Attachment 2 Pump Test Field Data Recording Form.pdf

PDF 126 KB Posted Aug 5, 2026

Attached to: S. DeGoede Well (COW)
Solicitation number: 75H7012
Issued by: Department of Health and Human Services Indian Health Service

About this file

Written by GovTribe AI · Aug 5, 2026

This is a Pump Test Field Data Recording Form used by the U.S. Public Health Service Indian Health Service for documenting water well drilling activities under Technical Provisions TP 31.0 Individual Water Well Drilling.

The form serves as a template for recording real-time field data during pump testing operations. It captures project identification information including project number, date, owner, location, pumping company, operator, and observers. The form documents the measuring point location relative to land surface and records the static water level with timestamp. Test pump specifications are documented including horsepower, make, and voltage. The primary data collection table includes columns for clock time, elapsed time since pumping started or stopped (in minutes), depth to water below land surface (in feet), drawdown or recovery measurements (in feet), pumping rate (in gallons per minute), and remarks. Multiple rows accommodate continuous data recording throughout the test period, with space for multiple pages to be numbered sequentially. A project inspector signature line appears at the bottom of each page. This form is designed to systematically capture the hydraulic response of water wells during pump testing to assess well performance and aquifer characteristics.

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Technical Provisions TP 31.0 Individual Water Well Drilling Page 12

U.S. PUBLIC HEALTH SERVICE

Indian Health Service

PUMP TEST FIELD DATA RECORDING FORM

Project No: Date Page of

Owner Location

Pumping Company Operator

Observers

Measuring Point is which is feet above/below surface.

Static water level is ________ feet below the measuring point at AM/PM.

Distance to pump from measuring point feet.

Test pump data: HP Make Volts

CLOCK TIME

ELASPED TIME

SINCE PUMPING

STARTED/STOPPED

(MINUTES)

DEPTH TO

WATER BELOW

LAND SURFACE

(FEET)

DRAWDOWN

RECOVERY

(FEET)

PUMPING

RATE

(GPM)

REMARKS

PROJECT INSPECTOR

Technical Provisions TP 31.0 Individual Water Well Drilling Page 13

Page of

CLOCK

TIME

ELASPED TIME

SINCE PUMPING

STARTED/STOPPED

(MINUTES)

DEPTH TO

WATER BELOW

LAND SURFACE

(FEET)

DRAWDOWN

RECOVERY

(FEET)

PUMPING

RATE

(GPM)

REMARKS

PROJECT INSPECTOR

Project No:

Date:

Page:

of:

Owner:

Location:

Pumping Company:

Operator:

Observers:

Measuring Point is:

which is:

Static water level is:

feet below the measuring point at:

Distance to pump from measuring point:

Test pump data HP:

Make:

Volts:

CLOCK TIMERow1:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow1:

DEPTH TO WATER BELOW LAND SURFACE FEETRow1:

DRAWDOWN OR RECOVERY FEETRow1:

PUMPING RATE GPMRow1:

REMARKSRow1:

CLOCK TIMERow2:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow2:

DEPTH TO WATER BELOW LAND SURFACE FEETRow2:

DRAWDOWN OR RECOVERY FEETRow2:

PUMPING RATE GPMRow2:

REMARKSRow2:

CLOCK TIMERow3:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow3:

DEPTH TO WATER BELOW LAND SURFACE FEETRow3:

DRAWDOWN OR RECOVERY FEETRow3:

PUMPING RATE GPMRow3:

REMARKSRow3:

CLOCK TIMERow4:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow4:

DEPTH TO WATER BELOW LAND SURFACE FEETRow4:

DRAWDOWN OR RECOVERY FEETRow4:

PUMPING RATE GPMRow4:

REMARKSRow4:

CLOCK TIMERow5:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow5:

DEPTH TO WATER BELOW LAND SURFACE FEETRow5:

DRAWDOWN OR RECOVERY FEETRow5:

PUMPING RATE GPMRow5:

REMARKSRow5:

CLOCK TIMERow6:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow6:

DEPTH TO WATER BELOW LAND SURFACE FEETRow6:

DRAWDOWN OR RECOVERY FEETRow6:

PUMPING RATE GPMRow6:

REMARKSRow6:

CLOCK TIMERow7:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow7:

DEPTH TO WATER BELOW LAND SURFACE FEETRow7:

