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Ohio Department of Natural Resources Division of Oil and Gas Resources Management GROUND WATER CONTAMINATION/DISRUPTION QUESTIONNAIRE GENERAL INFORMATION Name: Date of Complaint: County: Township:
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Groundwater contamination/disruption questionnaire pdf is a form used to report any incidents or issues related to groundwater contamination or disruptions.
Any individual or organization that has knowledge or involvement in groundwater contamination or disruptions is required to file the questionnaire.
The questionnaire must be filled out by providing accurate and detailed information about the incident, including the date, location, cause, and impact of the contamination or disruption.
The purpose of the questionnaire is to document and address incidents of groundwater contamination or disruptions in order to protect the environment and public health.
Information such as the date, location, cause, and impact of the contamination or disruption must be reported on the questionnaire.
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