Contact Us Today to Learn More About
Samsco Wastewater Evaporator Systems

* Fields are required.

Customer Information:

Name:*

Title:

Company Name:*

E-Mail:*

Phone:*

Fax:

Address:

City/Town:

State/Prov:*

Zip Code:

Country:

Wastewater Application Information:

Waste Stream Description:

Volume Per Year:

1.)

2.)

3.)

4.)

5.)

Current Wastewater Disposal Method(s) and Costs

 

Hauling:

Gals/Year:

$

Sewer Discharge:

Gals/Year:

$

Septic Discharge:

Gals/Year:

$

On-site Treatment:

Gals/Year:

$

If disposal is on-site, please describe current method:

Fuel Source(s) Available

(Please check all that apply)

Natural Gas:

Propane Gas:

Electricity:

Steam:

Waste Oil:

Other:

What Factors Have Influenced You to Consider a Wastewater Evaporator?

(Please check all that apply)

Cost Savings:

Eliminate Sewer Accountability:

Achieve Environmental Compliance:

Handle Multiple Waste Streams:

Current Method Too Complex:

Current Method is Difficult to Maintain:

Current Method Cannot Handle Volume:

Current Method is Too Costly:

Other: (please describe)