Site Installation Report online form

* = required field

Well-head serial number

Borehole assembly serial number*

Installer's certificate number*

Certified installer's phone number*

Certified installer's first name*

Certified installer's family name*

New pump owner's contact mobile phone number*

New pump owner's first name*

New pump owner's family name*

Town*

County, state or province*

Country or region*

New pump owner's email address

Please confirm the following key installation steps have been completed:* HDPE down-pipe joined to correct ports at both endsWire tightly twisted twice around all HDPE jointsCable ties tightly secured with pliers at least every 120cm (4 feet) along HDPE pipesHDPE pipes cut no longer than 50m

Photo of the HDPE pipes If a camera is available, please upload a photo showing the HDPE pipes correctly joined together and onto the SLX-40 borehole unit. Please include everything shown in the example image.

Please also confirm the following key installation steps have been completed:* Maximum head (i.e., the height from the deepest seasonal ground water level to the maximum tank level) is no more than 50mTank raised above the highest point on the well-head (D)Outlet (F) is installed above the tank-hose connection (A)Good quality UV resistant suction hoses or pipes are installedHose clips are used on all hose jointsSurface-pump is installed in the correct directionTank has a lid Photo of the final installation If a camera is available, please upload a photo showing the above installation steps have been followed with the installed well-head (D), Surface-pump and tank correctly installed and connected. Please include everything shown in the example image below.

Surface Pump*

What is the cut length of HDPE pipes?*

Unit length feetmetres

What is the height of the top of the tank from the well-head base plate?*

feetmetres

Is the pump installed in a hand-dug well or a borehole?*

Hand-dug wellBorehole

Estimated deepest seasonal depth to well water level from ground level before pumping

feetmetres

Estimated daily water demand

litres/day

How long did the installation take after you arrived at site with the tank stand and well-head support installed?

hours

Please confirm the new pump owner is fully satisfied with the SLX-40 and the installation and that the following statements are true:* The pump runs as it should, any air has been expelled and there are no leaks.The new pump owner understands how to connect and run the pump including how to expel air.The new pump owner knows where to get additional support if needed.

Additional notes

I agree with the handling of my data in accordance with the Impact Pumps Privacy Policy.

Read our Privacy Policy.

Site Installation Report online form

Helpful links

Stay in touch