Well Test Request

Mailing Address *

Include Address or P.O. Box and City

Well Address is the same as the Mailing Address

Well Address

Include Address and City

Phone

Email Address

Well Number (if known)

Is this the only well on the property

Is this well shared between more than one property?

Please provide a brief description of where your well is located.

Is the well located a minimum of 100' from your septic system?

Have you had your well tested before by Cedar County?

Is there a location outside where water samples can be collected (hydrant or spigot)?

Do you utilize any water softener, filtration system, or reverse osmosis system for your drinking water? If so, please include details below.

Would you like Cedar County to add your well to our yearly sample schedule?

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