DRINKING WATER SYSTEM FORM

FIRST NAME *
LAST NAME *
PHONE NUMBER *
EMAIL ADDRESS *
CITY *
STATE *
ZIP CODE *

>> PLEASE CHECK WATER SOURCE * CITY
WELL
 
>> PLEASE CHECK TYPE OF SINK * PORCELIN
STAINLESS
OTHER
>> WHAT TYPE OF COUNTERTOP * FORMICA
GRANITE
OTHER
>> DO YOU HAVE A PRE-DRILLED HOLE IN SINK? * YES
NO
 
>> WHAT TYPE OF FLOOR IN YOUR KITCHEN? *
* WOOD FLOORS REQUIRE LEAK PROTECTOR
CEMENT
TILE
WOOD
>> WOULD YOU LIKE TO HOOK UP SYSTEM TO ICE MAKER? * YES
NO
 
>> TYPE OF FAUCET PREFERRED * CHROME (Included)
BRUSH / NICKEL
ANTIQUE
  BRONZE
BLACK
WHITE
>> TYPE OF SYSTEM PREFERRED? * BASIC $29.50/month


PREMIUM $35.50/month

*Includes Leak guard