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2. SC Adopt-a-Stream Test Kit Reporting Form

   Hi SC Adopt-a-Stream Volunteer!  Please report any issues with the Town of Fort Mill Stormwater Department test kits (Freshwater) here!

4. Volunteer First Name*
5. Volunteer Last Name*
7. Phone Number
8. Email Address
12. Which Kit are you reporting on?*
    -- Select One --Kit AKit B
14. Check which item needs a refill/reorder*

    1. Dissolved Oxygen Kit (full reorder)
    2. pH Water Test Kit (full reorder)
    3. Petrifilm
    4. Gloves
    5. Manganous Sulfate Solution
    6. Alkaline Potassium Iodide-Azide
    7. Sulfuric Acid
    8. Sodium Thiosulfate
    9. Starch indicator
    10. pH Wide range indicator
    11. Whirl-pak bags
    12. None of the above
16. Tell us more!

    Let us know more about what needs to be reordered

18. Other Item(s) need attention

    If another aspect of the kit needs attention, please let us know!

    1. Backpack
    2. Cooler bag
    3. Glass test tube
    4. Ice pack
    5. Incubator digital max/min thermometer
    6. Kit container
    7. Pipet
    8. Pipette tips
    9. Sample bottle
    10. Sharpie/Dry erase markers/Pens
    11. Still-air incubator
    12. Thermometer
    13. Titrator
    14. Waste bottle
    15. Wash bottle
    16. Other
20. Tell us more!

    Explain more about what item needs repair/replacement 

21. Photo upload

    If you would like to include a photo of the kit issue, attach it here.

23. Other Information

    If you have any other suggestions or supply requests, feel free to add it here!

25. Thank you for helping keep our SC Adopt-a-Stream kits in good shape!
Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field