TROJAN UV MAX D4
650694

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Name: ____________________________________________________________

Address:___________________________________________________________

City :_______________________________________ State: _____________ Zip: ______________

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My water is (circle one)    private well        municipal chlorinated      community well

Do you need more information, if so please fill out this online form, or e-mail us or call
_________________________________________________________________________________

Trojan UV™ Model D4, 9 GPM UV System MODEL 650694

 $590.00 Free shipping

Call 973-293-7856 for the cheapest on the web price to order.

Replacement Bulb 602805:
$109.00
Sleeve:  602732 $55.00

 (New Jersey residents add sales tax) 

Payment can be made by Check, VISA or MASTER CARD. 
ALPHA will notify you upon receipt of order and review all of the equipment 
ordered and verification of shipping and handling. 
Please make check payable to: ALPHA WATER SYSTEMS INC

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Card # ___________________________________ 
Exp. Date: ____________
Name on Card:_________________________
Signature: ______________________________________________ 
Date: _____________________

Items Ordered
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Fax this form to us @ 973-293-8056

Mail this form to: 
Alpha Water Systems Inc 
P.O. Box 1210 Montague, N.J. 07827
You can also call, at 973-293-7856 or 
E-Mail us with your order and info.

Worldwide Delivery Always Available!











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