Get the free idph well sealing form - isws illinois

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How to fill out idph well sealing form

How to fill out idph well sealing form:

1. Obtain the idph well sealing form from the IDPH (Illinois Department of Public Health) website or any local IDPH office.
2. Fill out the personal information section accurately, including your full name, address, phone number, and email address.
3. Provide the details of the well being sealed, such as the well location, permit number (if applicable), and reason for sealing.
4. Specify the sealing method to be used and provide any additional information regarding the sealing process.
5. Indicate whether there are any existing wells or underground structures on the property that may affect the sealing procedure.
6. Attach any supporting documentation, such as well inspection reports or previous sealing records, if required.
7. Review the completed form for accuracy and make any necessary corrections.
8. Sign and date the form.
9. Submit the filled-out idph well sealing form to the appropriate IDPH office either in person or by mail.

Who needs idph well sealing form:

1. Individuals or property owners who have a well on their premises that needs to be properly sealed according to IDPH regulations.
2. Contractors or professionals responsible for well sealing activities, who need to document the sealing process and comply with IDPH requirements.
3. Any entity involved in the sealing or decommissioning of water wells in the state of Illinois, as mandated by the IDPH.

People Also Ask about idph well sealing form

How do you seal a drilled well?

5 Tips for Sealing a Water Well Go the depth. Be sure to extend the seal down to the first impermeable sediment layer. Mind the gap. To create an effective seal, make sure the borehole diameter is at least two inches greater than the casing diameter. Use neat cement. Create a berm. Wait to the water pump.

How do you seal a well pipe?

A cement mixture with no sand (also known as neat cement) or bentonite is ideal for creating a seal. Mixed with water, this forms a thin grout or slurry that will be pumped or poured down between the casing and the borehole wall.

What is involved in sealing a well?

Properly sealing a well casing involves filling the annulus with a material that will stop water from flowing down the side of the casing. The process of filling the annulus is called grouting.

How do you seal a well in Illinois?

Most dug or bored wells can be sealed by filling them with clean clay. Drilled wells are somewhat more complex to seal and require pea gravel or limestone chips (fill material) and neat cement grout, or any bentonite product manufactured for water well sealing (sealing material).

How do you seal a well?

5 Tips for Sealing a Water Well Go the depth. Be sure to extend the seal down to the first impermeable sediment layer. Mind the gap. To create an effective seal, make sure the borehole diameter is at least two inches greater than the casing diameter. Use neat cement. Create a berm. Wait to the water pump.

For pdfFiller’s FAQs

What is idph well sealing form?

The idph well sealing form is a document used to report the sealing of water wells to the Illinois Department of Public Health (IDPH).

Who is required to file idph well sealing form?

Well owners, contractors, or authorized agents are required to file the idph well sealing form.

How to fill out idph well sealing form?

To fill out the idph well sealing form, you need to provide information about the well owner, well location, well construction, sealing method, and contractor details.

What is the purpose of idph well sealing form?

The purpose of the idph well sealing form is to ensure proper sealing of water wells to protect public health and prevent contamination.

What information must be reported on idph well sealing form?

The idph well sealing form requires information such as owner's name and contact details, well location, well construction details, sealing method used, and contractor information.

When is the deadline to file idph well sealing form in 2023?

The deadline to file the idph well sealing form in 2023 may vary. Please refer to the IDPH website or contact them directly for the specific deadline.

What is the penalty for the late filing of idph well sealing form?

The penalty for the late filing of the idph well sealing form may include fines or legal consequences. It is important to submit the form within the designated timeframe to avoid penalties.

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