Borehole Diameter and 2 Depth fields. Click on the date to = Do not enter latitude or longitude values in this field. For private wells, the local Otherwise, make sure the No button is activated. name field and the modifier (e.g. Well Location:This form shall be submitted to this Department or the local health department not more than 30 days after a water well, boring or monitoring well is sealed. Value should range from 80 to 85 degrees. registered inspector's water well sealing record permit # _____ start date ___/___/___ expiration date ___/___/___ new well destruction other _____ type If all the validations have been met, your well sealing data will be accepted and an official ODNR Well Sealing Report form will be created. If you are sealing a well in an existing basement, Refers to the direction from the state reference line. The following is a list of the commonly used fractions and the decimal equivalents: 1/8 Enter the values in the appropriate degrees, minutes and seconds fields. If the well is for a company, association, or church, the entire name should be entered in the owner's last name field (e.g. Boxes or Clicking "Yes" will result in a static water level value of zero. Entering a well log number will result in approximately 80% of the data fields being Optional Written Description The second borehole depth should be a depth Requirements for Sealing Abandoned Wells ... Also, a well sealing report documenting the materials and procedures used must be filed with the local health district and the Ohio Department of Natural Resources, Division of Soil and Water Resources. Type in the number without any commas (e.g. COMMUNICABLE DISEASES. If you omitted data or have some inconsistencies in what you entered (e.g. If water is flowing out the top of the well, click on the Yes button. for the well that is being sealed. use the floor of the basement as your zero point. If you used more than 4 different sealing materials, use this box to add the additional information. Enter the ODNR well log number for the well that is being sealed. 1/3 0.25 The well driller or installer shall, within thirty (30) days of becoming aware of the existence of injurious water or constituents transmit electronically through the Texas Well Report Submission and Retrieval System or deliver or send by certified mail, the original of the Injurious Water or Constituents Report … the type of casing that was used to construct the well. There are a few well uses that we have combined because they mean the same thing. Casing Perforated From 76.5 feet, Casing then drilled inside the casing, enter the smaller borehole information in the 2 0.88. This is only used if using the State Plane Coordinate System. Well Completion Reports contain information collected by drilling contractors during the drilling and construction of water wells, including the location, dates of construction, planned use, depth of the well, subsurface geologic units encountered, well construction, and well yield. Do not use the "&" character. If you are using Internet Explorer to file well sealing reports and you are not getting the confirmation page with your well sealing log number and the option to print the PDF, please follow the directions below to correct this. ADMINISTRATION. They are as follows: NOTE: The coordinates of the well are mandatory in either Latitude/Longitude or in State Plane. Fill the hole over the well casing with clean soil material after the inspection. The sealing method chosen should be dependent on both well construction and site geologic/hydrogeologic conditions. Only the valid townships for the county selected will be listed. former RVAAP. Contact the MDH Well Management Section 651-201-4600 or 800-383-9808 Click here for Conversion Chart for Sealing of an abandoned well must be documented per the Ohio Revised Code (ORC) Section 1521.05 (B). Either borehole diameter or casing diameter is required. Spell out the full name of the road. a pull-down list of all the valid directions and street types. 0.19 Address of Well Location: The street * Concrete or cement may be used if the upper part of the well is dry. A value 7/8, = Units are required (e.g. 1/2 The section number can be obtained from either the county road map or a topographic map. To first access online reporting, click the link below and complete the three steps required. Click the "Yes" button if all of the casing was pulled from the ground. Keep this record with your other property records. in, use the land surface as your zero point. Final Status Report of Well Sealing on State Land Author: Nick Kroska Subject: final status report for DNR Waters Well Sealing Program Keywords: DNR, Division of Waters, well sealing, wells, abandoned wells, ground water, State land, aquifer, groundwater, groundwater protection, cistern, Ground Water Protection Act Created Date 1234 Mt. was bent). Sheet ____ of ____ For PDF submission: Report must be printed on legal size paper (8.5 x 14 inches) and be signed in ink. Pleasant Rd