Permission Yes, MPCA and/or its contractors have permission to sample my well. No, MPCA does not have permission to sample my well (we will not contact you again) I do not have a well. Name Property address Unique well number Is your home connected to city water? Yes No Property status Own Rent Manage Email Phone number Mailing address (if different from well address) Name, phone number, and address for the property owner Are your outside taps on? Yes No Unknown Are your outside taps filtered? Yes No Unknown Do you have a water softener? Yes No Unknown Are your outside taps softened? Yes No Unknown Do you have a copy of your well log? Yes No Unknown When was your well drilled? How many feet deep is your well? Describe location of exterior tap Submit Leave this field blank