Client Intake Questionnaire

So you’re thinking about rainwater harvesting (RWH) – how exciting! Please fill out this questionnaire if you’re considering working with BlueBarrel.

These questions are designed to give us the information we need to have a meaningful conversation about the rainwater harvesting possibilities at your site. We will contact you within a few business days of receiving your questionnaire to discuss next steps for your project.

Thank you!


CLIENT CONTACT INFO:

Primary Contact Name(s): *
Phone(s): *
Email(s): *
Mailing Address: *
Preferred time/method of contact:
Installation site address (if different from mailing address):

ABOUT YOU:

Are you the owner of the proposed installation site?(NOTE: BlueBarrel requires authorization from the property owner before providing installation services.)
Yes, I am the sole owner
Yes, I am a co-owner
No, I do not own this property
What attracts you to the idea of rainwater harvesting?
What are your intended uses for the water? (Check all that apply)
Drinking and other potable uses
Drinking source for pets, livestock or wildlife
Toilet flushing
Clothes washing
Car washing
Rinsing garden-ware
Garden irrigation
     Hand Watering
     Drip Irrigation
     Sprinkler Irrigation
     Edible Plants
     Non-Edible Plants
Other (Please Specify)
If you are planning to use the water for irrigation, how large is your irrigation area (in square feet)

ABOUT THE INSTALLATION SITE:

Is the property located within a city limit?
Yes   No
Are you aware of any regulations, permit requirements, or incentive programs within your jurisdiction related to rainwater harvesting? (NOTE: While BlueBarrel can research and report on local code and permit requirements as part of a consulting agreement, you, the client, are solely responsible for understanding and complying with local codes and regulations.)
Yes   No
If yes, please summarize what you know:
What material is your roof surfaced with?
Asphalt Shingle
Tile Shingle
Wood Shingle
Plastic
Standing-Seam Metal ( What kind of metal? )
Corrugated Metal (what kind of metal? )
Green (vegetated) roof
Mixed Surface (please specify)
Other (please specify)
Was your roof resurfaced within the last 3 years?
Yes   No   Don't Know
What are your gutters and downspouts made of?
Plastic
Metal (what kind? )
The building doesn't have gutters/downspouts
Other (please specify)
How would you describe your existing downspouts (if any)?
Round ( Diameter = inches )
Rectangular ( x inches )
Rain Chain
Other (please specify)
Are there any zinc, lead, copper, or galvanized materials as part of your roof or gutter/downspout system?
Yes (please specify)
No
Don't Know
Do you have any appliances located on your roof (e.g. solar panels, AC units...)? Please list with separated commas:
How did you hear about BlueBarrel?
Anything else you'd like BlueBarrel to know before we contact you to go over your questionnaire and discuss next steps for your project?
OPTIONAL: You may attach drawings or diagrams if you think it would be of help.