DRAWDOWN OR RECOVERY FEETRow7:

PUMPING RATE GPMRow7:

REMARKSRow7:

CLOCK TIMERow8:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow8:

DEPTH TO WATER BELOW LAND SURFACE FEETRow8:

DRAWDOWN OR RECOVERY FEETRow8:

PUMPING RATE GPMRow8:

REMARKSRow8:

CLOCK TIMERow9:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow9:

DEPTH TO WATER BELOW LAND SURFACE FEETRow9:

DRAWDOWN OR RECOVERY FEETRow9:

PUMPING RATE GPMRow9:

REMARKSRow9:

CLOCK TIMERow10:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow10:

DEPTH TO WATER BELOW LAND SURFACE FEETRow10:

DRAWDOWN OR RECOVERY FEETRow10:

PUMPING RATE GPMRow10:

REMARKSRow10:

CLOCK TIMERow11:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow11:

DEPTH TO WATER BELOW LAND SURFACE FEETRow11:

DRAWDOWN OR RECOVERY FEETRow11:

PUMPING RATE GPMRow11:

REMARKSRow11:

CLOCK TIMERow12:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow12:

DEPTH TO WATER BELOW LAND SURFACE FEETRow12:

DRAWDOWN OR RECOVERY FEETRow12:

PUMPING RATE GPMRow12:

REMARKSRow12:

CLOCK TIMERow13:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow13:

DEPTH TO WATER BELOW LAND SURFACE FEETRow13:

DRAWDOWN OR RECOVERY FEETRow13:

PUMPING RATE GPMRow13:

REMARKSRow13:

PROJECT INSPECTOR:

of_2:

CLOCK TIMERow1_2:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow1_2:

DEPTH TO WATER BELOW LAND SURFACE FEETRow1_2:

DRAWDOWN OR RECOVERY FEETRow1_2:

PUMPING RATE GPMRow1_2:

REMARKSRow1_2:

CLOCK TIMERow2_2:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow2_2:

DEPTH TO WATER BELOW LAND SURFACE FEETRow2_2:

DRAWDOWN OR RECOVERY FEETRow2_2:

PUMPING RATE GPMRow2_2:

REMARKSRow2_2:

CLOCK TIMERow3_2:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow3_2:

DEPTH TO WATER BELOW LAND SURFACE FEETRow3_2:

DRAWDOWN OR RECOVERY FEETRow3_2:

PUMPING RATE GPMRow3_2:

REMARKSRow3_2:

CLOCK TIMERow4_2:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow4_2:

DEPTH TO WATER BELOW LAND SURFACE FEETRow4_2:

DRAWDOWN OR RECOVERY FEETRow4_2:

PUMPING RATE GPMRow4_2:

REMARKSRow4_2:

CLOCK TIMERow5_2:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow5_2:

DEPTH TO WATER BELOW LAND SURFACE FEETRow5_2:

DRAWDOWN OR RECOVERY FEETRow5_2:

PUMPING RATE GPMRow5_2:

REMARKSRow5_2:

CLOCK TIMERow6_2:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow6_2:

DEPTH TO WATER BELOW LAND SURFACE FEETRow6_2:

DRAWDOWN OR RECOVERY FEETRow6_2:

PUMPING RATE GPMRow6_2:

REMARKSRow6_2:

CLOCK TIMERow7_2:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow7_2:

DEPTH TO WATER BELOW LAND SURFACE FEETRow7_2:

DRAWDOWN OR RECOVERY FEETRow7_2:

PUMPING RATE GPMRow7_2:

REMARKSRow7_2:

CLOCK TIMERow8_2:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow8_2:

DEPTH TO WATER BELOW LAND SURFACE FEETRow8_2:

DRAWDOWN OR RECOVERY FEETRow8_2:

PUMPING RATE GPMRow8_2:

REMARKSRow8_2:

CLOCK TIMERow9_2:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow9_2:

DEPTH TO WATER BELOW LAND SURFACE FEETRow9_2:

DRAWDOWN OR RECOVERY FEETRow9_2:

PUMPING RATE GPMRow9_2:

REMARKSRow9_2:

CLOCK TIMERow10_2:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow10_2:

DEPTH TO WATER BELOW LAND SURFACE FEETRow10_2:

DRAWDOWN OR RECOVERY FEETRow10_2:

