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Contact Us
Water Sample Kit Request Form
Water Sample Kit Request Form
.
2024-11-20T12:59:20-05:00
LEAD TEST
WATER SAMPLE KIT REQUEST
–
IMPORTANT INFO
–
MVD will only be providing the Water Sample Kit.
Water samples will be tested for LEAD ONLY.
An email will be sent when the Water Sample Kit is ready for pick up at MVD’s Office.
If you are human, leave this field blank.
SERVICE LOCATION
Enter the
STREET ADDRESS
for the location that is is connected to MVD water service.
STREET NUMBER AND STREET NAME:
*
CONTACT INFO
ENTER YOUR CONTACT INFO
Name:
*
MAILING Address:
Phone Number:
*
Email:
*
WATER SERVICE LINE MATERIAL INSPECTION INFO
HAVE THE WATER SERVICE LINE INSPECTION
RESULTS BEEN SUBMITTED TO MVD?
If the Water Service Line Inspection has not been completed as of yet, we kindly request submission as soon as possible.
Click HERE for Water Service Line Inspection Information.
Select Yes or No
*
Yes
No
IMPORTANT INFORMATION
IMPORTANT INFORMATION
Water Samples will be tested for lead
ONLY
.
MVD will be providing the Water Sample Kit
ONLY
; we do not take water samples at service locations.
MVD
WILL
NOT
be testing the water sample - water samples are sent to an independent laboratory that is accredited in accordance with the National Environmental Laboratory Accreditation Program (
NELAP
) & the New Hampshire Environmental Laboratory Accreditation Program (
NHELAP
).
Follow the Sample Collection Instructions
EXACTLY
to ensure testing is possible and results are accurate.
Once this request is submitted a confirmation will be sent - i
f an email is not received, MVD
DID NOT
receive this request.
A
SEPARATE
email will be sent when the Water Sample Kit is ready for pick up at MVD's Office.
Reminder: If the Water Service Line Inspection has not been completed as of yet, we kindly request submission as soon as possible.
Click HERE for Water Service Line Inspection Information.
CONFIRMATION & AGREEMENT
Confirmation:
*
By checking this box I confirm that I have read and understand the "Important Important Information Regarding the Water Sample Kit for Lead Testing" information.
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*
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