Request a Sample - LSZ, Inc.

Sample Request

I intend to use the LEDIZOLV sample for:

Items in red are required.

Personal Use:

In my home

In a friend/family member home

Other:

Professional Use (categorized by activity):

Contractor:

Certified Lead Contractor

Paint Contractor

Construction Contractor

Maintenance Contractor

Other:

Government Agency:

Health Department

Environmental Protection

Housing Agency

Child Welfare

Other:

Real Estate:

Manager

Owner

Maintenance

Other:

Lead Related Industrial Manufacturing:

Batteries

Solder

Weights

Other:

Education:

School Official

Board of Education

Building Maintenance

Other:

Gun Range:

Private

Military

Police

Other:

Healthcare Provider:

Doctor

Nurse

Other:

Daycare:

Manager/Owner

Maintenance

Other:

Military:

Building Maintenance

Healthcare

Other:

None of the above. My activity is:

My ultimate intended use for the LEDIZOLV is:

Ongoing maintenance cleaning

Cleanup during and after a construction job where lead dust may have been created

Cleanup during and after a lead abatement job

Other:

I intend to use the LEDIZOLV by the following method:

Wipe on/wipe off

Hand spray on/wipe off

Mop on/mop off

Other:

Size of area that I would like to clean with the test sample:

Please send the sample to:

Name:

Title:

Company:

Address 1:

Address 2:

City:

Region/Province/State:

Postal Code/Zip Code:

Country:

Phone:

Fax:

E-mail:

Web: