Submit Water Quality Data Form

Date (MM/DD/YY) e.g. 07/09/99

School Name (Please add your name in parentheses after the school name) Example: Howard High School (A. Cleveland)

City

State
DE
NC

Zip Code

Name of the body of water to be tested

Location of the body of water

Latitude:        Longtitude:

Appearance of water sample:

Odor of water sample:

Temperature of water sample (Celsius):

pH:

Dissolved Oxygen (ppm):

Nitrates (ppm) (This number should be recorded and submitted before it is multiplied by 4.4):

Phosphates (ppm):

Predominant Macroinvertebrate:

Overall Water Quality:

Local Land Use:

Land Use Upstream: