Schedule

Name

Email Address

Phone Number

Address of Service

Special Instructions

Services Services Water Quality Testing Standard Conventional Tests Standard FHA/ VA/ RD Tests = Comiform/E-coli + Nitrate +Nitrite + Lead Softener Check Tests= Iron + Hardness (Before & After Tests) Drinking Water System Check Tests= Coliform/E-coli + Nitrate Arsenic Test Coliform/E-coli (Bacteria) Test Heterotrophic Plate Count Hardness Iron Lead Nitrate Nitrite Partial Chemistry Volatile Organic Compounds(VOC) nsite Water Well System Evaluation Onsite Wastewater Disposal System Evaluation Sewer Camera Consult Troubleshooting/ Second Opinion Services

Bundles Bundles Standard Conventional Well/Water/Wastewater Evaluation + Tank Pumped Standard Conventional Well/Water/Wastewater Evaluation Standard FHA/ VA/ RD Well/Water/Wastewater Evaluation + Tank Pumped Standard FHA/ VA/ RD Well/Water/Wastewater Evaluation Standard Conventional Well/Water Evaluation Standard FHA/ VA/ RD Well/Water Evaluation Onsite Wastewater Disposal System Evaluation - + Tank Pumped

Notice Notice I have reviewed the description of the services I am ordering and understand the scope of work and associated fees of the services being ordered. I understand that the house utilities will need to be turned on and that buried utility lines should be marked by the owner or Miss Dig if desired as MI Water Operator LLC does not dewinterize water systems, prime water well pumps, and while great care is always taken while doing any necessary probing or digging in the ground—can not nor will be held responsible for damage done to unmarked buried utility lines including irrigation or cable/satellite lines. I also will make the homeowner aware of the option to call Miss Dig or have the utility lines marked before the appointment for the evaluation if the homeowner so desires.