All information is kept in strict confidentiality. The O.W.L. Foundation will not make public anything entered on these forms without the author's permission. The data will be used to establish county-wide conditions of wells, groundwater, and the water table.This data will be invaluable for planning ahead.
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O.W.L. Foundation P. O. Box 747-3030 Penngrove, CA 94951PLEASE FILL OUT SEPARATE FORMS FOR EACH WELL 1. How many wells are on your property? _______ This form refers to a: Domestic Well________ Irrigation well________ 2. Age of well? __________________years Don't know_____ 3. Depth of well? _____________________ft Don't know_____ Do you measure the depth regularly? Yes______ How often?_______ No_____ 4. Depth of water table? ____________________ft Don't know_____ 5. What kind of pump? Submersible Jet______ Don't know_____ 6. Depth of pump? ________________________ft Don't know_____ 7. Has water table lowered? Yes (by _________________ft) No_____ Don't know_____ 8. Lowered pump because water table dropped? Yes_____by ____________ft, when:___________No_____ 9. Have you drilled a new well(s) because water levels dropped? Yes_____ (How deep? ___________ft) No_____ 10. Overall water quality? Great_____ Good_____Fair_____ Poor____Terrible_____ 11. Ever have bacterial contamination? Yes____ No_____ Don't know_____ 12. Excess iron (over 0.3 mg/L)? Yes_____ No_____ Don't know_____ 13. Hardness? Soft_____ Moderate_____ Hard _____ Don't know_____ 14. Hydrogen sulfide (rotten egg) smell? Yes_____ No _____ 15. Do you rely on a well for daily household use? Yes_____ No_____ 16. Do you rely on a well for agricultural use? Yes_____ No_____ 17. Would you be interested in participating in an on-going monitoring program? Yes_____ No_____ Maybe_____ Property Owner's Name: Property Address: Phone Number: Email address: Signature of Property Owner: _______________________________________ Additional Comments:
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