Name Required First Required Last Required Phone Required Email Required Testing Location Address Required (If known) Testing Location Zip Code Required Testing Location Latitude Required Testing Location Longitude Required Sampled Water Type Required - Select - Surface Well What was the surface water type? What was the surface water type? - Select - Stream River Pond Lake Other… Enter other… If known, what was the estimated well depth in feet? Sampling Date Required Nitrite Reading Required - Select - 0 mg/L 0.15 mg/L 0.3 mg/L 1 mg/L 1.5 mg/L 3 mg/L (Closest to your hand on the test strip with two color pads). Nitrate Reading Required - Select - 0 mg/L 1 mg/L 2 mg/L 5 mg/L 10 mg/L 20 mg/L 50 mg/L Phosphate Reading - None - 0 mg/L 5 mg/L 15 mg/L 30 mg/L 50 mg/L (Test strip with a single color-pad). Additional comments or observations How did you learn about this project? Required How did you learn about this project? Required - Select - Social Media Word of Wouth Community Event Water Quality and Health Activity Book Other… Enter other… If you learned about this project at an event, what was the name and location of the event? (If known) Leave this field blank