1.Do you have a private well on your property?

Yes

No

I Don't Know

2.Please indicate the status of your well.

The well continues to be the primary water source for the home.

The well is only used for irrigation purposes.

The well has been properly sealed by a licensed contractor.

The status of the well is unknown. Please contact me to determine status.

3.Would you like us to contact you with information on how to properly seal your well? Wells can be a direct conduit for groundwater pollution. Minnesota statute requires that unused wells be sealed. Grant money may be available to seal private wells.

Yes, please contact me

Not at this time

4.Please provide your address

5.Please provide your name and contact information