Customer Questionnaire

Full Name *

Phone Number *

Email Address *

Physical Address

Country *
KENYA

County *
—Please choose an option—NairobiMombasaKisumuNakuruKiambuUasin GishuMachakosKajiadoMurang'aNyeriKirinyagaEmbuMeruTharaka-NithiLaikipiaNyandaruaSamburuTurkanaWest PokotTrans NzoiaBungomaBusiaKakamegaVihigaSiayaKisiiNyamiraHoma BayMigoriBometKerichoNandiElgeyo-MarakwetBaringoNarokKwaleKilifiTana RiverLamuTaita TavetaGarissaWajirManderaMarsabitIsioloMakueni

Type of Housing *
—Please choose an option—DomesticApartmentInstitutionOther

If Other (Housing)

Number of Occupants *

Daily Water Usage (Liters) *

Effluent / Final Discharge *
—Please choose an option—SoakingRecyclingDischarge to DrainageOther

If Other (Effluent)

Type of Plant Required *
—Please choose an option—BiodigesterWaste Water Treatment Plant (Recycling Plant)Modification of Existing SepticOther

If Other (Plant Type)

Soil Type *
—Please choose an option—Red SoilBlack CottonMurramOther

If Other (Soil)

Project Stage *
—Please choose an option—Already occupiedOngoing construction, occupancy in 0 - 3 monthsOngoing construction, occupancy in 3 - 6 monthsOngoing construction, occupancy in 6 - 12 monthsOngoing construction, occupancy in over 12 months

How did you hear about us? *

Additional Information (Optional)