Blue Basic Engineering GmbH
Bösch 73
CH-6331 Hünenberg
Tel. ++41 (0)41 784 40 75
Fax ++41 (0)41 784 40 71
info@blue-basic.com

Requirement form for energy and water supply



Please fill out the following form preferaby complete.
We will get in contact with you as soon as possible.


Company ZIP/City
Address Country
Planed object location Meters above sea level
Name First name
Phone Fax
E-mail



Energy

Estimated or existing user (12V DC oder 230V AC)

User Quantity power output daily use in hour day night


Water

Water demand for one day

Usage Quantity in litres
Drinking water
to water animals
Irrigation

Water depot

Existing Not existing

If yes, how many litres

Source of water

Source
Surface water
Brackish water
Sea water
Miscellaneous
Ground water
Ground water / Depth of water source
Borehole existing
Extraction height totally
Any analyses
Contamination through
bacteria, viruses
or algae
Any analyses
Contamination through
baterica, viruses
or algae
As data file: