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?
Drilled (6-8 inch casing with sanitary well cover)
Driven (1-3 inch diameter pipe with attached point)
Dug (2-8 foot diameter constructed of concrete or stones)
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.
Depth to Bedrock
Check if you've had any of the following problems
Not enough water
Hardness (scale, soap scum, poor lathering, white/tan particles)
Reddish, yellowish or blackish water or staining
Blueish green water or staining
Rotten egg smell
Methane gas odor
If you checked "other" above, please describe the problem
Other comments or questions?
Willingness to share your data?
No, please keep my data confidential.
Yes, you may use my address in connection with the data I have shared in this survey.
Please contact me for permission to share my data. (Provide your name and email below)
Optional contact information if you wish to be contacted directly about this survey. Name and email.
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