New Project Enquiry Form
KUBOTA MEMBRANE EUROPE (KME) Ltd.
Suite 7c, Elsinore House, 77 Fulham Palace Rd., London W6 8JA, UK. Tel.: +44(0)20 8741 5262 / Fax: +44(0)20 8563 1616
©2009 All information provided herein shall be treated as highly confidential
Currency in which you would like our price offer:
Estimated date (MONTH/YEAR) for purchase order:
(your company to KME)
Estimated date (MONTH/YEAR) for project delivery:
(your company to End User)
(A) INFORMATION ABOUT YOUR COMPANY
Company name and Registered address:
Main field(s) of activity:
Geographical area (country/countries) of involvement:
Contact information (tel. number, e-mail, official website):
Name and Position of contact person or Project Manager:
(B) INFORMATION ABOUT THE END USER (for requirements of Kubota Export License Agreement)
Company name and Registered address:
Main field(s) of activity:
Geographical area where membranes are to be installed:
Destination port for the consignment (this order):
(C) GENERAL PROJECT INFORMATION (please enter all applicable information)
Specific reason(s) for specifying MBR technology:
(e.g. land availability, requirement for effluent reuse, etc.)
Source of project funding (EU/state/private):
Your company’s Scope of Supply for this project:
Project Contractor (if different from your company):
Project Consultant (if different from your company):
Competition from other membrane manufacturers:
(D) PROJECT DESIGN INFORMATION (please enter all applicable information)
Source of wastewater to be treated:
(Municipal/Industrial-type of industry/Mixed-what percentage)
Average daily flow rate (m3/d):
Maximum daily flow rate (m3/d):
Peak hourly flow rate (m3/h):
Duration & Frequency of peak hourly flow in 24-h period
Does the design or existing plant have flow equalization?
What is the total volume (m3) and holding capacity (days)?
Wastewater temperature range, MIN-MAX (Deg. Celsius):
Wastewater FOG (fats, oils and grease) (mg/l):
(Please indicate Mineral Oil occurrence and concentration)
Wastewater Hardness (as CaCO3):
Wastewater Alkalinity:
Wastewater Conductivity (µS):
Wastewater NaCl concentration (mg/l):
Wastewater Total Dissolved Solids, TDS (mg/l):
Wastewater pH range:
Biochemical Oxygen Demand, BOD5 (mg/l): Influent:
Effluent:
Chemical Oxygen Demand, COD-Cr (mg/l): Influent:
Effluent:
Total Suspended Solid, TSS concentration (mg/l): Influent:
Effluent:
Total Phosphorus, T-P concentration (mg/l): Influent:
Effluent:
Total Nitrogen, T-N concentration (mg/l): Influent:
Effluent:
Total Kjeldahl Nitrogen, TKN concentration (mg/l): Influent:
Effluent:
Ammoniacal Nitrogen, NH3-N concentration (mg/l): Influent:
Effluent:
Additional comments (mineral oils, industrial chemicals, inorganic components, etc.):
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DECLARATION
For the purposes of complying with the Japanese Government requirements in accordance with ordinance of security export
control, please answer the questions below and declare accordingly.
Without these answers, Kubota is not allowed to carry out any commercial processes internally. We hope that this is understood
and kindly appreciate your full co-operation in this matter.
1) The final End User is not associated with manufacturing weapons of mass destruction or ordinal weapons.
2) Kubota’s products will not be linked to or used for the production of mass destruction or ordinal weapons.
I hereby declare that the answers above are true and correct.
Full Name and Position:
Date and signature:
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