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Element Autopsy Form

If you're interested in an element autopsy service, please complete the following form with as much infomration as possible. This form will help our technicians to more promptly process your autopsy. Or, feel free to print and complete this form and fax it to 760-597-2437.
First Name: *
Last Name: *
Company: 
Address 1:
Address 2:
City:   State:   Zip:
Country: *
Daytime Phone: *
Fax:
E-mail: *

Please check the following pretreatments which precede your RO system:

Plant reference name.
Select membrane type.
Membrane manufacturer.
Element manufacturer.
Element serial number.
From what part of the system did this element come?
Are the membranes brackish water or sea water elements?
What size is the element?     Other:
How old is the element?
Do you know your current salt rejection?
System array configuration.
Number of elements per array.
Please describe your cleaning regimen.
How often do you clean?
How many trains do you have?
What is your source water?     Other:
Feed Pressure:
Feed Flow:
Concentrate Flow:
Permeate Flow:
Permeate Pressure:
Interstage Pressure:
Concentrate Pressure:

Please enter the incoming RO feedwater data (after all pretreatment). It will be assumed that the values are ppm as ion. If some values are ppm as CaCO3, please indicate. You may also opt to fax your water data to 760-597-2437.
Ca Fe Ba F PO4
Mg Cu HCO3 pH Turbidity
Na Mn SO4 TDS SDI
K SiO2 CI CO2  
Sr AI NO3 CO3  
Chlorine Residual Temp

Please check the following pretreatments which precede your RO system:
, size:
, type:
, Type:

How often does the RO system shut-down? Please describe your start-up and shut-down procedure:

Please describe the problem you're having with the element:

What goal do you have in proceeding with an autopsy?

What type of fouling do you anticipate? Why?

Please enter any additional comments in the space provided below:
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