REQUEST FOR SAMPLE COLLECTION

When needed we are happy to come out and collect a sample. The prices are dependant upon the area. Please call for prices and scheduling, or you can fill out the form below and we will take care of the collection. Please fill in all required (*) fields

CONTACT



BILLING




NOTE: CASH OR CHECK ONLY - PAYMENT MUST BE MADE BEFORE RESULTS ARE RELEASED


**Required only if any other escrow information is filled in
TESTS REQUESTED

Purity / Bacteria Nitrate Great 28
Other Test:
PROPERTY INFORMATION

Yes No Yes No Yes No




PLEASE NOTE:

A confirmation email w/ date and time stamp will be sent upon receipt. Please note that someone will contact you via phone or email regarding your request within two working days from receipt.

Thank you,

Grants Pass Water Laboratory Staff