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Dealer Name: _________________________________________________
Dealer Address: _______________________________________________
Web Address: ________________________________________________
E-mail Address: _______________________________________________
Dealer Phone: ________________________________________________
Salesperson’s Name: ___________________________________________
Model Number: _______________________________________________
Date Installed: ________________________________________________
Number of People in Household: _________________________________
Meter Disk Number: ___________________________________________
Hardness: ________________ gpg
Ferrous Iron: _____________ppm Ferric Iron: _____________ppm
pH: _________________________ TDS: __________________ppm
Hydrogen Sulfide: ________ ppm
Temperature: ________________ Pressure: ___________________
Notes
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