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Form Summary

Title

Resource Protection Well Report

 
Form number Date Published Date Revised
ECY 050-12November 1987February 2011
VIEW NOW: Acrobat PDF format (Number of pages: 1) (Publication Size: 46KB)
Note: Please use the Microsoft Version of the Form.

Microsoft Word format (Publication Size: 61KB)
Note: May be filled out electronically, signed and sent to Ecology.

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Author(s) Marian Bruner
Description This form must be filled out within 30 days after construction or decommissioning of a resource protection, geotech soil boring or environmental investigation well. This form contains the construction or decommissioning details of the well.

The report is filled out by the person who constructed the well, typically a Washington State licensed well operator.
REQUEST A COPY The mission of the Department of Ecology is to protect, preserve, and enhance Washington’s environment. To help us meet that goal, please consider the environment before you print or request a copy.

Accessibility Options
Persons with hearing loss can call 711 for Washington Relay Service
Persons with a speech disability can call 877-833-6341
Contact Water Resources Program at 360-407-6872
Keywords report, well form, Water Resource form, Official Ecology Form
WEB PAGE Washington State Well Log Viewer
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