1. Personal Information for Potential Producer

Please complete the following questionnaire in order for Aquaculture Insight to supply a quotation for their respective Aquaculture Systems.

1. Personal information for potential producer

Name: ______

Physical & Postal Address: ______

__

Phone: ______Fax: ______

Email: ______

Is there a particular species of interest to you?

Trout______Tilapia ______Catfish ______Ornamental______

Marine Finfish______Oysters______Abalone______Shrimp ______

Other______

How many clusters (farm size) relevant to the species would you like to invest in?

1 2___ 3 ___ 4 ___ 5 ___ 6 ___ 7 ___ 8 ___ 9 ___ 10 ___ More ___

Aquaculture Insight has not taken into consideration the reproduction of fingerlings into their system design. Therefore this infrastructure is additional to the proposed system. Kindly indicate if you would like us to include this infrastructure?

Own hatchery___ Purchase fingerlings ___

2. Water source information

What is the source of water you propose to use for aquaculture?

Spring____River ____ Well ____ Dam ____ Stream ____ Borehole ____

Other _____

Has the water from this source been tested or is there any history of water quality testing available?

Yes______No ______(If yes, please attach copy of water test to this Questionnaire)

What is the flow produced by this water source (Litre per minute) or what is the surface area / m3of the dam / reservoir proposed for use and its estimated depth?

______

Does the water source lose considerable water volume during the dry months?

Yes______No ______

Is there a drop in elevation from the water source to the site of the planned production system (ie is gravity flow possible)?

Yes______No ______

If so, how many vertical meters (±) of the drop, measured from the water source to the planned production site? ______m.

What is the estimated distance from the water source to the site of the planned production system?

______

Where will the effluent water from the proposed aquaculture system drain (Hydroponics)?

______

3. Physical characteristics of the proposed site

Topography of the proposed production site:

Mountainous _____ Hills ______Gently sloping hills _____

Narrow valley_____ Wide valley _____

Estimated elevation of proposed production site: ______m above sea level.

GPS co-ordinates if available:

Is there road access to the site of the proposed production system?

______

Condition of the road: Paved _____ Dirt ______Gravel _____

No road access _____

Is the road maintained? Yes______No ______

Distance from the proposed production site to the closest tar road: ______km

Is the road suitable to accommodate a large truck? Yes______No ______

What is the nearest population centre (town) to the proposed production site?

Town Name ______Distance ______

Are the population : rural communities ______ urban communities ______

Is there a residence on or near the proposed production site?

Yes ______No______If yes distance from production site ______km

Is the residence occupied year-round? Yes______No ______

Is there electricity on the proposed site? Yes______No ______
Is there security for the site such as fencing, lighting, etc.? ______

4. Environmental Statutory Approval Process

A standardised application procedure is required towards environmental approval of all new aquaculture farming systems. Would you like Aquaculture Insight to identify an environmental consultant to assist in submitting this application?

Yes______No ______

5. Final information

Have you ever raised fish before? Yes______No ______

Will you require assistance from an aquaculture specialist to operate your aquaculture business?

Yes______No ______

Aquaculture Insight – Questionnaire