Site Information |
| Where do you intend to install the system? |
Cabin House House with Suite Trailer Office Houseboat Marina Live on Boat
Subdivision Other |
City or Town of Installation?
Site Address: Street Prov/State Post/Zip |
| How many people maximum will be residing in the house on a regular basis? |
If this is a cabin will people be using it on average per year?1-2 months 3-4 months 5 + months.
Approximately how many days per week ? 3 or less 4-5 6-7 |
| Will you be applying water conservation practices? Yes No |
| What is your reason for a new system? |
| Repair of current failed system? Remodel New Construction Change in government regulations |
| The overall lot size (where applicable) |
| There is an existing permit for wastewater disposal? Yes No |
| Intended method to handle effluent (wastewater) is No Discharge System Dispersal field River Lake Ocean Other |
| There is an existing dispersal field (where applicable)? Yes No |
| A percolation test and soil analysis test has been done? Yes No If Yes, please forward a copy. |
| Is electrical power available at the intended installation location? Yes No Solar or Solar for System Only |
| Well log? Yes No If Yes, please forward a copy. |
Distance from well to drain field?
Distance from two closest neighbours' wells to drain field. Neighbour 1 Neighbour 2 |
If Cabin installation, specify area for installing unit (height, width, length)
Would this cabin system be installed under a deck? Yes No |
| Will you require dentrification to remove all nitrates (not normally needed)? Yes No Don't Know |
| Would you like Go Green personnel to handle installation (BC, Alberta or Washington only)? Yes No |
| Would you like Go Green to handle all aspects of the project (BC, Alberta or Washington only)? Yes No |
| When will your project start? Immediately 2 - 3 months 4 - 5 months 6 - 11 months 12 months or more |
| Preferred method of responding to this request Email Fax Phone Letter Also, please send a brochure |
| Additional Comments: |
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