Chemical Tank Questionnaire

Note: Failure to answer questions or supply complete information about the chemical(s) or mixture to be stored in the tank may cause delays in the approval process.

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Job/Customer:
Your Name:
Address 1:
Address 2:
City:
State/Province:
Country:
Zip/PC:
Phone:
Fax:
E-Mail:

1. What is the name of the chemical to be stored? If the chemical will be a mixture of chemicals, list each component and the percent concentration (sum of concentrations should total 100%). Include trace chemicals and reaction gases or liquids.

Note: If only "trade names" are known, list the trade name, the name of the manufacturer, and a list of the individual components if known. Copies of MSDS(s) may be requested by CSI.

Chemical Name Normal Concentration (Sum=100%) Maximum Concentration(1)(2) Maximum Residence Time @ Max. Concentration Product Listed in CERCLA as Hazardous (yes/no)(3)

(1) Accounts for the possibility that a single component of a mixture could be dumped into the tank or basin.
(2) If the chemical is water (other than potable water or rain water) such as de-ionized, pure, ultra-pure, etc., show the concentration in ohm/cm.
(3) If chemical is listed in Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), the tank must be double wall.

2. Specific gravity range of the chemical or mixture:  to 

3. pH range of the chemical or mixture:  to    Unknown

4. How will the chemical(s) be stored in the tank? continuously    in an emergency
(NOTE: When used as an emergency spill tank, the customer may be required to flush the tank or basin of the chemicals after a spill depending on the resin selected for the manufacturer of the tank.)

5. Is the fluid/chemical soluble in water? yes   no   unknown

6. If a mixture, will the mixture phase separate or stay in solution? phase separate   stay in solution   unknown

7. Will the chemicals be under constant agitation? yes   no

8. Will a chemical process or the mixing of chemicals be done in the tank or basin? yes   no   unknown

If yes, identify the reaction or mixing process, the chemicals used or created, presence of agitation (continuous or intermittent), quantify the heat generation, how chemicals are introduced into the vessel (i.e., drop tube, side wall port, top grate, etc.)


9. What are the normal operating temperatures?
Minimum (°F)       Maximum (°F) 

10. Accessories (or drawing number):

 

11.Burial depth (grade to tank top):  feet

12. Miscellaneous Comments:

 

Note: Failure to answer questions or supply complete information about the chemical(s) or mixture to be stored in the tank or basin may cause delays in the approval process.