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NR 812 Compliance Report Form 3300305 (R 09/17)Page 3 of 3Instructions This Form may not be used for an NR 812 Property Transfer Inspection use Form 3300221. Inspections of spring boxes or surface.

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How to fill out the Nr 812 Compliance Report online

Filling out the Nr 812 Compliance Report is an important task for ensuring compliance with water system regulations. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to successfully fill out the Nr 812 Compliance Report

  1. Click ‘Get Form’ button to acquire the Nr 812 Compliance Report and open it in your preferred document editor.
  2. In Section 1, enter the well owner contact information available at the time of inspection. If you have an existing well construction report, you may attach it to this form and note any changes in the relevant sections.
  3. For Section 2, accurately identify the well location using available details such as County, Fire Number, Street address, and either Latitude/Longitude or Town/Range/Section—it is essential to complete all required fields.
  4. In Section 3, input the casing depth and total well depth for the 'Verification of well construction for an existing well' field. If a WI Unique Well Number (WUWN) is available, include it and attach any relevant documentation.
  5. For Section 4, tick the first box if any specified feature is present and input the distance to the well in the second box.
  6. In Section 5, provide comprehensive information about the pump and supply line that you can verify.
  7. In Section 6, only check those features that do not meet the compliance requirements outlined for existing wells in NR 812.
  8. Proceed to Section 7, where you will check only one box according to your findings and include comments as necessary.
  9. In Section 8, ensure that the person conducting the operation or inspection signs the report and enters their license or registration number.
  10. For Section 9, check only one box indicating the work done and clearly describe the results achieved.
  11. Once all sections are completed, save your changes, and consider downloading, printing, or sharing the form as required.

Complete your Nr 812 Compliance Report online to ensure your well system meets all necessary regulations.

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NR 812, Wis. Adm. Code to provide for the use of Type IL cement in the grouting and sealing of wells complies with the preservation of health, safety and welfare of the citizens of Wisconsin.

The well and pump installation must satisfy the requirements of Chapter NR 812 of the Wisconsin Administrative Code. The well must produce bacteriologically safe water; that is, the water must be free of coliform bacteria including E. coli. The well must not be cross-connected to the municipal water system.

How can I find out how deep my well is? Search the database to find the WCR for your well. The report will indicate the drillhole depth and the casing depth. If you cannot find a WCR for your well, you can hire a licensed well professional to inspect the water supply system and measure the well depth for you.

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