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Personal Water Evaluation Forms

Below are the most common questions we need answered in order to properly assist you with solving your water problem(s). Please take a few moments and answer as many of the items you can. Once you submit the information to us, we will review the information and reply directly to you within one business day, either by e-mail or telephone. Thank you for the opportunity to help you!

When taking a sample of water for testing, please draw the sample of water towards the evening. Water samples that are taken first thing in the morning will be of water that has been setting overnight in your plumbing lines (or well casing if you are on a well), and could have a different testing level of dissolved substances than a water sample taken after water has been used during the course of the day.

    How many people are in the home?

    How many full bathrooms are in the home?

    What is the hardness level of your raw, unfiltered water?

    For the hardness value above, what measurement of unit applies?
    GPG (Grains Per Gallon)Parts Per MillionMilligrams Per Liter

    What is the iron level of your raw, unfiltered water?

    For the iron value above, what measurement of unit applies?
    Parts Per MillionMilligrams Per Liter

    What is the pH level of your raw, unfiltered water?

    What is your flow rate in gallons per minute (GPM)?
    (See instructions at bottom)

    Does the raw water have any color when it is first drawn?
    YesNo

    Does the water have any odor?
    YesNo

    Is the water clear when first drawn?
    YesNo

    If the water is clear when first drawn, does it turn color after setting overnight?
    YesNo

    If there is an odor in the water when first drawn, is it gone after setting overnight?
    YesNo

    Is there any sediment at the bottom of the container after the water sets overnight?
    YesNo

    Is there any slimy buildup at the water line inside your toilet tank?
    YesNo

    Do you have iron stains on your plumbing fixtures?
    YesNo

    What is the size of the water line after the well pressure tank or public water supply?

    If you are on a private water supply, do you have a submersible pump (pump is in the well) or a jet pump (pump is above ground)?
    Submersible PumpJet Pump

    Comments. Please enter in the area below any additional comments you may have regarding the water problem(s) that you're trying to fix.

    Please enter the telephone number where we can reach you:

    Please enter the email address that we should respond to. You must enter your email address to get a response to this form.

    Please complete the security math question

    How to Check Your Flow Rate

    Private Water Supply:
    • Check the flow rate after the well pressure tank at one of your fastest flowing faucets.
    • Sometimes, there is a faucet installed right after the pressure tank. Or, you can open the hot
      and cold water faucets at a bathtub, full open, and let it run until the well pump kicks on.
    • Once the pump kicks on, put a 5 gallon bucket under the faucet and time it to see how many
      seconds it takes to fill the bucket to the top.
    Public Water Supply:
    • Check the flow rate at the fastest flowing faucet in the home, such as at a bathtub.
    • You should open the hot and cold water faucets, full open. Then, put a 5 gallon bucket under
      the faucet and time it to see how many seconds it takes to fill the bucket to the top.

    60 seconds = 5 GPM ..... 45 seconds = 7.5 GPM ..... 30 seconds = 10 GPM