Simple Pump Quote Sheet

Fill out sheet using your well log and email back to us at:

apreppersparadise@yahoo.com

copy and paste form to your word program to fill out.

STATIC WATER LEVEL_________FEET

DEPTH OF WELL______________FEET

CASING DIAMETER_______2”______4”______4.5”______5”_____6”_____6”SLEEVE 4” INNER

_______6.25”______7”_____8”

Casing Material        METAL_______ PVC________

IS THERE A SUBMERSIBLE PUMP?_________

If YES,  WITH PITLESS ADAPTER? ________

If YES, WITH PIPE THROUGH WELL CAP? __________

IF SUBMERSIBLE WHAT IS THE DEPTH____________FEET

RECOVERY RATE___________GALLONS PER MINUTE

USE OF SIMPLE PUMP-  INTO HOMES PRESSURE TANK ________  ,   NON PRESSURE TANK/OPEN CONTAINER _________

ANY GAIN IN HEIGHT?   VERTICAL DISTANCE FROM TOP OF WELL CAP TO DELIVERY POINT_____________FEET

FREEZING LEVEL?___________INCHES

CUSTOMER NAME__________________________________

PHONE NUMBER__________________

Email address:________________________________________________________