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WEBSITE OF THE STATE OF SOUTH DAKOTA DEPARTMENT OF HEALTH
Kim Malsam-Rysdon, Interim Secretary of Health

Sample Bottle Order Form

(testing private wells)

To request sample bottles for testing of water supplies, please complete and submit the following form, indicating the quantity of bottles needed for each test specified. Bottles include complete instructions for collecting and submitting water samples for testing. Fee information for the various tests is included. Questions can be directed to the Lab's mailroom at 605-773-3368. Sample bottles and instructions are also available from County Extension offices.

 

Shipping Information

Name
Street Address
Mailing Address
City
State
Zip Code
Work Phone Number
E-mail address



 
 
Quantity of Sample Bottles requested
Bacteria/Nitrate
Lead
New Well
Other (specify test type)
 
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