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

Filling out the Water Well Plugging Record Form WWC-5P is essential for documenting well plugging activities in Kansas. This guide provides clear and detailed instructions on how to accurately complete this form online, ensuring compliance with state requirements.

Follow the steps to fill out the form correctly.

1. Press the ‘Get Form’ button to obtain the Water Well Plugging Record Form WWC-5P and open it for editing.
2. Begin by entering the location of the water well. Fill in the county, the fractional references, and provide the street or rural address of the well location. If the exact address is unknown, indicate the distance and direction from the nearest town or intersection. If the well is at the owner's address, check the corresponding box.
3. Next, input the GPS unit make and model, and describe how the location was identified using a digital map, photo, topographic map, or land survey.
4. Provide information about the water well owner, including their address, city, state, and ZIP code.
5. Specify how the well was used, selecting from options such as domestic, irrigation, industrial, or others listed. Indicate whether a chemical or bacteriological sample was submitted to the department.
6. In the type of blank casing section, select the material used (e.g., steel, PVC, etc.) and specify the blank casing diameter. Indicate if the casing was pulled and provide the casing height as well.
7. Fill out the well’s static water level and the total depth of the well according to the provided measurements.
8. Mark the well’s location using an 'X' in the section box and provide GPS coordinates, including latitude, longitude, and elevation.
9. Complete the grout plug material section, providing details on the grout plug intervals and any plugging materials used, including their depths.
10. In the contractor’s or landowner’s certification section, confirm the completion date, the Kansas Water Well Contractor’s License number, and ensure the record is signed and dated.
11. Once all information is filled out, review for accuracy, and ensure clarity. Save your changes and choose to download, print, or share the completed form as necessary.

Complete your WATER WELL PLUGGING RECORD Form online today!