Data Selection

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Please enter the information below:

Business or Payee Name :
Location Address Sample 1 :
Location Address Sample 2 :
Location Address Sample 3 :
Date of Collection (MM/DD/YY) :
Date of Delivery to PH Lab (MM/DD/YY): :

Select All	Description	Cost Per Test
	WATER MICROBIOLOGY (Reminder: one collection container is needed per test requested)	$0.00
	-	$0.00
	MONDAY-THURSDAY: Presence/Absence (P/A) test for total coliforms & E. coli----------(Drinking Water only)	$37.00
	MONDAY-THURSDAY: Quanti-tray for Total Coliforms & E. coli----------(Drinking Water only)	$48.00
	-	$0.00
	- FRIDAY & THE DAY BEFORE A HOLIDAY CHARGES: FRI/HOL REQUEST	$0.00
	- Choose the following selections if dropping off a sample on a FRIDAY or on the following days	$0.00
	- Nov 27,2024; Dec 23,2024; Dec 30,2024; or Feb 11,2025	$0.00
	FRI/HOL REQUEST: Presence/Absence (P/A) test for Total Coliforms & E. coli (+$20)----------(Drinking Water only)	$57.00
	FRI/HOL REQUEST: Quanti-tray for Total Coliforms & E. coli (+$20)----------(Drinking Water only)	$68.00
	-	$0.00
	MONDAY-THURSDAY ONLY: Quanti-Tray for Total Coliforms & E. coli----------(Recreational & Waste water)	$53.00
	MONDAY-THURSDAY ONLY: Quanti-Tray for Enterococcus----------(Recreational & Waste water)	$53.00
	-	$0.00
	MONDAY-WEDNESDAY ONLY: Heterotrophic Plate Count----------(Drinking Water only)	$33.00
	-	$0.00
	WATER CHEMISTRY (Reminder: one collection container is needed per test requested)	$0.00
	-	$0.00
	TUESDAY ONLY: Nitrate or Nitrite individual test----------(Drinking Water only)	$31.00
	TUESDAY ONLY: Nitrate and Nitrite combined test----------(Drinking Water only)	$62.00
$0.00 Payment Amount:

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