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:
  1. COMPLETELY fill out form. Water will not be analyzed without Distributor’s Name.
  2. Let UNFILTERED water run from cold water faucet 2-3 minutes. Fill bottle!
  3. If troubleshooting existing equipment, take a treated sample from kitchen faucet and a raw water sample before equipment.  List Model #                   .
 Blue-Master-Water-Block70
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: ______________