1. General Project Information

Project Location
Project Location
Date Proposal Required
Date Proposal Required

2. Project Engineer Information

Name *
Name
Phone *
Phone
Company Address
Company Address

3. Influent Wastewater Characteristics at Design Flow

Please provide units wherever applicable.

4. Permit Effluent Requirements

5. Existing Site Conditions (if applicable)

Existing lagoon dimensions (email drawing if available to info@nexom.com). Specify "bottom" OR "water level" OR "top of berm".
i.e. 3:1, 4:1, etc.
If YES, please provide details in Section 6: General Description, below.
How would you prefer to be contacted?

If you have any questions at any point, contact us!

204-949-7500
info@nelsonenvironmental.com

Canada:
5 Burks Way
Winnipeg MB  R2J 3R8

United States:
101 Falls Rd, Suite 406
Grafton WI  53024

323 N. Spokane St. Suite 200
Post Falls ID  83854