Order Bottles

Company Name

Contact (required)

Phone (required)

Email (required)

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Shipping Address

Street Address (required)

Street Address Line 2

City (required)

Province / State (required)
AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundlandNova ScotiaNunavutNorthwest TerritoriesOntarioPrince Edward IslandQuebecSaskatchewanYukonAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConneticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming
Postal / Zip Code

Country (required)
CanadaUnited States

Date Requested (required)

# of Sampling Sites

Bottles per sampling site:

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HDPE Bottles

x 1 Litre Plastic HDPE

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PET Bottles

x 1 Litre Plastic PET

x 500 mL Plastic PET

x 250 mL Plastic PET

x 125 mL Plastic PET

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Amber Glass Bottles

x 1 Litre Amber Glass

x 250 mL Amber Glass

x 125 mL Amber Glass

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Other Bottles

x Bacteria Bottle

x 1 Litre Clear Glass

x Septum Vials (Drinking Water)

x Septum Vials (Wastewater)

x Soil Jar(s)

x Mercury Bottle