Water Test Request

Name*

First Last

Phone*

Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Are you on (privately owned) well water or city water?

Would you prefer your kit mailed or prepared for pick up at our office?

Test Requested

Total coliform/E. coli (bacteria)- $31.00
Nitrate/Nitrite- $36.00
Lead- $31.00
Water Wellness Test- $95 (Chloride, Sulfate, Conductivity, pH, Hardness, Nitrate/Nitrite, Coper, Lead, Iron, Manganese, and Sodium)
Other-

Other

Issues?

Other

Preferred method of contact?

Preferred method of reporting?

Real Estate closing or refinance?

If you have pictures of an issue in your water, upload them here:

Drop files here or

Accepted file types: doc, pdf, txt, docx, xlsx, xlsm, jpg, bmp, jpeg, tif, png, gif, Max. file size: 256 MB.

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State Environmental Laboratory Services
Department of Environmental Quality
707 N Robinson
Oklahoma City, OK, 73102