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["Nationwide Scan of Onsite Greywater, Blackwater and Wastewater Technologies Response Form (ANNEXURE A)"]
["Technology Information "]
["Technology Name"]
["Technology Type (e.g. Greywater / Blackwater / Wastewater)"]
["Technology Provider / Company"]
["Manufacturer"]
["Number of Installations in South Africa and Province Location"]
["Cost per unit (ZAR)"]
["Annual Operation & Maintenance Cost (ZAR)"]
["Contact Person Name"]
["Contact Person Contact Number"]
["Contact Person Email Address"]
["Description of Technology, Suitability and Service Model"]
["Describe the technology, treatment process and sludge / waste management (One page data sheet may be attached)"]
["Describe your technology reuse options"]
["Describe the various system templates or configurations your technology can be integrated in"]
["Applicable/suitable market segments for the technology (specify - informal settlements, schools, affordable housing, high-density buildings, green building, and etc)"]
["Describe the service model(s) associated with the technology installation (if applicable)","  "]
["Operations & maintenance model (if applicable)"]
["Compliance "]
["Describe regulatory compliance for the final effluent or product (if applicable)"]
["Describe compliance with installation requirement such as plumbing codes, building regulations, etc"]
["User Experience and Social Acceptability"]
["Describe user experience and acceptance of the technology"]
["Do you have testimonial of user acceptance / experience?"]