Exit this survey City of Fridley Private Well Survey Question Title * 1. Completing this survey will help ensure that your well is among those considered for the wellhead protection program, helping the City of Fridley to safeguard the aquifers that supply local wells (including your well). This information is only to determine how many private wells still exist in Fridley, what their status is and if you are interested in grant money to assist in sealing an unused well.Please provide the Property Owner's Name(s), Property Address, and an email address where we can contact you: Question Title * 2. Please answer the following questions to the best of your ability. Does your property contain any wells that are currently in active use? How many wells are in use on your property and what is their primary purpose? (drinking water, irrigation, monitoring, other) Check all answers that apply. No Wells in use at this property Well(s) used for drinking water Well(s) used for irrigation Well(s) used for monitoring Well(s) used for other purposes (please describe) Question Title * 3. Does your property contain any wells that are no longer in use, but haven’t been sealed? If so, how many wells are not currently in use on your property? None 1 2 3 4 5 6 or more Question Title * 4. Do you have any interest in obtaining grant money to seal your wells that are no longer in use? Yes No My property does not have unsealed wells that are no longer in use Question Title * 5. Does your property contain wells that have been sealed? Yes No Question Title * 6. If you answered “Yes” to question 5, please list how many sealed wells are on your property and (if known) the approximate date (to the nearest year) of when they were sealed? Question Title * 7. Do you have any plans in the foreseeable future (next 5-10 years) to either abandon your existing wells and/or replace your existing wells? Yes No I have no existing wells on my property Question Title * 8. If municipal water supply is made available to you (assuming it isn’t already available), do you have any interest in connecting to municipal water supply? Yes No I am connected to the municipal water supply Question Title * 9. Would you like to receive additional educational materials over the coming years about proper well maintenance, water sampling opportunities, and possibly grants for well maintenance? Yes No Question Title * 10. Thank you for taking the City of Fridley Private Well Survey! If there is any other information about your wells that you wish to share, please include it here. Useful information includes the age of your well(s), the depth of your well(s), the aquifer(s) your well(s) pumps from, or any water quality issues you’ve encountered. Also, if you have any concerns about water quality issues, please feel free to share those concerns here: Done