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  Boiler and Cooling Towers Service Form 

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It is important to retain an experienced water treatment company, on a continues consulting basis to recommend, and to administer water treatment programs for your systems . This practice is recommended because water conditioning program can vary depending upon the season of the year, geographical location and on the changing chemical characteristics of the makeup or feed water source.

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Your Name :

Company Name :

Company Address :

Country/City/Code :

Telephone Number :

E-Mail Address :

Fax Number :

Type of Business :

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Cooling water survey (Plant Details)

Gallons make up water-(Gallons/Day)

Rate of recirculation -(Cubic Meter/hr)

Temperature (degree Celsius)

Water holding Volume (Cubic Meter)

Name of Biocide Used

Boiler Water survey Report

Type of Boiler/Horsepower

          Make up water (Gallons/Day

Operating pressure-PS1 / Kg/cm2

Total steam generation-Ton/day

No of Hrs in operation- /day

Water analysis Report (both for boiler water and cooling water systems)

Please use / to separate readings

Return Line

Feed Water & Boiler

 Tower & Chiller

Treatment used

pH Reading 

Total Hardness

Alkalinity M

Alkalinity P



Total Dissolved solids

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