Get Water Well Plugging Record Form Wwc-5p Division Of ... - Kdheks

This guide provides a thorough overview of how to effectively complete the WATER WELL PLUGGING RECORD Form WWC-5P Division Of ... - Kdheks online. Follow these steps to ensure accurate submission and compliance with local regulations.

Follow the steps to effectively fill out the form online.

1. Press the ‘Get Form’ button to obtain the form and access it for filling out online.
2. Provide the location of the water well by inputting the county name, section number, township number, range number, and fractional description as applicable. Include GPS information such as latitude and longitude in decimal degrees, along with the elevation and datum used.
3. Complete the address of the water well owner by entering their rural route number, street address, city, state, and ZIP code.
4. Indicate the type of well usage by checking all that apply from the list, including options such as domestic, irrigation, and others.
5. If applicable, specify whether a chemical or bacteriological sample was submitted to the Department by selecting ‘Yes’ or ‘No.’
6. Select the type of blank casing used from the given options (e.g., steel, PVC) and provide the casing diameter and height above or below the land surface.
7. Record the depth of the well and the static water level.
8. Select the grout plug material and provide the interval depths where the plugging materials are applied.
9. Identify any possible sources of contamination near the well location and their distance from the well.
10. Complete the contractor’s or landowner's certification by entering the date of completion, the contractor’s license number, and signing the form.
11. After completing the form, you can save your changes, download it, print it for your records, or share it with the necessary parties.

Complete your WATER WELL PLUGGING RECORD Form WWC-5P online today.