Free Corrosion Water Test Kit / Analysis Form

For a limited time we are offering free copper and pH test strips and a free analysis of your water in our lab. To receive your kit and a sample bottle to return to us, please fill out as much information as you can in the form below.. To receive your free test kit we do need at least a complete address and your email address.

No salesman will call and we never sell or give away your personal information, however if you wish a technician to phone you with the results, please put a day time phone in the text box below so we can contact you. Your free test kit will include test strips for copper and pH.

You will receive a sample bottle and mailer tube that you can use to send us a sample so we can do a more professional analysis in our lab. The analysis will include hardness, pH, total dissolved solids, alkalinity, iron and a Langelier Saturation Index calculation, along with a report on steps you can take to stop or slow down the corrosion problem.

Note: if you wish to send in a sample bottle of your own and not wait until we send you a bottle with your water test kit, please fill in and submit this form and let us know in the text box below you will be mailing us a sample. Use any 1/2 liter clean plastic bottle such as a small bottled water container and mail to the address below.

Contact Info
Name:
Mailing Address:
City: State:
Zip/Postal Code: Country:
E-mail:  
Water Source:
Private Well Shared Well Spring River / Creek
City Cistern I do not know
Water Quality Concerns (check all that apply):
Blue or green stains Rust stains White spots / scale
Odors Bad tastes
Corrosion Pin Hole Leaks
 
Type of Piping:
Copper pipe Galvanized iron pipe
PVC plastic pipe PEX tubing
Other
   
Please describe your corrosion problem here:. If you wish us to call you please leave a day time phone number:
Disclaimer:
These water test kits and water analysis are provided at no cost for educational purposes and are not meant to provide a certified water analysis. Results can vary. Clean Water Systems Inc. neither accepts or assumes any liability associated with the test kits or recommendations based on the analysis. No warranty or guarantees are extended. I agree to hold harmless Clean Water Systems Inc for any information contained herein and take full responsibility for my own water systems, pipes and corrosion problem..
I agree I do not agree