Blank Wisconsin Well Inspection Form

Wisconsin Well Inspection - Usage Guidelines

Completing the Wisconsin Well Inspection form is a straightforward process that requires attention to detail. This form collects essential information about the well and pressure system, which is crucial for ensuring compliance with state regulations. Follow these steps to fill out the form accurately.

1. Begin with the General Inspection section. Fill in the name and mailing address of the person requesting the inspection, along with their city, state, and ZIP code. Then, provide the owner's name, mailing address, and telephone number.
2. Next, move to the Location Information section. Indicate the county of the water system location and provide the grid, street address, or road name and number if available. Include the subdivision name, lot number, and block number.
3. In the Source Information section, specify the source type by checking the appropriate box: drilled, driven point, dug, spring, jetted, or other. Include the government lot number, section, township, and range. Indicate the number of homes or other structures served by the well and provide the latitude and longitude.
4. Proceed to the Well Data section. Indicate whether the information comes from a well construction report or the pump installer, or if it is based on the owner's memory. Provide the well location details and approximate year of construction. Fill in the casing diameter, casing material, well depth, and yield. Note if the well is located in a floodplain.
5. In the Pump Data section, provide the location of the pump, its name and type, and the installer’s name. Confirm whether the well is properly separated from contamination sources, both on the property and neighboring properties. Include details about the pipe material, method of discharge, and any cross connections.
6. Then, move to the Conclusions & Recommendations section. Answer whether the water system is working correctly and if visible portions comply with regulations. Note if vermin proofing is in place, if a bacteria sample was taken, and if well filling and sealing are needed. Indicate whether a variance exists and provide a description if applicable.
7. Finally, include any comments or repairs needed. Fill in the inspector's name, telephone number, DNR license number, and the date signed.

When filling out the Wisconsin Well Inspection form, consider the following guidelines:

• Do provide accurate and complete information in all sections of the form.
• Do ensure that the inspection is conducted by a licensed well driller or pump installer.
• Do include the correct mailing addresses for both the requester and the owner.
• Do specify the source of the water system clearly, including the type of well.
• Don't leave any sections blank; all fields must be filled out as required.
• Don't submit the form without verifying that all information is current and accurate.
• Don't assume that using the form guarantees DNR approval for the well and pressure system.
• Don't forget to check for any variances that may apply to the well system.

Filling out the Wisconsin Well Inspection form can be straightforward, but many individuals make common mistakes that can lead to delays or complications. One frequent error is providing incomplete contact information. The form requires both the inspector's and owner's names, mailing addresses, and telephone numbers. Omitting any of these details can hinder communication and processing.

Another mistake involves the location information section. Failing to specify the exact grid or street address can create confusion. It is crucial to include details like the county and subdivision name. Without this information, the inspection may not be accurately recorded or linked to the correct property.

People often misidentify the source of the well. The form includes options such as drilled, driven point, and dug spring. Selecting the wrong source can lead to incorrect assessments and recommendations. It's essential to choose the correct option based on the well's construction.

Inaccurate well data is another common issue. For instance, individuals may forget to provide the well's depth or casing diameter. These measurements are vital for assessing the well's safety and compliance. If this information is missing or incorrect, it may result in an inadequate inspection.

Moreover, some people neglect to indicate whether the well is located in a floodplain. This detail is significant for understanding potential risks. If the form does not reflect this accurately, it could lead to serious safety concerns.

Finally, individuals often overlook the conclusions and recommendations section. Failing to answer whether the water system is working correctly or if a bacteriological sample was taken can leave important questions unanswered. This section is crucial for ensuring the well meets safety standards and for guiding necessary repairs or upgrades.

When conducting a well inspection in Wisconsin, several additional forms and documents may be necessary to ensure compliance and thorough understanding of the water system. Each of these documents plays a crucial role in the overall process, helping both the inspector and the property owner to address specific aspects of the well and pressure system. Below is a list of commonly used forms that accompany the Wisconsin Well Inspection form.

• Well Construction Report: This document provides detailed information about the construction of the well, including the materials used and the methods employed. It is essential for understanding the well's design and history.
• Water Quality Testing Report: This report outlines the results of water quality tests conducted on the well water. It helps determine if the water meets safety standards for drinking and other uses.
• Well Abandonment Form: If a well is no longer in use, this form is required to properly document its abandonment. This is important for environmental safety and compliance with regulations.
• Hold Harmless Agreement: This legal document protects one party from liability during activities related to the well inspection. For more information, you can visit Ohio Documents Online.
• Pump Installation Report: This document details the installation of the pump, including specifications and performance data. It is vital for assessing the pump's functionality and compliance with standards.
• Maintenance Log: A record of all maintenance activities performed on the well and pressure system. This log helps track repairs and upkeep, which can influence the system's longevity and performance.
• Property Transfer Disclosure Form: This form is used during real estate transactions to disclose information about the well and water system to potential buyers. Transparency in this area is crucial for informed decision-making.
• Variance Request Form: If any part of the well or pressure system does not meet current codes, this form can be used to request a variance. It outlines the reasons for the request and any proposed alternatives.
• Inspection Fee Payment Form: This document is used to process payments for inspection services. It ensures that all fees are accounted for and helps maintain financial records.
• Certification of Compliance: After the inspection, this certificate confirms that the well and pressure system meet the required standards. It is often necessary for property transactions.
• Emergency Response Plan: This plan outlines procedures to follow in case of contamination or other emergencies related to the well. Having a clear plan is essential for ensuring public health and safety.

Understanding these forms and their purposes can significantly enhance the inspection process. They ensure that all aspects of the well and pressure system are thoroughly evaluated, documented, and addressed, thereby safeguarding both the property owner and the community.