Xitech Incorporated

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1. What type of product will be recovered from your pilot well?

2. What is the recovery rate of the product in your pilot well ?: (feet per hour)

3. When did you last check the recovery rate of the pilot well? (Date)

4. What is the current product thickness in your pilot well?: (feet)

5. What is the well diameter of your pilot well ?: (inches)

6. What is the depth to water of your pilot well ?: (feet)

7. What is the depth to the bottom of your pilot well?: (feet)

8. Is your well casing : PVC Metal

9. Which is easier to provide?: 12 volt car battery (preferred) 110 AC

10. What is the distance from the top of well to the product holding tank?: (feet)
We prefer a 55 gallon drum be placed near the well!

11. What is the distance from the top of well to the pump controller?: (feet)
We prefer the controller be place near the well and near the drum!

12. What is the distance from the pump controller to the air source?: (feet)
We prefer the bottle be placed near the controller, drum and well!

13. What is the distance from the conltroller to the holding tank? (feet)
We prefer them to be placed near each other!

14. Are you interested in applying a low vacuum to the well to increase production? Yes No

IF YES, go to our WEB site and print out the "Short" Pilot Study Procedure

IF YES, do you have a vacuum pump? Yes No

IF YES, can your vacuum pump supply a LOW vacuum between 10 & 20 inches of water?
Yes No

IF NO, we can have our vacuum vendor rent you one.

15. When would you like to install the pilot study?: (date)

16. What is the name of the pilot site?:

17. Is this site a State reimbursed site?: Yes No

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