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Contact Person:______________________________________________________

Company Name:______________________________________________________

Street Address:______________________________________________________

City, State, Zip Code:__________________________________________________

Telephone:___________________________ Fax:___________________________

Number of Rectangle Tanks:____ Length:______ft. Width:_____ft. Depth:_____inches

Number of Circular Tanks:_______ Diameter:__________ft. Depth:__________inches

Species:________ Have you worked with these species before? Yes_____ No_____

Maximum Density:______lbs. per gallon per tank (Tank # 1______, Tank # 2_____etc.)

Individual Weight of Fish/Crustacean at Harvest______ Frequency of Harvest________

What is the source of the replacement water?______________ Approx. Gals./Min.___

Is there a filtration system present? Yes_____ No_____ - If Yes, Please describe the filtration system including flow rate, components and any water quality problems.

____________________________________________________________________________

What is the intended use of the system, your project goals and what water quality problems are you most concerned about? (Please Describe)

____________________________________________________________________________

Power Supply Available:

115/230 Volt - Phase 1 Yes______ No_______
230/460 Volt - Phase 3 Yes______ No_______

SITE DIAGRAM
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Please include your site plan, if available, or provide a simple sketch of the site to aid us in preparing an accurate design to meet your requirements.

Please note your preferred general layout or floor plan including number of tanks and dimensions, if known, preferred location of filtration system and any additional pertinent information. Complete confidentiality is assured. Please return your site diagram and checklist via fax or mail to:

Advanced Aquaculture Systems, Inc.
4509 Hickory Creek Lane
Brandon, FL 33511
Toll Free: (800) 994-7599
Phone: (813) 653-2823 · Fax: (813) 684-7773

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