Request Service Service Request Step 1 of 3 33% Service Request FormPlease complete the form below to allow us to provide the best service possible. Ordered By* First Last Phone*Email* Address of Testing Site* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Is the well pump operational?*Testing cannot be completed unless there is a working pump in the well and the pump is operational. Please call 208-573-6261 if there is no pump in the well. Yes No I don't know Is the well pump power turned on?*Power to the well pump must be on to complete the test process. IF POWER IS NOT AVAILABLE, A PORTABLE GENERATOR SERVICE IS AVAILABLE AT AN ADDITIONAL COST. Yes No I don't know Generator Services*If the well power is not available Price: Approximate location of the well:* Is this a shared well?To get accurate results, water should not be used while the test is underway. Sprinkler systems need to be off, and any other devices that use a large amount of water. Don't fill the hot tub, etc. Restroom use is ok during the test period. Yes No Has permission to test the well been received from the owner of each home that is connected to the system? Water service may be disrupted during the test. All consumers of water from the system must be made aware of that possibility. There may also be a temporary change in the color of the water. Yes No Is there a water filtration system currently in use?*If yes, filtrations systems can reduce pressure and flow, especially if not properly maintained. Yes No Is there a cistern or water tank as part of this water system?*Cisterns or storage tanks can skew test results. Yes No Please provide details about the cistern or storage tankIs the property occupied?* Yes No Have the occupants been notified of the pending test?*Drake Diversified strives to minimize inconvenience to all parties (owners and renters). Yes No Please provide the occupant's phone number*Is there a contract or contigency inspection deadline that needs to be met?*Drake Diversified works to provide fast and professional service. Well productivity testing service is usually available within 7 days after receiving a service request. Test results and lab test results are typically available within 3-5 business days after the date of collection. Customers can expect delivery of the well productivity test and any requested samples 6-8 business days after the date of testing. EXPEDITED SERVICE IS AVAILABLE FOR AN ADDITIONAL COST. Please call for details 208-573-6261. Yes No Please note the contract or contingency inspection deadline:* MM slash DD slash YYYY Additional Comments/Information Services RequestedPlease select all services requested. Well productivity Test and InspectionIncludes a written report detailing GPM, pressures, PH and temperature taken at 10-minute intervals over a one-hour period. Also includes an inspection of the well cap, conduit, casing, pictures, and the well driller's report (if available). 1 Hour Well Productivity Test & Inspection Health related testing for EPA primary contaminantsV.A. Loan Testing requires Coliform/Ecoli, Nitrate, Nitrite, and Arsenic testing. For Radon Testing, call 208-573-6261 (requires extended lead times). Total Coliform/Ecoli (select this option for "potability" testing) Nitrate Nitrite Lead Arsenic Uranium Aesthetic Related testing for EPA secondary contaminants Iron Iron Bacteria Manganese Expedited Service Requested*If your real estate closing time is less than seven days from today, or if you need immediate service, please select YES below and call for additional details at 208-573-6261. Yes No Courier FeeWe use a courier to deliver all samples to the lab since samples are time and temperature sensitive. Price: Estimated Trip Charge*Select LocationTrip Charge - McCall/DonnellyTrip Charge - Surrounding AreasTrip Charge - New Meadows / CascadeTrip Charge - Other Locations (Call for Exact Quote)Estimated Services Total $0.00 No payment is due at this time. Well productivity, inspection. lab results, and an invoice will be emailed as soon as possible after lab test results are received by our office. Guarantee of Payment*I guarantee payment for services rendered and testing fees. UNLESS PRIOR ARRANGEMENTS HAVE BEEN MADE, PAYMENT IS DUE UPON RECEIPT OF THE REPORT. A LATE FEE OF $35 WILL BE APPLIED TO ANY INVOICES UNPAID PAST 30 DAYS FROM DELIVERY OF THE REPORT. I Agree After hitting "Submit" you should receive a success message - if not, please scroll back up and complete the missing required fields!