NW). to be changed to decimals. Spell out the entire city name (up to 25 characters). Statewide Advisory: Sealing Materials for Water Wells, Monitoring Wells, Cathodic Protection Wells, and Geothermal Heat Exchange Wells This advisory is to inform well drillers, local enforcing agency staff, and others about important sealing material considerations for well construction(annular seals) and destruction in the If two first names are given (e.g. If the well is flowing, make sure the Flowing of Well Location: Enter directions and distances from the nearest streets or other landmarks (up to 120 characters). RT) followed by a route number, enter the number of the road or route in the street Water Resources. In the private water and closed loop systems program, the Illinois Department of Public Health (IDPH) administers the licensing of water well and pump installation contractors and regulates the construction, modification and sealing of all water wells, with the exception of community water wells. hyphenated, type in the hyphen without any spaces between the names and the hyphen 0.38 Required Prior to Constructing, Altering, or Sealing Private Water Systems. Such wells are to be sealed not more than 30 days after they are abandoned in accordance with the sealing 0.67 *Source in most web browsers. If the well was installed in a subdivision, enter the lot number of the subdivision (up to 4 characters). A collection of documents on various well drilling topics, such as plugging, surface sealing and completion, well siting, standards, and injurious water. The property owner is responsible for effectively filling and sealing all abandoned water wells according to these water-well abandonment guidelines (PDF). Enter the sealing permit number, if issued by the county health department or Ohio EPA (up to 10 characters). 7.625 inches). generated from the well log database. Enter up to 2 places past the decimal point (e.g. please conduct a well record search at A licensed water well driller must seal an abandoned well. A more detailed description of the sealing and abandonment procedure is available in section Click on the day the well was sealed to populate 1/4 your total depth is greater than the last depth in the placement of sealing material) you will be prompted to add/edit the data and then click on the Verify Sealing Report button again. Clicking on the date field will bring up a calendar in most browsers. You receive a copy of this record as well. complete this field. HEALTH DEPARTMENT. If you do not know the well log number, 3/8 Adams, Asotin, Columbia, Ferry, Franklin, Garfield, Grant, Lincoln, Pend Oreille, Spokane, Stevens, Walla Walla and Whitman. From the pull-down list, select a Township. Record this value to the nearest tenth of a foot (e.g. (A) As used in this section: (1) "Construct" or "construction ... abandoned well with grouting or other approved materials in order to permanently prevent the vertical movement of water in the well and thus prevent the contamination of ground water … Repeat Borehole and Casing information if lowermost depth to which the sealing material was installed (up to 1 decimal place). Well sealing reports must be filed for any well or boring that require a well construction log be filed. (i.e. ODNR Water Well Log and Sealing Report Search (link to the text based searches such as county and road name) If you are unable to locate a well log or sealing report please contact the Ohio Department of Natural Resources, Division of Geological Survey at (614) 265-6740. 12/22/2011). If reporting in Degrees and Minutes, there should be no decimal places for degrees and three places past the decimal point for Minutes (e.g. § 1521.05. 423 should be entered as: There is From the pull-down list, select the datum plane that applies to the coordinate source that you selected for the Source of Above Coordinates field. Therefore, a street address 0.265 inches). click the "Yes" button to the response for was the casing perforated. For GPS units, this can be found in the owner's manual. If your property is served by a municipal drinking water system, a municipal well filling and sealing ordinance may also require you to obtain a permit or permanently fill and seal any private wells on your property. = John and Mary Smith), enter both first names separated with a forward slash "/" (John/Mary). SDR 21, SDR17 and SDR 26 and Schedule 40 & 80 well casing. WELL CONSTRUCTION AND MAINTENANCE; SEALING OF ABANDONED WELLS Statutory Authority: N.J.S.A. Perforated To 86.5 feet). and any additional information that you have collected that is not specifically Removal of obstructions Remove equipment, materials, debris, and obstructions that may interfere with sealing of the well or boring. Do not enter latitude or longitude values in this field. The second borehole depth should always be greater than the first a second borehole or casing was utilized using the borehole and casing fields that of Above Coordinates: From the pull-down list, indicate how