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Full Name

Well Address

Mailing address (if it differs from the well address)

Preferred Contact Method

Do you have a private well or a municipal water line?

Please select any treatment options that are applicable to your water.

Have you participated in any LWCD well sampling programs in the past

For questions, please contact:
Heather Wood - Water Resources Specialist

Dunn County Environmental Services Dept. 
Land and Water Conservation Division

3001 US Highway 12 East, Suite 240 A
Menomonie, WI 54751

715-231-6532