Name *

First Name

Last Name

My washing machine is connected to

Municipal Waste Water Treatment

Septic Tank

My washing machine is a

Top load

Front load

I wash my clothes with

Hot water

Cold water

I am using a *

Lint LUV-R Filter

Guppyfriend Garment Bag

Date filter cleaned

Only answer if using the Lint LUV-R

MM

DD

YYYY