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MnWARN Membership Application Questionnaire <br />System Name: <br />Check all that apply: <br />Water Wastewater Stormwater <br />Distribution Only Treatment Only <br />Collection Only <br />Which department is responsible for Gopher State One -Call (GSOC) response? <br />WATER: <br />System Connections: <br />Population Served: <br />Water <br />Wastewater <br />Stormwater <br />GPM production capacity: <br />Are accurate maps available? <br />Type of supply: <br />Treatment Process: <br />System Classification - <br />Number of licensed operators: A <br />Type of equipment available - <br />Yes <br />No <br />Ground Water <br />Softening <br />Surface Water <br />Iron Removal Zeolite <br />Other (describe) <br />A B C <br />D <br />B C D <br />Backhoe <br />Portable Generator <br />Tools <br />Routine water/wastewater/storm water pumps <br />Pressure washers and equipment <br />Other (describe) <br />Size of curb stop riser pipe (Choose one): <br />Current type of hydrants in use and type of thread: <br />1 inch <br />1 1/4 inch <br />Trucks <br />WASTEWATER: <br />System Capacity: Million Gallons a Day (MGD) <br />Population Served: <br />Treatment System: <br />Collection System: <br />Collection Only: <br />Activated Sludge Trickling Filter <br />Biologically Activated Filter (BAF) <br />Rotary Biological Contact (RBC) <br />Other (please list) <br />Yes <br />Yes <br />No <br />No <br />Extended Filter <br />