New Customer Environmental Enrollment Form

Enrollment Information

Enrollment Information

Identification Information

Identification Information
Current/previous account ID (if known)
Wisconsin Department of Natural Resources
Wisconsin Department of Agriculture, Trade and Consumer Protection

Contact Information of person completing this form

Contact Information of person completing this form
Example: 123-456-7890

Type Of Testing Site For This Order

Type Of Testing Site For This Order

Shipping Information

Shipping Information
Example: 123-456-7890

Billing Information

Billing Information
Example: 123-456-7890

Send Reports To:

Send Reports To:
Example: 123-456-7890

Order Form: Potable Water

Order Form: Potable Water

Certification Samples

Quality Control Standards

(Total Cyanide)
(Total Cyanide)


(Antimony; Arsenic; Barium; Beryllium; Cadmium; Chromium; Copper; Lead; Mercury; Nickel; Selenium; Sodium; Thallium)
(Antimony; Arsenic; Barium; Beryllium; Cadmium; Chromium; Copper; Lead; Mercury; Nickel; Selenium; Sodium; Thallium)


(Nitrate as N; Nitrate + Nitrate as N; Fluoride; Sulfate)
(Nitrate as N; Nitrate + Nitrate as N; Fluoride; Sulfate)


(Nitrate as N)
(Nitrate as N)

Order Form: Non-Potable Water

Order Form: Non-Potable Water

Certification Samples

Quality Control Standards

(Biological Oxygen Demand; CBOD; Chemical Oxygen Demand)
(Biological Oxygen Demand; CBOD; Chemical Oxygen Demand)


(Total residual chlorine)
(Total residual chlorine)


(Total Cyanide)
(Total Cyanide)


(Hardness [EDTA])
(Hardness [EDTA])


(Aluminum; Barium; Cadmium; Calcium; Chromium; Cobalt; Copper; Hardness; Iron; Lead; Magnesium; Manganese; Nickel; Potassium; Silver; Sodium; Zinc)
(Aluminum; Barium; Cadmium; Calcium; Chromium; Cobalt; Copper; Hardness; Iron; Lead; Magnesium; Manganese; Nickel; Potassium; Silver; Sodium; Zinc)


(Arsenic; Mercury; Selenium)
(Arsenic; Mercury; Selenium)


(Antimony; Beryllium; Molybdenum; Strontium; Thallium; Vanadium)
(Antimony; Beryllium; Molybdenum; Strontium; Thallium; Vanadium)


(Bismuth; Lithium; Silicon; Titanium)
(Bismuth; Lithium; Silicon; Titanium)


(Boron; Tin)
(Boron; Tin)


(Alkalinity CaCO3; Chloride; Conductivity; Fluoride; Sulfate)
(Alkalinity CaCO3; Chloride; Conductivity; Fluoride; Sulfate)


(Nitrite as N)
(Nitrite as N)


(Ammonia as N; Nitrate as N; Nitrate + Nitrite as N; ortho‐Phosphate as P)
(Ammonia as N; Nitrate as N; Nitrate + Nitrite as N; ortho‐Phosphate as P)


(Total Kjeldahl nitrogen [TKN]; Total phosphorus)
(Total Kjeldahl nitrogen [TKN]; Total phosphorus)


(HEM)
(HEM)


(pH)
(pH)


Total Dissolved Solids [TDS]; Total Suspended Solids)
Total Dissolved Solids [TDS]; Total Suspended Solids)

Order Form: Water Microbiology

Order Form: Water Microbiology




Other Environmental Samples

Other Environmental Samples
Customers wanting to order Survey Validated Samples or Rapid Response PT please provide order information from WSLH PT coordinator in the field below.

Order Total

Order Total
Add price of all checked items

Payment Information

Payment Information


Verification

reCAPTCHA is required.
This step is to verify this form is being completed by a person and not a computer.