C
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W
C
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W
Name:_____________________________________________
Address: ___________________________________________
City: _____________ State: ____________ Zip Code: ______
Phone#: ________________ Fax# ______________________
1. Grains if Known.
2. ppm's if Known.
3. Do you have iron present in
your water?
4. Had you installed an Iron filter
prior to purchasing the
ClearWave™?
5. Where did you purchase the
ClearWave™ from?
6. Date purchased.
7. Mfg. date code.
Hardness
Level Check
One
Light:
1-3 grains
17-51 ppm
Moderate:
4-6 grains
52-102 ppm
Hard:
7-10 grains
103-170
ppm
Very Hard:
10 grains &
above
170 ppm &
above
a
v
e
™ Warranty Registration
a
v
e
™
YES
If Yes, circle one
NO
YES
ppm's if Known
NO
Briefly describe any current water
problems; scale build up, odor, taste,
staining, etc...____________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
Page 7
Light
Moderate
Heavy
Very Heavy
(ppm-Parts Per Million)
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