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Individualized Water Equipment Form

Although all of our water softening systems are advanced and engineered to provide you with the cleanest, purest water you’ve ever experienced, every home or office has different needs for their equipment.  This form will help us to help you in designing a custom system to meet your water needs in a more thorough, satisfactory way than you ever thought possible.

**When taking samples for water testing, please be sure to secure them in the evening rather than the morning (especially in those tests which require an overnight test of the sample).  Water that has sat overnight in the plumbing lines or well casing may test to an inaccurate level of dissolved substances due to the material of those structures, and we would like to be exact in our evaluation of your needs.**

***Overnight tests should last for at least 12 hours and exceed no more than 18 hours.***

1. How many people are living in the building on a day-to-day basis?
2. How many full bathrooms are in the home?
3. What is the hardness level of raw, non-filtered water?
4. What unit of measurement applies to the hardness value? GPG (Grains Per Gallon)
Parts Per Million
Milligrams Per Liter
5. What is the iron level of your raw, non-filtered water?
6. What unit of measurement applies to the iron value? Parts Per Million
Milligrams Per Liter
7. What is the pH level of your raw, non-filtered water?
8. What is your flow rate in gallons per minute (GPM)?
(See instructions below)

How to Check Your Flow Rate

If you get your water from a private supply (like a tank located under your house), you should check the flow rate at the well pressure tank.  You should use whichever of your faucets you find will flow the fastest, or with the most pressure.
A faucet may have been installed directly by the pressure tank, and if so you can use this.(If there isn’t one, don’t worry; you can perform this test by turning on the hot and cold water faucets at a bathtub to a full, open flow.  Be sure to let it run with the drain open so you don’t flood the house.)  Turn the faucet on to its maximum flow until the well pump starts to run.  
Once the pump kicks on and is running smoothly, put a 5 gallon bucket under the faucet and time it (preferably with a satellite-controlled stopwatch, such as those found on cellular phones) to see how many seconds it takes to fill the bucket to the top or 5-gallon line.  

If your water comes from a public supply (such as a city-wide well), you should check the flow rate at the fastest flowing faucet in the home, such as at a bathtub.
You should perform this test the same way as above; turn on the hot and cold water faucets to their maximum flow. Then place a 5 gallon bucket under the faucet and time it with a stopwatch to see how many seconds it takes to fill the bucket to the top.

60 seconds = 5 GPM.....45 seconds = 7.5 GPM.....30 seconds = 10 GPM

9. Does your unfiltered water have any coloring when first drawn? YES
NO
10. Does the raw water have any odor? YES
NO
11. Is the unfiltered water clear when first drawn? YES
NO
12. If the water is clear when first drawn, does it gain color after being left in the open (such as on a kitchen counter in a normal drinking glass) overnight? YES
NO
13. If there is an odor in the water when first drawn, is it gone after being left out overnight? YES
NO
14. Is there any substance (gritty, sand-like sediment or a more ‘muddy’ discharge, or even a tea-leaf-like residue) gathered in the container of unfiltered water after being left out overnight? YES
NO
15. Is there any slimy buildup at the water line inside your toilet tank? YES
NO
16. Do you have iron stains (dark or rusty-looking discoloration)  on your plumbing fixtures? YES
NO
17. What is the height of the water line after the well pressure tank or public water supply?
18. If you are on a private water supply, do you have a submersible pump (a pump located in the wall) or a jet pump (pump that is visible aboveground)? Submersible Pump
Jet Pump
19. Comments. Please add any additional comments, questions, or information you think may be necessary or applicable to help us determine the qualities of your water supply's needs.
Please enter a telephone number where we can reach you between the hours of 10:00 am and 7:00 pm on weekdays:
Please enter an email address that we may respond to. An accurate, up-to-date email address is necessary for us to be able to send you a response to this form.  Please check your inbox at least 48 hours after your initial submission of this form. (required)
Thank you for choosing Liberty Pure Solutions, Inc.!