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Please indicate the municipality that the well is located in. If Town of Chilton, please use other form.
HOMEOWNER'S PACKAGE: includes Bacteria, Nitrate, pH, Alkalinity, Hardness, Chloride, Conductivity, Corrosivity Index ...
METALS PACKAGE: includes 11 metals, including an arsenic screen......
DACT SCREEN: tests for Atrazine and its byproducts
Payment is due in September when kits are distributed or returned. No payment will be collected until September.
Indicate when you will most likely pick up your test kit.
Indicate the location and time you most likely will return the full test kits. Samples must be drawn on Monday, Sept 13
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