Customer Order Form


Thank you for choosing Pure Water Connection. Please complete the customer information section and select which products you are interested in. Once you have completed the order form, one of our customer representatives will get in touch with you to provide an estimate and complete your order.

Customer Information

To reorder water click the banner above.

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I am a current customer
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2 Stage - Sediment/Carbon Filter System
Use: Residential Commercial
Dispensing Method: Water Cooler Faucet at Sink Faucet at Sink with under counter water chiller
I am interested in: Purchase Rental

pH Balance 4 Stage Reverse Osmosis System
Use: Residential Commercial
Dispensing Method: Water Cooler Faucet at Sink Faucet at Sink with under counter water chiller
I am interested in: Purchase Rental

5 Stage - PureValue Reverse Osmosis System
Use: Residential Commercial
Dispensing Method: Water Cooler Faucet at Sink Faucet at Sink with under counter water chiller
I am interested in: Purchase Rental


Iceberg Undersink Water Cooler (Room Temp. and Cold Model)
I am interested in: Purchase Rental

Assorted Filters
We carry the most popular types of replacement filters for residential, commercial and industrial systems. Replacement filters available for the following: in-line gac, sediment, carbon block, gac, reverse osmosis membranes, mineral boosters and ph boosters. A wide array of sizes for the smaller residential system to a commercial system big blue style housing.
Please indicate the type /size and quantity you are interested
Water Softeners
I am interested in: Purchase

Multi Media Filters
I am interested in: Purchase

Distillation
I am interested in: Purchase

Activated Carbon Filtration
I am interested in: Purchase

Ultraviolet Lights
I am interested in: Purchase

Miscellaneous Accessories
We carry a variety of miscellaneous accessories for our water conditioning systems. (ex. Iron out, Res Up, Hydrogen Peroxide, Activated Carbon, Liquid Chlorine, Pellet Chlorine)
Please indicate the type /size and quantity of filters you are interested
Reverse Osmosis
Use: Residential Commercial
# of People: 0-10 11-30 31-50 more than 50
Are you currently using bottled water? Yes
If yes how many bottles are you using per month?
0-10 11-20 21-30 31-40 more than 40
BPA Free: Yes
I am interested in: 18.9L 11.35L

Steam Distilled
Use: Residential Commercial
# of People: 0-10 11-30 31-50 more than 50
Are you currently using bottled water? Yes
If yes how many bottles are you using per month?
0-10 11-20 21-30 31-40 more than 40
BPA Free: Yes
I am interested in: 18.9L 11.35L

Monashee Spring Water
Use: Residential Commercial
# of People: 0-10 11-30 31-50 more than 50
Are you currently using bottled water? Yes
If yes how many bottles are you using per month?
0-10 11-20 21-30 31-40 more than 40
BPA Free: Yes (only available in 18.9L )
I am interested in: 18.9L 11.35L 4L 500ml
Avalanche Crystal Mountain Coolers
Model: Hot & Cold – $353.70
I am interested in: Purchase Rental

Glacier Crystal Mountain Coolers
Use: Residential Commercial
Model: Room Temp. and Cold – $341.55 Hot & Cold – $378.00
Colour: White Black
I am interested in: Purchase Rental


Aspen
Model: Room Temp. & Cold – $295.65 Hot & Cold – $324.00

Nordic Stainless Cabinet
Model: Hot & Cold – $384.75
H2OK Cleaning Kit – $15.00

Hand Pump – $30.25

Stainless Steel Bottle Cradle – $23.80

Crown Neck Valve - $23.80

Aqua-Stakka – $14.75

Bottle Buddy
$38.50 ea.

Dry guard – $42.00

Battery Powered Pump – $37.00
All Prices are Subject to Change without notice.
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Bottled Water
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Edmonton Delivery
& Pick Up Locations
Edmonton & Area
Delivery Schedules
Pick Up Locations
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Order Form
Pure Water Connection
10739 – 180 Street, Edmonton, AB T5S 1G6
P: (780) 413-6547 F: (780) 413-6501
E: accounts@purewaterconnection.ca
Hours
Mon, Tues, Wed, Fri: 9AM – 5PM
Thurs: 9AM – 6:30PM
Weekends: Closed
* Closed Holiday Weekends