Groundwater and Wells General Complaint Form

Wake County’s Groundwater Program is responsible for permitting and inspecting new private wells, well repairs and well abandonments and responds to health and safety concerns related to private wells. If you are having a concern with water provided by a public water system or a community well, please contact the utility that provides your water.

Please use this form to report any
- improperly abandoned wells (open wells)
- concerns about improper well construction
- renter concerns about water from a private well
- concerns about man-made contamination in a well
If you are seeking routine well water testing, need to repair or abandon a well, or need a well permit, please apply on the Wake County Permit Portal or contact a certified well contractor.

Click here to see if you might qualify for financial assistance to correct this problem.
Report anonymously?
Name

First NameLast Name
Are you the (check all that apply):*

Property ownerRenter/TenantComplainantContractor
Please verify that you are human*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Site/Property Address*
What type of property?*
Type of Business*
Number of Employees per Shift
Number of Shifts per Day
Number of Days per Week of Operation
What is the issue you are reporting?*

Old open wellLandlord won’t test well waterOdor/taste/sediment/turbidityPossible well water contaminationOut of waterOther
Contact pump installer or well contractor. Visit wakegov.com/wells and click on "Find a Well Contractor."
Start Date (When did you first notice the problem?)*

MonthDayYear
Date
How frequent is this problem? (after rain, every day, only in spring, etc.)*
Have you reported this well issue previously? If so, when?*
What is the primary water supply for the property?*

Individual WellShared WellCommunity/Municipal System (15 or more connections)Unknown
If you are experiencing problems with water from a community or municipal water system, please call your water utility or the NC Department of Environmental Quality at 919-791-4200.
Rental Property?
Dogs?
Part of Real Estate Transaction?
I understand and agree that I am using an electronic submittal process which requires me to provide my electronic signature. To the best of my knowledge and belief, all information supplied is true, accurate, and complete. I understand the application and any communication and/or permits issued as a result of this submittal are public records subject to disclosure pursuant to the North Carolina Public Records Act (North Carolina General Statutes Chapter 132).
Signature of Complainant*
Type in name above if completing form by email.
Today's Date*

MonthDayYear
Date
Should be Empty: