Solano County - Well Reporting Form

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ABOUT SSL CERTIFICATES

Well Reporting Form

Solano County is asking landowners to report any well issues they are having with their water well. This information will help in our efforts to gain a better understanding of the groundwater basin conditions. Please help provide this information by reporting any problems you experience with your well. Given the sensitive nature of private well information, we will not publicize information about specific wells. Thank you for your voluntary participation.

Please provide the following information. Well Locations will not be made public.

RM Well Reporting Form

* Date:

* Contact Name:

* Contact Address:

* Contact Phone:

* Contact Email:

Well Location Address:

Well Location APN:

Cross Streets:

Latitude:

Longitude

Township

Range:

Section:

General Area:

* Primary Well Use:

		Domestic
		Ag/Irrigation
		Combination Domestic/Ag
		Other

Casing Diameter (inches):

Year Well Was Installed:

Casing Type:

		PVC
		Steel

Depth of Well (feet below ground surface)

Depth to Water:

Gallon per Minute:

Percent Change in Gallon per Minute:

Date Measured Water Level:

Static Measurement?:

		Yes
		No

Please describe the issue with the well (check all that applies):

Well is Dry (no longer producing water)

Reduction in water pressure/lower flows

Well is pumping sand/muddy water

If other, please describe:

* Has the problem been fixed?

		Yes
		No

If Yes, please describe how:

Is there anything else we should know?

For any questions, please email [email protected] or call us at (707) 784-6765.

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