LCR Sampling Screening Form

If you are interested in participating in the 2025 Lead and Copper Rule (LCR) Sampling Program, please complete the form below.

After completing the screener, the Philadelphia Water Department (PWD) will review your information and contact you regarding your eligibility for participating. Completing the screener does not guarantee inclusion in the program. However, PWD also provides free lead and copper testing for customers, outside of the LCR Sampling program.

If you are selected, and successfully complete the requirements of the program, we will provide a $100 credit to a subsequent water/sewer/stormwater bill for your property.

Email for non-humans

Do you live in a single-family residence? *

• Yes
• No

Do you rent or own this property? *

• Rent
• Own

What type of home do you live in? *

Choose one:

• Single (Detached) House
• Twin House
• Row/Townhouse
• Apartment

Do you know when your house was built? *

• Before 1950
• After 1950
• Do not know

Please confirm your service line material where it enters your home.

If you received a letter or email from us directing you to this form, our records indicate the portion of your service line that enters your home contains lead. For this sampling program, only homes where we can confirm the presence of lead in the service line are eligible. If you have checked your service line material or had it replaced, and believe it is not lead, please select the correct material below.

• Lead
• Galvanized Iron/Steel
• Non-Lead (Copper or Plastic)
• Unknown

During the past 3 years, have you installed any new plumbing or fixtures or made plumbing repairs? *

• Yes
• No

Please explain: *

Do you have any plumbing leaks at your house? *

Consider leaking pipes, toilets, faucets, shower heads, water valves, outside hose bibs or outdoor faucets, or other leaks at your house.

• Yes
• No

If yes, can the leak be isolated? *

• Yes
• No

What type of kitchen faucet do you have? *

Choose all that apply:

• Single lever
• Separate hot and cold knobs
• Pull-out/Pull-down faucet

Do you use any water treatment/filtration systems or devices in your house? *

• Yes
• No

If yes, please check if you have: *

• Water softener
• Whole-house filter
• Filter at the kitchen tap
• Other

What other home treatment systems/devices do you have? *

Can the filter/treatment system be bypassed?

• Yes
• No
• I'm not sure

Has the water main on your street or the service line connecting the water main to your house been replaced in the last three years? *

• Main
• Service Line
• Both
• Neither

How did you hear about this Screening Form? *

• Letter/Email from PWD
• Other

Please tell us about how you got here: *

Please provide your contact information:

Name *

Home Address *

Zip Code *

Phone Number *

Alternate Phone Number (optional)

Email Address (optional)

Best time to contact you:

We can not guarantee that we will contact you during a specific window, but we will try to consider your preference when reaching out.

Submit

Call 215-685-1406 or send an email to waterquality@phila.gov if you have any questions.