If you have any questions, please contact Randy Ruszkowski at (330) 493-9904, extension 2028, or via email at
Water Well Test Request Form
Step 1: Save this PDF fillable form on your device.
Step 2: Please complete the following information:
Step 3: Please select the type of test(s) you are requesting below.
If a lending institution is requiring a water test, verify what test(s) are being required. Please note that
each lending institution and loan is different.
(Total Coliform and E Coli)
PROPERTY TRANSFER WELL EVALUATION
(Total Coliform/E Coli, flow yield, well inspection,
and final water well evaluation by the Stark County
RE-SAMPLE PROPERTY TRANSFER WELL
LEAD - STANDARD $13.00 14-21
LEAD - RUSH* $26.00 7-14
NITRATES/NITRITES - STANDARD $32.00 14-21
NITRATES/NITRITES - RUSH* $64.00 7-14
*Rush results are only available for lead and nitrate/nitrite tests.
Step 4: Submit completed form to email@example.com.
Our clerical staff will email you the invoice and a link to make payment online. Once payment is made
our field staff will contact you to schedule an inspection time.