Date*

Person or Agent Ordering Test*

Phone*

Email*

Street Address of Well Property *

City of Well Property*

State of Well Property*

Zip Code of Well Property*

APN (County)*

Nevada

Yuba

Placer

Well Description*

With Pump and Power

No Power and Pump

With Pump No Power

Person(s) paying for test: *

Mailing Street Address*

Mailing Address City*

Mailing Address State *

Mailing Address Zip Code*

Phone*

Email*

Additional Chemical sample(s) requested - (Real Estate transactions require ecoli and coliform testing only)*

Special directions to the property, gate code and well location*

Property is*

Vacant

Occupied

Reason for test*

Real Estate Transaction

Building Permit

Personal Information

By submitting this form and signing up for texts, you agree to receive informational messages (appointment reminders, account notifications, etc.) from Peters Drilling at the number provided. Msg & data rates may apply. Msg frequency varies. Unsubscribe at any time by replying STOP, and no further messages will be sent. Reply HELP for help or email us at info@petersdrilling.com. Privacy Policy: https://www.petersdrilling.com/privacy.

Note: All information is required to schedule a well test. Placer county well tests are 4 hours long and appointments will be scheduled at 8 a.m. *Well test package includes yield and potability (bacteria) sample. **Counties outside Nevada County may incur additional costs.

Well Test
Intake Form

Peters' Drilling & Pump Service is a family-owned business with a large, full-time staff. We recognize the seriousness of being out of water and are committed to dealing with your emergency in a fast efficient manner.

Well Test Intake Form

Well TestIntake Form

Peters' Drilling & Pump Service is a family-owned business with a large, full-time staff. We recognize the seriousness of being out of water and are committed to dealing with your emergency in a fast efficient manner.

Well Test Intake Form

Well Test
Intake Form