AWG Application Survey Questionnaire

Elementale Enterprises, Inc 525 Woodland Square Blvd Suite 250 Conroe, TX 77384 Ph: 936-283-4115 www.elementale-ent.com

Take control over your organization's water - clean, healthy, on demand - with no need for added plumbing! Our Atmospheric Water generators are built-to-order. Please complete this form to receive an accurate, thorough quotation within 24 hours. Our goal is to give you an 18 month ROI.
Name
Site Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone
Water Usage

AgricultureStainless SteelCommercialMarine GradeIndustrialMedical
Water Capacity per 24 Hours
Drinking Water-Only? Gray-Water only? BOTH?
Please enter choices
Noise Level if it is restricted
Average Temperature (low/high) - if known
Minimum
Average Humidity (low/high) - if known
Maximum
Site Location

< 1 mile from the SeaBetween 1 mile to 10> 10 miles from the Sea
Additional Features: Filter System/Power Source/Ancillary Equipment

CarbonMineralizedSedimentPOWER SOURCESolarWindGridANCILLARY ITEMSRain catcher grillFlow MeterPLCWheelsOther
Additional Customization Needs:
Note: Additional features and customizations are subject to additional costs.
Should be Empty: