Private Wells in Western Maine (outside FWD)
This anonymous survey will only track the data you submit. Only some of the questions are required to complete this survey. If you are willing to be contacted for more information, please leave an email at the end of the survey.
Your address (99 Somewhere Rd, Anytown, ME) -- all information will be kept confidential unless you agree to share it with your signature at the end of this survey. *
What type of well do you have? *
When was your well drilled? *
What company installed your well? (You can check the well cap if you don't know)
If you have a copy of your well completion report, please provide the information below.
Well Depth
Casing Depth
Depth to Bedrock
Well Yield
Check if you've had any of the following problems *
If you checked "other" above, please describe the problem
Other comments or questions?
Willingness to share your data? *
Optional contact information if you wish to be contacted directly about this survey. Name and email.
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