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Water Test Request
For Refinancing
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Before beginning...
Many of your questions can be answered here
*
Indicates required field
Homeowner's Name
*
First
Last
Homeowner's Email
*
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.
*
Power On?
*
Yes
No
Power to the well pump is required in order for us to be able to collect the sample.
If No Power, Date(s) Power On:
*
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.
Home Occupied
*
Yes
No
If the home is NOT occupied, we recommend a chlorination.
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?
*
Type of Financing
*
None Selected
VHDA
VA
Conventional
FHA
Cash
Test results will be emailed to Homeowner and Closing Firm, unless requested otherwise.
Closing Firm Contact
*
Closing Firm
*
Closing Firm Phone Number
*
Closing Firm Email
*
Closing Firm Fax
*
Tests to be Ordered*
*
Bacteria Test & Chlorination** $125
Chlorination of Lines into Home $70
Lead Test $70
Nitrate/Nitrite Test $90
FHA Sketch & Letter $82.50
FHA Sketch $55
FHA Letter $45
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.
* If you are unsure of what tests are needed, please contact the loan underwriter. We can not advise you on what tests to order.
**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).
Payment is required upfront. Please contact Petra at 804-693-7294 or
Petra@WaterProInc.com
after submitting test to make payment.
Billing Address if different than site address
*
Line 1
Line 2
City
State
Zip Code
Country
Closing Date
*
Is this a rush order?
*
Yes
No
Our standard turnaround time to provide you with results is approximately 5 business days from when the test is submitted. If you require a Rush, additional charges may apply. Please submit the test and contact Kelly at 804-693-7294 to discuss your time frame and if any additional charges will apply.
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."
If you would like to confirm receipt of your test, please email
Petra@WaterProInc.com
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