Contact:
419-261-0115
Email:
info@washtwphenry.com
Contact:
+
419-261-0115
Email:
info@washtwphenry.com
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Water Supply Survey
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Water Supply Form
Name
Email
Address
1) Type of Water Source
Private Well
Pond
Public Water
Haul Water
2) If a Private Well, What Type?
Drilled Well With Casing
Drilled Sand Point
Dug Well
Unknown
N/A
3) Do you know when your well was installed?
Unknown
N/A
Yes
Year Installed
4) Do you know the depth of your well?
0-20
21-30 ft.
31-50 ft.
51-75 ft.
76-100 ft.
101-125 ft.
126-150 ft.
Over 151 ft.
Unknown
N/A
5) Have you ever had to increase the depth of your well to have reliable water?
Yes
No
6) Does your water source, if from a well, contain sulfur?
Yes
No
7) How would you rate the overall quality of your water supply?
Poor
Below Average
Average
Above Average
Good
8) Have you ever had problems with your well not producing enough water to meet your household needs?
Yes
No
Not Applicable
9) Do you have a treatment system for your water?
Yes
No
10) What do you treat for, if applicable?
Sulfur
Water Hardness
Iron
Other Impurities
11) Are you concerned about the township having an adequate water supply to meet future residential or business growth?
Yes
No
Hadn't really thought about it
12) Would you be interested in obtaining a public water source at your residence if it were available?
Yes
No
Depends on the cost
If you are human, leave this field blank.
Submit