Water Sample Request

At the Logan County Health District, we offer bacteriological testing of well water. Reasons for testing your well water vary, but may include: you are trying to sell or buy a house that has a well and the bank requires a safe water sample to approve a loan, you are a homecare provider and are required to have a safe water sample once a year, you operate a home bakery, you or a family member have been ill recently and may be questioning the safety of your drinking water, or you may just be interested in the quality of your water. We can test for total coliform and E. coli here in our lab. We typically take our water samples on Tuesdays, and as the health department, we will come to your property to take the sample. A water sample is $40 or $60 for real estate transaction. Please fill out this form below or call 937-651-6202 to be put on our schedule.

Name

First Name

Last Name

Phone

(###)

###

####

Preferred Contact Method:

Please select at least one:

Phone

Property Address

Where the water sample will be taken:

Property Township

Preferred Date and Time

Please list a Tuesday and your preferred time.

Other Water Samples

Do you need any other water samples taken at this time (ie: nitrate, lead)? Prices may vary:

Do you need a septic inspection at this time?

Your tank will need to be pumped 1-2 days before the inspection (additional fees will be required):

Yes

How would you like to pay:

Receive a call to pre-pay for your sample (by card)

Pay for your sample at appointment (cash or check)