First Name (required):

Last Name (required):

Phone (required):

Email:

Address:

City:

State:

Zip Code:

Name and Location of Lake/Pond:

Water Problem

Please describe type of weed and algae growth:

Water Uses:  Swimming Boating Fishing Water Supply

Other:

Fish Varieties:

Characteristics of Lake/Pond:

Water Temperature (approximately in Fahrenheit):

Hardness:

Prior Treatment

Chemicals Used:

Type:

Frequency of Application:

Quantities Used:

Pond Size

Length of Lake/Pond:

Width of Lake/Pond:

Depth Max:

Depth Average: