Drinking Water Bottle Order Form

Complete the form below. When you are finished, click the Submit button. Your request will be processed immediately.

Contact Information

Name

Company

Phone

Fax

Address

City

State/Province

Zip

Email

Project Name and Number

Requested bottle receive date

* Please allow a minimum of 3 business days from the date of request

Requested Analytical Result TAT

Standard

Expedited - Surcharges will apply. Contact us for a quote.

Comments

Complete the form by entering the number of samples requested for each parameter.

Inorganic Parameters

Lead

Copper

Nitrite

Nitrate/Nitrite

Chlorate

Chlorite

Bromide

Bromate

pH

Alkalinity

Turbidity

Hardness

Free Chlorine Residual

Total Chlorine Residual

UV 254

Sulfate

Total Organic Carbon

SUV A

Total Dissolved Solids

Sodium

Manganese

Calcium

Magnesium

Cyanide

Fluoride

Organic Parameters

Dioxin

VOC 524.2 Chlorinated

VOC 524.2 Unchlorinated

TTHMs

515.1 Herbicides

508 Pesticides

525.2 Semi-volatiles

531.1 N-methyl Carbamates

547 Glycophosphate

548.1 Endothall

549.2 Diquat and Paraquat

552.2 HAA5s

Groups

Full SOC

(504, 507, 508, 515.1, 525.2, 531.1, 547, 548.1, 549.1)

Full IOC

(Sb, As, Ba, Be, Cd, Cr, Hg, Ni, Se, Tl, F, CN)

Complete New Well Kit**

Inorganics
(Alkalinity, Antimony, Arsenic, Barium, Beryllium, Cadmium, Calcium, Chloride, Chromium, Copper, Cyanide, Fluoride, Iron, Lead, Magnesium, Manganese, Mercury, Nickel, Nitrate, Nitrite, Nitrite/ Nitrate, pH, TDS, Selenium, Silver, Sodium, Sulfate, Thallium, Zinc)
Radiologicals
Gross Alpha
Radium 228
Volatile Organic Chemicals
VOCs
Synthetic Organic
SOCs (Alachlor, Atrazine, Simazine)
Bacteria
Total Coliform (2 Samples)

** Additional Testing may be required

Bacteria

Total Coliform