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Water Test Request
For HOMEOWNER
Before beginning...
Many of your questions can be answered here
Payment is required before sampling will be done.
After submitting your request, you will receive an emailed Invoice with a link to make a payment online.
*
Indicates required field
Homeowner's Name
*
First
Last
Homeowner's Email
*
Test results will be emailed, unless requested otherwise.
Homeowner's Phone Number
*
Site Address
*
Line 1
Line 2
City
State
Zip Code
Country
*A Mileage Charge will apply if property is located outside of Gloucester, Mathews, or Middlesex.
Please include any special directions or property identifiers.
*
Outside Faucet Accessible?
*
Yes
No
Unrestricted access (no dogs, locked gates, etc.) is required to an outside faucet with running water (power and pump on). This allows us to collect a sample without someone being present. If there are special access circumstances, please provide instructions.
Lockbox code:
*
Outside Dogs?
*
Yes
No
Please be sure that all dogs are secured so that our technicians can easily and safely access your outside water faucet.
Location of well if known:
*
Water treatment equipment?
*
Yes
No
If there is a whole house water treatment unit, we may need to access it.
If water treatment is present, where is it currently located?
*
Tests to be Ordered
*
Bacteria Test & Chlorination* $125
Chlorination of Lines into Home** $70
Lead Test $70
Nitrate/Nitrite Test $90
GPM Test $25
Pump & Tank Inspection $105
Pump & Tank Inspection with Other Service $75
Free Water Analysis to recommend water treatment
You will need to confirm with loan underwriter/mortgage company what tests they are requiring for the loan.
*Chlorination included with Bacteria Test means we will provide a chlorination of the well, line, or sample point as the configuration allows.
If the bacteria test fails, we will provide the second bacteria test at no additional charge (excluding Mileage or Rush Charges).
**Chlorination of Lines into Home means we will put chlorine in the well or in the plumbing lines as close to the well as possible (as the configuration allows). We will then draw chlorine into every faucet and let it sit for 5 minutes. You may then use water as normal but with caution for the next 24 – 48 hours, including not washing any colored clothes.
Billing Address if different than site address
*
Line 1
Line 2
City
State
Zip Code
Country
Additional Information
*
Please Note: All Required Fields marked with
*
must be answered/completed or test will not Submit.
Please make sure you receive the following message to confirm your request went through: "Thank you. Your information has been submitted."
Payment is required before sampling will be done. After submitting your request, you will receive an emailed Invoice with a link to make a payment online.
If you have any questions, please contact Petra at 804-693-7294 or
[email protected]
Send
Home
About
Products
Homeowners
Commercial
Services
Homeowners
Realtors
Commercial
Contact
Resources
FAQ
Links We Like
Instructions & Manuals
Blog
eNews
Still Have Questions