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Toxxscan (Sharp data for clean water solutions)
This is an inquiry form created by Envirohealthmatters for Green Water team, to collect data for clean drinking water solutions
greger test *
Personal info
Email address *
What are contaminents in the water ?
What is the source of the water ?
What is the current way of treating the water ? *
How much water do you need to treat in a day ?
Are you aware of any water borne disease, that are occuring to those who are drinking this water today ?
Which contaminents are you most worried about ?
Do you have access to grid energy ?
Location of problem *
Attach water analysis *
Required
Do you have access to a goverment approved lab, which can carry out water test ?
Priority *
Very high
Very low
Due date
MM
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DD
/
YYYY
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