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Please provide us with your contact information and we will get back to you soon or download the form, fill it out and email or fax it to us.

Download the Tarn-Pure Data Form

Your Name (required)

Address

City

State

Zip Code

Country

Phone Number

Fax Number

Your Email (required)

Tarn-Pure™ Facility Data Form:

Are you with a Facility, Engineering Firm, or Contractor?

Description of Building (e.g. Hospital, Nursing Home, office building, apartment, condominium, vegetable washing, car wash, etc.):

Description of Application (e.g. hot water or cold water for potable or non-potable water):

Cold Water Usage: (per day, month, or year)

Hot water usage: (per day, month, or year)

Plumbing Material:

Age of Plumbing System:

Water Temperature & Pressure:

Hot Water Tank or Instantaneous:

Number of Floors:

Number of Patients:

Water Conductivity:

Copper Level:

pH Level:

Water Hardness:

Water Hardness:

Kitchen:

Laundry:

Note: If you cannot determine the conductivity, background copper level or water hardness you can send us a water sample and we will perform a free water quality analysis for you.