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Water Test Submittal Form Mobile App

We are providing the Water Test Submittal Form mobile app information to help you choose the appropriate water test for your home and to assist you in taking a proper water sample. The document suggested water quality testing for wells and provides a general description and educational information to help you consider which test would be most useful. This app contains the water testing guide providing descriptions of the common water tests available from the Department of Environmental Services (DES) Laboratory.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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Take a peek inside the Water Test Submittal Form Mobile App

Included Features

Our App Builder gives you the power to easily add and remove the ones you want. {{controller.show_all ? 'See included features.' : 'See more features.'}}

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico statictext

    (please fill out completely)

  • Ico statictext

    The lab cannot accept bacteria samples after 12:00 on Fridays or the day before a holiday

  • Ico statictext

    The following is information about where the sample(s) was collected:

  • Ico date

    Date

  • Ico time

    Time

  • Ico textbox

    Owners Name (of well)

  • Ico textbox

    Street Address (well location)

  • Ico textbox

    City/Town

  • Ico dropdown

    State

  • Ico integer

    Zip Code

  • Ico textbox

    Phone Number

  • Ico dropdown

    Source of sample water:

  • Ico dropdown

    What kind of well?

  • Ico dropdown

    Has this well been disinfected recently?

  • Ico date

    DATEd

  • Ico multiline

    If there is a water treatment/filtration system on line, what are you treating for?

  • Ico checkbox

    If there is water treatment/filtration on line, was sample taken BEFORE

  • Ico checkbox

    or AFTER treatment?

  • Ico multiline

    Comments about the sample

  • Ico multiline

    The following is the mailing address where you would like us to send the laboratory report:

  • Ico statictext

    PLEASE CHECK TEST CHOICE

  • Ico statictext

    * These tests are included in the Standard Analysis

  • Ico checkbox

    Standard Analysis $85

  • Ico checkbox

    Radiological Analysis/Radon $80

  • Ico checkbox

    Volatile Organic Chemicals $120

  • Ico checkbox

    Drinking Water Bacteria* $15

  • Ico checkbox

    Basic Analysis* $3

  • Ico checkbox

    Swimming Water Bacteria $20

  • ...and More!

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