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VOLUNTARY RURAL
RESIDENTIAL WATER USE SURVEY
1 What
water source(s) are used on your property?
Individual well serving one residence only
Well shared with one neighbor
Surface water
Community water system (multiple homes on one system) List system
name:
Skagit PUD
Other (please describe)
If you have more
than one source of water, please describe which source is used for specific
tasks (e.g., Use public utility for in-home use and use well for outdoor
watering)
If you do not
use an individual well on your property, then no further answers are
necessary.
We would still appreciate it if you would provide your address below
so that we can take you off of our individual well list.
Address
City
Zip
If water from
a well is used, we appreciate responses to the following questions:
2
What is the well water used for:
In home domestic use
Lawn and garden watering
Pasture/Crops
Stockwatering
Other (please describe)
3 Are you
a full-time or seasonal resident?
Full Time
Seasonal
If seasonal, please note your typical occupancy time during a typical
year:
4
How many people typically occupy this residence?
:
5
Do you operate a business out of your residence? Yes
No
If
so, what kind?:
6
Do you have:
Rain Barrels
Lawn Irrigation
Garden Irrigation
Water-conserving appliances/fixtures, etc.)
Other water conservation things I do (please describe)
7
How do you handle wastewater (sewage)?
Sewer System Customer
On-site sewage (septic) system
Other (please describe)
8
Would you be willing to provide access to the County
to install a flow meter on your existing well and conduct monitoring
of flow data for a period of one year?
Yes
No
If so, please
provide your name and contact information:
Name
Address
City
State
Zip
Phone
Email
THANK YOU FOR YOUR HELP!
Skagit
County, the Washington State Department of Ecology, and the City of
Anacortes greatly appreciate your help in conducting this study. We
believe this information will help better manage our precious water
resources.
If you have
any questions at all, please do not hesitate to contact the study project
manager, Gary Stoyka with Skagit County, at (360) 416-1400, Jacque Klug
with the Department of Ecology at (425) 649-7000, or Fred Buckenmeyer
with the City of Anacortes at (360) 293-1919.
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