For Homeowners & Contractors
CWT Lab Slip
Clean Water Testing Lab Slip
This lab slip is used for real estate transactions, homeowner samples, water service connection samples and all other samples that don't fit in any of the other categories. All samples submitted are considered private information and results will only be released to the party responsible for paying for the sample.
Download

For Contractors

Pump Work Test Request
Lab Slip for Pump Work
Request for a coliform bacteria test and is required any time a well is entered (for instance, pump work on a submersible pump). When using this form, the test results will be submitted to the private drinking water division of the DNR, as required.
Download
 
First Well Sample Test
New Well Lab Slip

This lab slip is not available online but only with a well driller's new well packet. When using this form, the bacteria test results will be submitted to the private drinking water division of the DNR, as required.
First Well Sample Test
Lab Slip for Wells Without a Pump

This lab slip is used for water samples that are collected between the time a well is drilled and the pump is installed.

Download
 
DNR website screenshot
Public Water Supply Lab Slips
Any time a well serves the public, it is considered a public facility. If you are obtaining a sample from a facility with more than 15 service connections, or a facility that serves more than 25 people at least 60 days a year, you should obtain the appropriate lab slip from this website. When using these forms, all water test results will be submitted to the public drinking water division of the DNR, as required. (Results WILL NOT be sent to the private drinking water division.)
Go to website

When submitting your water sample to Clean Water Testing, it will need to have the appropriate lap slip included with it. This ensures your test results are sent to the correct parties. Please print out and complete the correct lab slip from the choices below.

Lab Slips