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| Company: |
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| Address: |
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| City: |
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| State: |
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| Zip code: |
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| Email address: |
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| Phone: |
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| Fax: |
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| Specific Uses for Turnkey Bottled Water Plant |
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| What type of water do you wish to market? |
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| How much water do you currently need per day? |
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| How much do you expect to need per day in one year? |
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| How much do you expect to need per day in three years? |
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| How many hours per day do you needto fill the water produced? |
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| If you intend to bottle the water, do you have bottles, coolers, caps, etc. available? |
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| Do you need assistance in procuring these items? |
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| If you plan to bottle the water, what size bottles do you plan to utilize? |
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| Do you plan on filling additional sizes of bottles? |
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| Do you plan on labeling? |
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| Do you plan on packing? |
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| Please indicate your voltage: |
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| If yes, please indicate additional sizes: |
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| Are sample bottles available for us to view at your factory? |
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| How are your bottles currently capped? |
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| Are samples of caps available? |
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| What additional information do you feel we need to know? |
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| Do you have a maintenance person who is specifically responsible for your operation? |
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| Do you have an existing facility for the Turnkey Bottled Water Plant? |
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| If no, do you have a facility under construction or renovation |
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| Please enter the code at the right in the box: |
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