Private Water Testing Request

Please complete all required fields and include well details if possible.

Fees are payable - view fees and charges.

We collect personal information in this form including your:

- name
- contact information
- location
- water quality test results

We collect your personal information in order to:

- fulfil your request to sample and test your drinking water; and
- conduct testing in accordance with the Drinking Water Standards (DWSNZ) established under the Health Act 1956

Besides our staff, we share this information with:

- other WDC departments in order to monitor trends in water quality within the aquifers supplying the Waimakariri District

You have the right to ask for a copy of any personal information we hold about you, and to ask for it to be corrected if you think it is wrong. If you’d like to ask for a copy of your information, or to have it corrected, please contact us at, or 0800 965 468, or Private Bag 1005, Rangiora 7440.

By submitting this form, you affirm your acknowledgement of your privacy rights. If you do not agree with the WDC retaining your water quality information, please contact alternative water testing services to perform your water testing.


Contact and Test Details:

First name and last name
Enter your address
Address continued
Address continued
(Test results will be emailed)
Select from drop-down options
Select from drop-down options
Well Details (if possible)
Is there an installed and designated "sample point" existing at the well head/pump shed?
Any extra information can be entered below