the Latitude/Longitude Complete the water well sealing report and submit the report to the Health District when requesting an inspection of the sealed well. From the pull-down list, indicate how the surface elevation at the well was obtained. counties that use the post direction field are Stark, Tuscarawas, and Fairfield. Date last amended: January 2, 2018 For regulatory history and effective dates, see the New Jersey Administrative Code Operative date: March 1, 2018 Table of Contents SUBCHAPTER 1. Rural Route numbers. Water Wells A pproximately 5,000 new water wells are constructed and 2,700 abandoned wells are sealed in Illinois each year. 1.4 Well sealing reports must be completed and filed with the ODNR within 30 days after the completion of the sealing of the well in accordance with ORC 1521.05(C). address in the database is broken into house 758756.86). Bureau of Water Resource Management 625 Broadway Albany, NY 12233-3508 Records of wells decommissioned in Kings, Queens, Nassau and Suffolk counties must be sent to the Region 1 office (see section I, above). Enter the A well sealing report must be submitted to the Ohio Department of Natural Resources (ODNR) Division of Water. Indicate the accuracy at which the elevation was obtained (in feet). Enter the surface elevation, in feet above mean sea level, at the wellhead. required but is of importance to you or your client (up to 500 characters). From the pull-down list, click on the reference point used to measure the static water level. Required fields are marked by a red asterisk "*". Water Resources; 06 Clearing Log jams Common; 01 Great Lakes Compact - Common; 02 National Floodplain Insurance Progam - Common; 05 EPA Dumping - Common; 04 Water Withdrawal Registration - Common; 10 Consumptive Use; 11 Floodplain Development Permit; 03 Dam Construction Permit - Common; 12 Watershed and Basin Map; 13 Dam Inspections 1521.05 Well construction logs - well sealing reports. If you only have a company name, leave the first name field empty. Information should be provided for every box on the form where available. After you reach water with any drilling project, it is time to put the tools away and rest in a job well done — almost. A county must be of 123 N. Main Street NW should be broken up as follows: For addresses Eastern region. From the pull-down list, select the primary use of the well while it was still being used. The number appears in the upper right hand corner of the ODNR Well Log and Drilling Report form. • Using proper equipment and safety devices, remove at least the top 2 feet of the well casing. If the full name is more than that, use your judgment to enter enough of the name so that a search would result in that log being retrieved. water-well sealing, clean clay, or neat ce-ment grout. Enter the ODNR well log number value in inches up to 3 places past decimal (e.g. Some of the depth. Without proper sealing, surface water may enter the borehole and contaminate the well water. that use State Route (SR), County Road (CR), Township Road (TR) or US Route (US You will be prompted with the well sealing number and be given the opportunity to save and/or print the well sealing log as either a PDF or tif. Well construction logs; sealing reports. number, street direction, street name, street type, and post direction. pull-down list, select the method that the sealing material was installed. Enter the Enter value *1 Borehole California Well Completion Report Map Application provides direct statewide access to copies of Well Completion Reports. information. If … Enter the values in the appropriate degrees, minutes and seconds fields. Sheri McMicheal Well report (log) tracking sheri.mcmicheal@ecy.wa.gov 509-329-3541. Do not enter P.O. If you drilled, set casing and 3/16 selected before a township can be selected. Use the post direction field if the county The actual method and materials used depends on the . Ohio State Plane Y value. in feet to the nearest tenth of a foot (e.g. 1. from land surface. of zero should be entered for Static Water Level. at which the casing was perforated (e.g. Click the "No" button if only the upper few feet Sections are one-mile squares. Environmental Health Water Well Sealing Report. 5/8 IMMUNIZATIONS. *Street From the Enter a description of the condition of the casing (e.g. Enter the date that the static water level was measured as mm/dd/yyyy. Use the Project Well ID box to provide that A major consideration in constructing these wells is to prevent contamination from the ground surface or shallow ground water, sewage disposal systems and other hazardous sources, from entering the well. Application/Permit and Site Plan Form (electronic fill-in) https://apps.ohiodnr.gov/water/maptechs/wellogs/appNEW/custom.aspx characters long). The casing will be either brick, stone, concrete block, porous tile, or other \Òsð$¯é‹\\ʈƱ*#êó—íG]ÕHhý®!Ëoª]½å6 ióyQËÎm{jðÎÚäú¡Úw‰SÅ\%g×Èõ~:/™ƒ°Ò¨ž(Àê~"ŒvÆÐ¼Uz5¢RÓx½—MÏÇd搛Ñ8íu'~-þvdœ:^Tw’Áz±êٟr–Gëòö×;ƒŠ?Œ%vTvü½ÙlÁ€F?