PUMPING RATE GPMRow10_2:

REMARKSRow10_2:

CLOCK TIMERow11_2:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow11_2:

DEPTH TO WATER BELOW LAND SURFACE FEETRow11_2:

DRAWDOWN OR RECOVERY FEETRow11_2:

PUMPING RATE GPMRow11_2:

REMARKSRow11_2:

CLOCK TIMERow12_2:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow12_2:

DEPTH TO WATER BELOW LAND SURFACE FEETRow12_2:

DRAWDOWN OR RECOVERY FEETRow12_2:

PUMPING RATE GPMRow12_2:

REMARKSRow12_2:

CLOCK TIMERow13_2:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow13_2:

DEPTH TO WATER BELOW LAND SURFACE FEETRow13_2:

DRAWDOWN OR RECOVERY FEETRow13_2:

PUMPING RATE GPMRow13_2:

REMARKSRow13_2:

CLOCK TIMERow14:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow14:

DEPTH TO WATER BELOW LAND SURFACE FEETRow14:

DRAWDOWN OR RECOVERY FEETRow14:

PUMPING RATE GPMRow14:

REMARKSRow14:

CLOCK TIMERow15:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow15:

DEPTH TO WATER BELOW LAND SURFACE FEETRow15:

DRAWDOWN OR RECOVERY FEETRow15:

PUMPING RATE GPMRow15:

REMARKSRow15:

CLOCK TIMERow16:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow16:

DEPTH TO WATER BELOW LAND SURFACE FEETRow16:

DRAWDOWN OR RECOVERY FEETRow16:

PUMPING RATE GPMRow16:

REMARKSRow16:

CLOCK TIMERow17:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow17:

DEPTH TO WATER BELOW LAND SURFACE FEETRow17:

DRAWDOWN OR RECOVERY FEETRow17:

PUMPING RATE GPMRow17:

REMARKSRow17:

CLOCK TIMERow18:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow18:

DEPTH TO WATER BELOW LAND SURFACE FEETRow18:

DRAWDOWN OR RECOVERY FEETRow18:

PUMPING RATE GPMRow18:

REMARKSRow18:

CLOCK TIMERow19:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow19:

DEPTH TO WATER BELOW LAND SURFACE FEETRow19:

DRAWDOWN OR RECOVERY FEETRow19:

PUMPING RATE GPMRow19:

REMARKSRow19:

CLOCK TIMERow20:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow20:

DEPTH TO WATER BELOW LAND SURFACE FEETRow20:

DRAWDOWN OR RECOVERY FEETRow20:

PUMPING RATE GPMRow20:

REMARKSRow20:

CLOCK TIMERow21:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow21:

DEPTH TO WATER BELOW LAND SURFACE FEETRow21:

DRAWDOWN OR RECOVERY FEETRow21:

PUMPING RATE GPMRow21:

REMARKSRow21:

CLOCK TIMERow22:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow22:

DEPTH TO WATER BELOW LAND SURFACE FEETRow22:

DRAWDOWN OR RECOVERY FEETRow22:

PUMPING RATE GPMRow22:

REMARKSRow22:

CLOCK TIMERow23:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow23:

DEPTH TO WATER BELOW LAND SURFACE FEETRow23:

DRAWDOWN OR RECOVERY FEETRow23:

PUMPING RATE GPMRow23:

REMARKSRow23:

CLOCK TIMERow24:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow24:

DEPTH TO WATER BELOW LAND SURFACE FEETRow24:

DRAWDOWN OR RECOVERY FEETRow24:

PUMPING RATE GPMRow24:

REMARKSRow24:

CLOCK TIMERow25:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow25:

DEPTH TO WATER BELOW LAND SURFACE FEETRow25:

DRAWDOWN OR RECOVERY FEETRow25:

PUMPING RATE GPMRow25:

REMARKSRow25:

CLOCK TIMERow26:

ELASPED TIME SINCE PUMPING STARTEDSTOPPED MINUTESRow26:

DEPTH TO WATER BELOW LAND SURFACE FEETRow26:

DRAWDOWN OR RECOVERY FEETRow26:

PUMPING RATE GPMRow26:

REMARKSRow26:

PROJECT INSPECTOR_2:

Text1:

File details come from the government source that posted it. Updated Aug 5, 2026.