Groundwater Questionnaire

Groundwater Survey
Thank you for participating in our Groundwater and Well Water Safety Survey. Your input is crucial in helping us understand the needs and concerns of residents, businesses, and agricultural properties in our community regarding groundwater and well water quality.

As part of our ongoing commitment to ensuring safe and sustainable water resources, we are conducting this survey to gather valuable insights into the experiences and practices of well owners across the region. Your responses will help shape future initiatives, educational programs, and conservation efforts aimed at protecting our water supply for generations to come.

The survey should take approximately 10 minutes or less to complete. Your participation is voluntary. This is an independent project and results will be anonymized in reporting. Contact information is not required. The information you provide will be used solely for the purposes of this campaign and to better serve our community.
1. Do you reside, own a business or operate a farm within the Agricultural Reserve or Rural Transition Zones in Montgomery County, Maryland or within the boundaries of the green outline in the map below?*

Yes, I live hereYes, I own or run a businessYes, I operate a farmYes, In Frederick CountyYes, In Carroll CountyYes, In Howard CountyNo, I do not live or work here

2. Do you have a well on your residential, agricultural or business property or do you get your water from a system that draws from municipal wells?*

YesNo

3. Do you have a septic system?*

YesNo
4. How old is your septic system?*

Less than 5 years5-10 years10-12 yearsOver 20 yearsUnsureNot Applicable

6. If you answered no to having have your well tested, what prevented you from testing the well.*

CostLack of awarenessNo perceived needOther
If you selected other please specify.

27. Rack your brains! Is there anything else you would like to share or concerns you have about groundwater or septic systems?
If you would like to be contacted about your response please provide the your name and email address.
example@example.com
Name

First NameLast Name
Should be Empty:

Groundwater Survey