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Site Name:
Contact name:
Company:
Address:
Postcode:
E-mail:
Telephone:
Fax:

Status of building:	Old New site
Size of building:
If building is a hospital, number of beds:
Current Legionella control:	Temperature Regime Chemicals Other:

Mixing valves?	Yes No
Number of valves:
Orca system treating:	Hot water Cold water Both
Water supplied	Mains Borehole Both Comments:

Water passed to tanks?	Yes No
Number of tanks:
Type of tanks:
Capacity of tanks:	Litres

Type of water heating system:
Number:
Is water softened?	Yes No
Water consumption:	Litres per minute