Well Water Testing

Well Water Testing Request Form

To order your NJ well water test online, please fill out the following form:

Note: A PWTA well test is required for Real Estate Transactions in NJ. (To order a PWTA test for an existing well, please select Buy House, Sell House, or Rental when prompted below for the purpose of the test). The standard PWTA test includes analysis for: Coliform, Nitrate, Arsenic, Iron, Manganese, Lead, pH, Gross Alpha Radiation and 26 Volatile Organic Chemicals. Where required by County, the PWTA test may also include: Mercury or Uranium. Some Municipalities require additional parameters, which are included in the pricing shown below. Please do not use this form to order well testing for FHA or VA loans, as the Standard PWTA test may NOT meet your lenders requirements, please call our office at 973-927-7303 to discuss testing for FHA or VA loans.

If the home is not involved in a real estate transaction, but you are interested in well water quality testing, you can use this form to order a similar test that includes the same analysis parameters but does not include PWTA State Reporting and GPS positioning. Choose “Water Quality Only” when prompted below for the purpose of the test.

The Standard Turnaround Time is 6 business days. If you need a faster turnaround time please call the office at 877-723-6600 for a price quote, subject to availability. You cannot order a rush sample online.

Please note: we will make every attempt to accommodate your first or second preferred scheduled date; in some instances we may not be able to accommodate your requested dates based on volume or other factors outside of our control. You will be contacted to choose the next available date if we cannot accommodate your preferred dates.

Municipality / County*

Price

What is the purpose of the test?* Sell House (PWTA)
Buy House (PWTA)
Rental (PWTA)
Water Quality Only (will NOT be accepted for real estate transactions)

First Name*

Last Name*

Billing Street Address*

City*

State*

Zip Code*

Phone Number*

Alternate Phone number

Email Address*

Email Address Confirmation*

Estimated closing date, if selling

Does the house have water treatment equipment?* Yes No unknown

What type of water treatment? Cartridge filter
Water softener
Neutralizer/Calcite filter
Chlorinator
Arsenic System (Granular Ferric Oxide)
Reverse Osmosis
UV Light (Ultraviolet Disinfection)
Unknown
Other

Type the water treatment*

I acknowledge that the water sample must be able to be collected prior to any treatment devices. The RAdata technician will not be able to alter my water treatment in any way. If this house has water treatment, I will be on site for the water collection and I can bypass the treatment myself. If while the RAdata technician is on site, the water treatment system cannot be bypassed (or there is no bypass on the system) and the sample cannot be collected according to NJ DEP protocols, an $85.00 travel charge will be assessed and I authorize this potential additional charge in addition to the price of the testing.*

Approximate year home was built*

Was the well drilled less than two years ago?* Yes No

NJ Well Permit # Yes No

NJ Well Driller Name (licensed person/company)

Well Drilling Date

Is Test Location Address same as Customer Address?* Yes No

Test Location Street Address*

Test Location City*

Test Location State*

Test Location Zip Code*

Municipal Block Number

Municipal Lot Number

Contact Person Name

Contact Person Phone Number

Please choose the first preferred date/time that you would like this water sample taken*

Please choose the second preferred date/time that you would like this water sample taken*

I certify that this well has not been disinfected with chlorine or other disinfectant/if it has, I have run all of the chlorine out until no smell is detected. If my water tests positive for chlorine upon arrival, I understand that a sample cannot be collected and I will be charged a trip fee for this visit. If chlorine is detected in my water when the technician arrives to sample the water, I authorize this additional $85.00 charge in addition to the price of the testing.*

I certify that this house has running water (it is not currently winterized) and the plumbing is not disconnected, missing, or otherwise compromised in such a way that would prevent sampling the water according to the NJ State guidelines.*

I certify that this house has electrical power turned on. (Power is required for a well pump to pump water for sampling.)*

I acknowledge that this is my notification that if the house is vacant, that I have been advised to run the water for approximately 2-4 hours at a rate of approximately 1 gallon per minute (best practice is to hook up a hose to an outside spigot to prevent all of this water from going into the septic. Call 877-723-6600 if questions). This running of the water should be completed 1 day prior to the sampling event. This will ensure that the water being sampled is fresh water that comes from the well and is not surface water or water that has been sitting in the holding tank or plumbing system.*

I acknowledge that if any of the information provided on this form is incorrect or incomplete, or the fixtures, bypass(es), and/or equipment at the sampling site is inoperable, a trip charge of $85.00 will be assessed and payable at the time of the visit for any water sample that cannot be collected.*

TERMS AND CONDITIONS OF SALE

By placing your order for a PWTA well test online you agree to the following terms and conditions of sale:

You MAY NOT schedule a well test online for a home that you do not own (unless you are a realtor representing the home owner in a real estate transaction or have a Power of Attorney for the home owner). If you do not own the home, please call our office at 877-723-6600.

You are placing an order for a well test and a making a request to schedule an appointment for the test. While we will make every attempt to accommodate your first or second preferred scheduled date; in some instances we may not be able to accommodate your requested dates based on volume or other factors outside of our control. You will be contacted to choose the next available date if we cannot accommodate your preferred dates. .

The price is for a PWTA sample on an existing residential well only. New well testing and Commercial testing includes more parameters and can NOT be ordered online, call 877-723-6600 for pricing.

The price is for the standard turnaround time (STAT) of 6 business days. If you need a faster turnaround time please call the office at 877-723-6600 for a price quote, subject to availability. You cannot order a rush sample online.

If you order an INCORRECT sample and there is an amount due or a refund amount, you will be charged or refunded the appropriate difference. (i.e. if you do not choose your correct municipality).

Each PWTA sample includes the State mandated collection of your raw (untreated) water and if applicable, the collection of one bottle of treated water (analysis for up to 3 post treatment parameters) taken AT TIME OF INITIAL VISIT, if the home has existing water treatment at the time of sampling. If you request return visit(s) to resample your water or to re-draw this treated water sample this will require an additional fee. Due to hold times for Gross Alpha radiation, Gross Alpha is not included in these retesting parameters.

I agree to the Terms and Conditions.*

You will receive a confirmation email or phone call when your test has been confirmed. If we issue a confirmation and you are a no show for your testing appointment or if the sample cannot be collected after the technician is dispatched for circumstances outside of RAdata’s control, you will need to reschedule and will be charged an $85.00 trip fee for the missed visit. By submitting this form, you authorize any applicable $85.00 trip charge(s) in addition to the price of the testing.

There will be a non-refundable fee of $50.00 for orders cancelled by the customer after placing the order. By submitting this form, you agree that you authorize a $50.00 cancellation fee if you decide that you no longer want the testing.

Thank you for submitting your request for a Well Test online with RAdata. Someone will contact you shortly by email or telephone to confirm that your desired appointment is available. In the mean time, if you have any questions, feel free to call us at 877-723-6600 during our business hours of 8AM-5PM EST, Monday through Friday (excluding Holidays).

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