«qÄ%p e÷Æ{)¤,˜Ù=ÑW¤Ú°–•¦K8¢–eJ†ÙãÎO2¬|¼è®äás­¸bô0"¥Ö’ˆwEڙšÈ-#´…•b»¿F9º}Ї;„²Å°ë–ÆÝˆìõ\6ò üc¯¡ä3'g[çO›Ó±’oÄÎIP€ÐFZÏ]µ¤¼±¶´¼­3Û}ÚޏûGN–'ܲÒ.ªŸ„gº¢,òùí¥bƒS~Œî§-`Qe&Nì`ÊüŸj´¨mcuŠ. Do not use abbreviations unless the road name is over 35 SR or CR etc) in the street type field. 81° 32.123'). appears in the upper right hand corner of the ODNR Well Log and Drilling Report Indicate the depth to water, in feet, after giving the well time to recover from any pumping, bailing, or other well disturbance (up to 1 place after the decimal point). Fill out Well/Drillhole/Borehole Filling & Sealing Report Form 3300-005 as completely as possible for each well or borehole filled and sealed. = It documents the well is properly sealed. If reporting in Degrees, Minutes, and Seconds, there should be no decimal point for Degrees and Minutes and one place past the decimal point for Seconds (e.g. 42° 23' 32.1"). If you know the well owner's first name, enter it here (up to 20 characters). 0.33 If road names are The Ball Bearing Company, Trinity Lutheran Church, etc). If the casing was perforated, = Richland/Hanford the date field. Depth: Enter the depth of the borehole. or the State Plane coordinates were obtained. There are 35 characters for this field. NEWS RELEASES. Placed From field of the next line if more than 1 type of sealing material was used. 0.75 From the pull-down list, select a county. Well Sealing Report . Either North or South zone. Start with the uppermost material installed and work your way down the borehole. (up to 35 characters). documented with children and pets falling into unsealed water wells. Not all of Ohio was surveyed using the Township, Range, and Section method; therefore not all of Ohio has section numbers. Enter the date that the well was sealed as mm/dd/yyyy (e.g. From the pull-down list, select Attachment A contains the Well Sealing Report, and Attachment B contains the Final Investigation Derived Waste (JDW) Letter Report for December 2018 Well Abandonment of FWGmw-017. Well report (log) tracking Help desk: 509-575-2597. of casing were cut off or if the casing was left in the ground. Enter 0.5 = You do not have to fill in both. Therefore, the particular method for sealing a well depends on the type of water well and the local geological features. 0.63 122.5 feet). diameter or casing diameter is required. Well construction logs; sealing reports. Before you hang up your work boots, you must seal your well to protect it from surface water contamination. Then, enter the uppermost and lowermost depths, in feet below ground surface, DETAILS SECTION. Once you have completed entering all the well information, click on the "Verify Sealing Report" button on the bottom of the page. gallons, 110 lbs). 1878709.07). If entering the 9-digit zip code, use the hyphen with no space before or after it (e.g. Sign each form. The number No abbreviations. is divided into 4 quadrants and they attach NW, SW, NE, or SE after the street name CONSTRUCTION are preceded by the number 2. If reporting in Degrees and Minutes, there should be no decimal places for degrees and three places past the decimal point for Minutes (e.g. casing was rusty, casing This value will be populated in the Depth https://apps.ohiodnr.gov/water/maptechs/wellogs/appNEW/custom.aspx. form. Either borehole Value should range from 38 to 42 degrees. Ohio State Plane X value. Enter value in inches up to 3 places past decimal (e.g. volume or weight of sealing material installed (up to 25 characters). 240 Please note that these forms are subject to change. 1045.22 feet). 42° 12.123'). This number should be between 1 and 36. 13:1D-1 et seq., 58:4A-4.1 et seq., 58:12A-1 et seq., and 58:10A-1 et seq. HEALTH EDUCATION. Once fully sealed, the contractor is required to submit a Well and Boring Sealing Record to MDH. 43074-9965). Enter the diameter of the borehole NOTE: = for private wells. Water well abandonment is covered by Act 610, Water Well Drillers License Act (PDF) and Pa. Code, Title 17, Chapter 47, regulations concerning the drilling of water wells. (A) ... of an abandoned well with grouting or other approved materials in order to permanently prevent the vertical movement of water in the well and thus prevent the contamination of ground water or the intermixing of water between aquifers. Drillholes and exploratory boreholes must also be properly filled and sealed when they are no longer in use. Enter why the well was sealed If you filled in a well that was located in a pit and the pit was filled Abandoned Well Sealing Demonstration Project Final Report Submitted to: South Dakota Department of Environment and Natural Resources Watershed Protection Program 523 East Capitol Avenue Pierre, South Dakota 57501 Prepared by: Jay Gilbertson, Manager East Dakota Water Development District 307 6th Street, City Plaza Mall If reporting in Degrees, Minutes, and Seconds, there should be no decimal point for Degrees and Minutes and one place past the decimal point for Seconds (e.g.
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