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MI AGRICULTURE ENVIRONMENTAL ASSURANCE PROGRAM 2012 DRINKING WATER WELL SCREENING SAMPLE INFORMATION SHEET Sample Code Number (Please Leave Blank)Please complete this form and turn it in with your

How to fill out water well screening form

How to fill out water well screening form

1. To fill out the water well screening form, follow these steps:
2. Start by providing your personal information, such as name, address, and contact details.
3. Next, specify the purpose of the screening form, whether it's a routine check or a specific concern.
4. Provide detailed information about your water well, including its location, depth, and any previous maintenance or repairs.
5. Identify the potential sources of contamination near your well, such as septic tanks or agricultural activities.
6. Answer all the questions related to the quality and characteristics of your well water, such as taste, odor, and appearance.
7. If you have conducted any previous water tests, include the results and provide information about the laboratory or facility that performed the analysis.
8. Finally, review the form to ensure all the necessary information is provided and submit it according to the specified instructions.

Who needs water well screening form?

1. Anyone who owns a water well or relies on a private water supply should fill out a water well screening form.
2. It can be beneficial for homeowners, farmers, or businesses that depend on well water for their daily activities.
3. Individuals concerned about the quality or safety of their well water can also use the screening form to identify potential issues.

For pdfFiller’s FAQs

What is water well screening form?

Water well screening form is a document that collects information about the water well to ensure compliance with regulations and assess potential contamination risks.

Who is required to file water well screening form?

Property owners or individuals responsible for the water well are required to file the water well screening form.

How to fill out water well screening form?

To fill out the water well screening form, one must provide accurate information about the well's location, construction, and usage.

What is the purpose of water well screening form?

The purpose of the water well screening form is to evaluate the quality of water from the well and identify any potential risks to public health.

What information must be reported on water well screening form?

Information such as the well's location, depth, construction materials, and water usage must be reported on the water well screening form.

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