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MnWARN Membership Application Questionnaire <br /> <br />System Name: ________________________________________________________ <br />Check all that apply: Water Wastewater Stormwater Collection Only <br />Distribution Only Treatment Only <br />Which department is responsible for Gopher State One-Call (GSOC) response? <br />WaterWastewater Stormwater <br />WATER: <br />System Connections:_______________________________________________________ <br />Population Served: ________________________________________________________ <br />GPM production capacity: __________________________________________________ <br />Are accurate maps available?.............Yes No <br />Type of supply:..................................Ground Water Surface Water <br />Treatment Process: ............................Softening Iron Removal Zeolite <br />Other (describe) ___________________________ <br />System Classification:........................A B C D <br />Number of licensed operators:...........A_____ B_____ C_____ D_____ <br />Type of equipment available:.............Backhoe Portable Generator Tools <br />Routine water/wastewater/storm water pumps <br />Pressure washers and equipment Trucks <br />Other (describe) <br />Size of curb stop riser pipe (Choose one): 1 inch 1 ¼ inch <br />Current type of hydrants in use and type of thread: _______________________________ <br />WASTEWATER: <br />System Capacity: ________________________________Million Gallons a Day (MGD) <br />Population Served: ________________________________________________________ <br />Treatment System: ............................Activated Sludge Trickling Filter <br />Biologically Activated Filter (BAF) <br />Rotary Biological Contact (RBC) Extended Filter <br />Other (please list) ___________________________ <br />Collection System: ............................Yes No <br />Collection Only: ................................Yes No <br /> <br />