Name: ____________________________________________________________
Address:___________________________________________________________
City :_______________________________________
State: _____________ Zip: ______________
Phone # (
) (
)
E-mail Address:
______________________________
My water is (circle
one) private well
municipal chlorinated community well
If you know your
water readings enter here: Iron(Fe) _______ppm Hardness(CaCo3)__________gpg
Have you ever
sent us a water sample: (circle one)
yes
no
Do you need more
information, if so please fill out our
online form
, or e-mail us
or call
________________________________________________________________________________
ROS-36
36 Gallon Per Day Reverse Omosis Unit.
$450 +$48.00 S&H(USA) =$559.00
Replacement Filters:
Prefilter (ROSPRE)
Pre $6.95 each. Change once a year
Post filter (ROSPOST)
Post $19.95 each. Change every 2-3 years
AICRO (TOP FILTER)
$19.95 Change every 4
years.
Membrane TFC
$99.00 Change every 4-8 years
Plus S&H
(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
Credit card type:
__________________
Card # ___________________________________
Exp. Date: ____________
Name on Card:_________________________
Signature: ______________________________________________
Date: _____________________
Items Ordered
__________________________
____________________________
____________________________
____________________________
____________________________
____________________________
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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