phase
460 Volt 3 Phase
TBD

Items Clock Position   Discharge Lines 3:00-- Primary Invert Secondary Invert Location of Control Center Pipe Diameter of Primary Invert Pipe Diameter of Secondary Invert

If a site plan is available, please email it in PDF or AutoCAD format to info@emops.com once you've submitted this form.