System Selector Help Form

Quick Response - we will get back to you quickly, typically in less than 24 hours!

Fill in as much information as you have available, but we need at least your name and email address to be able to respond to you. If this is for your home please do tell us the number of bathrooms in your home and/or your well's flow rate so we can properly make a recommendation.

If you would like to have a technician call you during daytime or early evening hours, please give us your phone number. No salesman will call you, but our techs can often answer technical questions quickly over the phone. *These fields are required.

Contact Information
First Name *
Last Name *
Email *
Street Address
City
State or Province
Postal Code
Country
Phone Number (if you want us to call with results)
Phone Evening
Fax (if you would like us to fax you in addition to emailing)
Water Source Information (check all that apply). If this is for your home please tell us either the number of bathrooms your house has and (if you happen to know it) your well flow rate (gallons or liters per minute). This will help us in sizing a system for you if you need any recommendations:
Number of Bathrooms *	Please select one 0 (N/A) 1 1.5 2 2.5 3 or more
Water Source *	Please select onePrivate Well Community Well Spring River / Creek Lake Rainwater Other Don't Know
Well Flow Rate (its easy to find this out yourself..more info...)
Red, Rust or Orange Stains	Yes No
Brown or Black Stains	Yes No
Blue Stains	Yes No
White Spots / Scale	Yes No
Sediment	Yes No
Color	Yes No
Sulfur odor in cold well water	Yes No
Sulfur odor in hot water only	Yes No
Water has other odors	Yes No
Corrosion	Yes No
Common Water Chemistry Information: Enter any data you may have. If you are experiencing staining, spotting, corrosion, scaling on appliances or fixtures or odors, the tests below are good tests to have done.
Hardness mg/L or PPM
Hardness Grains/Gallon
Iron
Manganese
pH
Total Dissolved Solids
Tannin
Coliform Bacteria Present	Yes No
Fecal Coliform Bacteria Present	Yes No
Nitrate
Hydrogen Sulfide
If you think you are having problems with any of these items, please click any that apply:
Iron	Yes No
Manganese	Yes No
Nitrate	Yes No
Bacteria	Yes No
Chemical or Heavy Metals	Yes No
Salts	Yes No
Additional Background Information, Water Chemistry Data or Questions:
Please give us as much background info as you wish so we can learn more about your concerns or goals regarding your water quality. You can also enter any other water chemistry data you may have that is not covered by the above boxes:
The Usual Disclaimer:
The information contained here is believed to be reliable and offered in good faith with no warranties or implied warranties or fitness for a particular use. System design suggestions are based on best judgement or estimates considering limited information provided by customer. The end-user or the customer is responsible for determining suitability of application and usage under site-specific circumstances, environmental conditions and water quality profile. The customer is responsible for determining that Information in this document is appropriate for the specific application, and ensuring compliance with applicable laws and regulations. Installation by a qualified mechanical contractor / plumber, and ongoing sampling and monitoring protocol may be required to determine actual performance and the appropriate frequency of service. Clean Water Systems & Stores Inc. neither accepts nor assumes any liability associated with water treatment system design. No warranty or guarantees are extended to cover piping systems, appliances or other water using fixtures. I agree to hold harmless Clean Water Systems & Store Inc. for any information contained herein and take full responsibility for my own water systems and applications. Yes No
Subscribe to the Clean Water Report while you are here and receive coupons for $50 on future purchases at the Clean Water Store! Yes:

By the way, we NEVER sell or share your personal data, email or information with anyone. We take this very seriously and your information is safe with us.