Master Water Conditioning Corporation
Water Conditioning Systems
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Taking The Test
Taking The Test
This is a SAMPLE FORM with explanation pop ups for each field
PLEASE NOTE: We do not test for
Bacteria
.
Purity a question?
Contact your local Health Department.
WATER SAMPLING PROCEDURE:
COMPLETELY fill out form. Water will not be analyzed without Distributor’s Name.
Let UNFILTERED water run from cold water faucet 2-3 minutes.
Fill bottle!
If troubleshooting existing equipment, take a treated sample from kitchen faucet and a raw water sample before equipment. List Model #
.
224 Shoemaker Road, Pottstown, PA 19464
PLAINLY PRINT INFO BELOW:
PHONE
GENERAL INFORMATION:
Owner:
No. of Persons in the Household
Owner:
No. of Bathrooms
Distributor:
Branch:
No. of Whirlpools
REMARKS:
Water Supply
City
Water Pressure
Pipe Diameter
Well
PSI Setting
Well
Pump Capacity
gal per min.
ON SITE RESULTS, IF ANY:
Run boiler drain on well tank piping for10 min. Time the fill rate of a 5 gal. bucket
CO2
Hardness
Iron
PH
Sulfur
Submersible Pump
Jet Pump
When drawn, water is:
clear
colored
sediment
Does air spurt from faucet?
HOT
COLD
Notable stains
orange/brown
blue/green
black
yellow
Taste/Odor
____ rotten egg - hot
____ rotten egg - cold
____ rotten egg - both
____
Chlorine
____ musty / earthy
____ Other: ______________