If you've been pleased with your Little River Pond Mill^® circulator we would like to hear from you Please fill out the following form. This assists us in keeping our customer profiles up to date, to improve customer service and to find out where we can improve our products and services.

			* Indicates a required field
1.	*	Name
2.	*	Company/Organization
3.	*	Address
4.	*	City or Town
5.	*	Province / State
6.	*	Postal Code / Zip
7.	*	Country
8.	*	Phone
9.		Fax
10.		Cell
11.	*	Email
12.	*	Number of Pond Mills
13.	*	Serial Numbers NOTE: Your serial number is located on the center section of the Little River Pond Mill® circulator to which the support legs are attached or on the inside upper rim of the 700 series body. (If inadequate space is provided below, please put remaining circulator numbers into #30.)
14.		When did you purchase?
15.	*	What operation were the machines originally purchased for?	Choose One Hog Dairy Fish Water Supply Other. Describe Below Other:
16.	*	Are they presently being used for this purpose or have they been put to use elsewhere? Yes No  If "no," please describe below.
17.	*	Are your machines currently in operation?  Yes No  If "no," list reasons for discontinued use.
18.	*	Overall, are you satisfied with your Little River Pond Mill® circulator(s)?  Yes No  Please describe.
	*
19.	*	If you are satisfied with your Little River Pond Mill® circulator, may we use you as a reference?	Yes No
20.	*	If you are satisfied with your Little River Pond Mill® circulator, may we use your testimonial in our publications?	Yes No
21.		Do you know anyone else who would benefit from the Little River Pond Mill® circulator?
22.		How can we serve you better?
23.	*	Do you know the authorized dealer or service person in your area? Yes No  If "yes," what is their name:
24.	*	Has the Little River Pond Mill® circulator authorized dealer taken care of your concerns or requests in the past? Yes No  If "yes," wonderful to hear! If "no," please inform us of your concerns (our customers are very important to us.)
25.	*	Do you require any parts and/or servicing for your Little River Pond Mill® circulator (s)? Yes No  If "yes," please describe below.
26.		Are you interested in a service contract? Yes No A service contract eliminates the worry component of machine servicing, ensuring that machines are well maintained and will serve you for years to come. Any insurance repairs can also be handled by your service contract provider.
27.		Are you interested in an extended limited warranty? Yes No  An extended limited warranty lengthens the time that parts are warranted for manufacturer defects.
28.		Are you interested in having testing done of your liquid holding facility, i.e. surface water, wastewater, or liquid sewage, to assist you in maximizing the efficiency of your operation/organization? Yes No  Testing can include such things as biological oxygen demand, dissolved oxygen, nutrients, carbon oxygen demand, pH,... Test results can assist our environmental specialist in determining if the machines are working satisfactorily and locate any potential or realized trouble areas within your operation that may be reflected in the holding facility contents. If using the liquid for fertigation purposes, testing can ensure maximum nutrient content with the lowest suspended solids content (to ensure ease of pumping and to ensure irrigation emitters do not become plugged).
29.		Are you aware of any Little River Pond Mill® circulators that belong to a friend or neighbour that require servicing? Yes No  If "yes," please let us know of the location and owner, if known.
30.		Other comments, suggestions, messages
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