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Help >> Custom Water System Design & Questionnaire (Part 1)

Custom Water System Design & Questionnaire

Only your name and email are required, but fill in as much as you can. We will design a water treatment system for you, and email you a recommendation with options, prices and ordering information. If you would like us to call you during day time hours please include your phone number.
Questions? Call (831) 462-8500 or email:info@cleanwaterstore.com
How did you hear about CWS?
*Name:
Site address:
City: State:
Country: Zip/postal code:
Mailing Address:
City: State:
Country: Zip/ postal code:
Home phone: Work phone:
Fax: *E-mail:
Source of Water Piping Info
City Small community # of bathrooms
Private well Spring, lake, river Any pressure problems? yes no
Don't know Water pressure (PSI)
Other: Pipe size at inlet
Water Chemistry Copper pipe? yes no
Hardness (ppm) Galvanized pipe? yes no
pH (1-14) PVC pipe? yes no
TDS (ppm) Drain nearby? yes no
Iron (ppm) Electrical outlet nearby? yes no
Manganese (ppm) Point of Use Filtration Info
Tannin (ppm) Icemaker installation? yes no
Nitrate (ppm) Install at sink? yes no
Copper (ppm) Porcelain sink? yes no
Alkalinity (ppm) Stainless steel sink? yes no
Bacteria Existing hole for faucet? yes no
Date analyzed - - Granite countertop? yes no
Household Info Tile countertop? yes no
# of people Existing Treatment Info
# of years at house Existing water softener? yes no
Drink bottled water? yes no Brand?
Icemaker? yes no Existing point of use filter? yes no
Instant hot dispenser? yes no Brand?
Solar water heater? yes no  
Spa-type bath tub? yes no

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