Mobile Filtration Work Order | Top It Off Bottling

Customer*

Address*

Street Address Address Line 2 City State ZIP Code

Contact Name*

First Last

Title*

Phone*

Email*

Fax

(optional)

Cell*

Additional Contact

(optional)

First Last

Requested Filtration Date*

Bottling Date*

Filtration Site Address*

Same as billing address

Anticipated Final Filtration*

Site Information

Site Description*

Select all that apply

Paved
Gravel
Level
Outside
Covered
Inside

Locked Gates?*

Yes
No

Gate Code

(if applicable)

Electric Power*

Select all that apply. Top It Off requires a dedicated circuit of a 100 amp, 3-phase 230 volt service (Hubbell No. 41000M19W) or a 60 amp, 3-phase 460 volt service (Hubbell No. 460M17W). Power must be located within 100 feet of bottling site. One of the above winery-supplied receptacles should be installed and properly wired prior to bottling.

230 v. 3ph // 100amp
208 v 3ph // 100amp
230 v. 3ph // 60amp
208 v. 3ph // 60amp
480 v 3ph // 60amp
480 v 3ph // 30amp
Generator 45kw 3ph - Minimum
Plug Available
Pigtail into Service Disconnect

Water*

Select all that apply

Hot
Cold

Is Water Filtered?*

Yes
No

Water Source*

Well
City-supplied
30 psi and 10 gpm or better
Other (complete additional details below)

Additional Water Info

(if applicable)

Wine Information

Has wine been racked and blended?*

Yes
No

Brix is less than 10°*

Yes
No

Wine Temp (Reds)

55° - 65° F

Yes
No

Wine Temp (Whites)

35° - 65° F

Yes
No

Turbidity*

Less than 800 NTU? If you do not know the Turbidity of your wine, you can send us a sample to test.

Yes
No
Unknown

NTU Estimate

If available. It's okay if not known.

Does the wine contain any CO2, seeds, or pumice?*

Yes
No

Are all clarifying products listed below?*

Yes
No

Any previous filtrations?*

Yes
No

Type of previous filtrations

(if applicable)

Wine #1 Details*