Confirmation
*
According to the inventory map, I have confirmed my home is unlikely to have lead service line. But I am interested in receiving the test.
Contact information
Name
*
First Name
Last Name
Phone
*
Please enter a valid phone number.
Email
*
Confirmation Email
example@example.com
Property information
Address where sample will be taken (must be within Denver Water’s
service area
).
Street Address
*
Unit/Apartment # (if applicable)
City
*
ZIP Code
*
Property type
*
Single-family (house)
Multi-unit (apartment, duplex, etc.)
Homeowners association or apartment name (if applicable)
Has Denver Water replaced all or part of the home's service line?
*
Yes
No
I don't know
Year when property built.
*
If you are unsure, type "I don't know". Homes built before 1951 are more likely to have lead service lines.
Does the home's service line contain lead?
*
Yes
No
I don't know
Have there been any recent plumbing upgrades?
*
Yes
No
I don't know
Because you answered yes, please provide description and when it occurred.
*
Do you use any devices that filter your water?
*
Yes
No
Because you answered yes, please provide description.
*
Select the faucet location where samples will be taken.
*
Kitchen
Bathroom
Select the floor level where sample will be taken.
*
Basement
Main level
Upper level
Infant information
Are you expecting, or have a formula-fed infant under the age of 24 months?
*
Yes
No
Please verify that you are human
*
Submit
Should be Empty: