Property Information Form

Please answer these questions about your property and an AquaterreX water consultant will contact you.

Your Name*
First Last
Property Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone*
GPS coordinates: (if you have this data)
How long have you owned the property?*
What is the size of your property?*
Purpose of property (what type of activity do you have on it?):*
Any history of the property that could somehow have an impact on a water well location and well drilling project?
How much water do you need?*
Are there existing well bores on the site? a) if so, flow rate? b) issues with water quality?*
Anything else you would like to mention about the property that you feel is pertinent or might have an impact on this project?

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