PA Water Systems Fluoridation Equipment Inventory
The purpose of this inventory is to identify and quantify upcoming needs for fluoridation equipment in Pennsylvania. To thank you for your time, all COMPLETE surveys submitted on or before December 27, 2019 will be entered into a drawing for one of two $250 Amazon gift cards. Winners will be notified using the email address specified in the survey.
Email address *
1. PWSID *
2. Name of Water System *
3. Name and title of person completing this survey *
4. Email address of person completing this survey. We will use this email address to contact the winners of the two $250 gift cards. *
5. Plant Capacity (MGD) *
6. 2018 Average Production (GPD) *
7. Population served by water system. *
Please enter the number of people served by your water system.
8. Zip codes served by your water system *
Please enter the zip codes of all communities served by your water system, separated by commas. Example: 16354, 16341.
9. Source Water Natural Fluoride Level (mg/L) *
10. Do you currently adjust fluoride in your water system? *
Please select one answer.
10a. If you purchase water from a system that fluoridates, please name the supplier.
11. What fluoride additive(s) do you use? Select all that apply. *
Required
12. What fluoridation process equipment do you use? Select all that apply. *
Required
12a. If you selected "other" in question 12, please specify:
13. In the next 1 - 5 years, do you anticipate needing to replace any of the items indicated in questions 12 and 12a? *
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