TE_F-20_Ground_Water_Reports.xlsx
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TE_F-20_Ground_Water_Reports
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Ground Water 1
| TE F-20 Georgia Environmental Protection Division | |
| Water Withdrawal Permitting Program - Groundwater Unit | |
| Monthly Groundwater Withdrawal Report | Report Month/YR: |
| For permit holders who maintain a Groundwater Use Permit that allows withdrawal from multiple aquifers, please report usage from each aquifer | GW Withdrawal Permit Number: | 089-0003 | |||||
| seperately. Use the additional columns in the table below to list the aquifer name and the reported usage from that individual aquifer. | |||||||
| Day of Month | Aquifer 1 | Aquifer 2 | Aquifer 3 | Aquifer 4 | Aquifer 5 | County | Liberty |
| Permit # 089-0003 | Permit Holder: | DPW Environmental Division- FS | |||||
| 1 | |||||||
| 2 | Permit Address: | 1550 Veterans Parkway | |||||
| 3 | Building 1137 | ||||||
| 4 | Fort Stewart, Georgia 31314 | ||||||
| 5 | Contact Person: | Robert R. Baumgardt | |||||
| 6 | Send to: Georgia Environmental Protection Division | ||||||
| 7 | Drinking Water & Water Withdrawal Program | ||||||
| 8 | Engineering & Permitting - Groundwater Unit | ||||||
| 9 | 2 Martin Luther King Jr. Dr., S.E. | ||||||
| 10 | East Floyd Towers, Suite 1362 | ||||||
| 11 | Atlanta, GA 30334-9000 | ||||||
| 12 | Phone: (404) 463-1511 | ||||||
| 13 | E-mail: ground.water@dnr.ga.gov | ||||||
| 14 | I certify that all information contained on this form is | ||||||
| 15 | correct and true to the best of my knowledge. | ||||||
| 16 | |||||||
| 17 | _________________________________ ________________ | ||||||
| 18 | Signature Date | ||||||
| 19 | |||||||
| 20 | |||||||
| 21 | Print Name | ||||||
| 22 | |||||||
| 23 | |||||||
| 24 | Title | ||||||
| 25 | |||||||
| 26 | |||||||
| 27 | |||||||
| 28 | |||||||
| 29 | |||||||
| 30 | |||||||
| 31 | |||||||
| Total (MG)* | Email Address | ||||||
| Average (MGD)** | *: MG represents millions of gallons. | ||||||
| Grand Total from all aquifers: | MGD | **: MGD represents million gallons per day. | |||||
| Please submit data for each Groundwater Withdrawal Permit. Permits that were not used must still be reported by inputting zero's for each day. | Average is calculated by dividing total quantity of water | ||||||
| withdrawn by the number of days in the calendar month. | |||||||
| Enter Public Water System Identifier for water bought and/or water sold. Enter the monthly average (in MGD) of any water purchased or sold. | Average = (Total in MG / Days in month) | ||||||
| Sold water to PWSID: | |||||||
| Monthly ave water sold: | |||||||
| Purchased water from PWSID: | |||||||
| Monthly ave water purchased: | |||||||
| Georgia Environmental Protection Division | |||||||
| Water Withdrawal Permitting Program - Groundwater Unit | |||||||
| Monthly Groundwater Withdrawal Report - Continued |
Reported Month: Permit No.: Permit Holder Name:
| First Well Data | Static Water Level*** | ft | Elevation: | ft | Well No. | |
| Date Measured | Number of hours shutdown for Static Water Level: | hrs | ||||
| Pumping Water Level*** | ft | Elevation: | ft | Well No. | ||
| Date Measured | Number of continuous hours pumped for Pumping Water Level: | hrs | ||||
| Method of Measurement: | Airline | Probe | Tape | Other (Specify | ||
| Measurement From: | Ground | Top of Casing | Other (Specify | |||
| Second Well Data | Static Water Level*** | ft | Elevation: | ft | Well No. | |
| Date Measured | Number of hours shutdown for Static Water Level: | hrs | ||||
| Pumping Water Level*** | ft | Elevation: | ft | Well No. | ||
| Date Measured | Number of continuous hours pumped for Pumping Water Level: | hrs | ||||
| Method of Measurement: | Airline | Probe | Tape | Other (Specify | ||
| Measurement From: | Ground | Top of Casing | Other (Specify | |||
| Third Well Data | Static Water Level*** | ft | Elevation: | ft | Well No. | |
| Date Measured | Number of hours shutdown for Static Water Level: | hrs | ||||
| Pumping Water Level*** | ft | Elevation: | ft | Well No. | ||
| Date Measured | Number of continuous hours pumped for Pumping Water Level: | hrs | ||||
| Method of Measurement: | Airline | Probe | Tape | Other (Specify | ||
| Measurement From: | Ground | Top of Casing | Other (Specify | |||
| Fourth Well Data | Static Water Level*** | ft | Elevation: | ft | Well No. | |
| Date Measured | Number of hours shutdown for Static Water Level: | hrs | ||||
| Pumping Water Level*** | ft | Elevation: | ft | Well No. | ||
| Date Measured | Number of continuous hours pumped for Pumping Water Level: | hrs | ||||
| Method of Measurement: | Airline | Probe | Tape | Other (Specify | ||
| Measurement From: | Ground | Top of Casing | Other (Specify | |||
| Fifth Well Data | Static Water Level*** | ft | Elevation: | ft | Well No. | |
| Date Measured | Number of hours shutdown for Static Water Level: | hrs | ||||
| Pumping Water Level*** | ft | Elevation: | ft | Well No. | ||
| Date Measured | Number of continuous hours pumped for Pumping Water Level: | hrs | ||||
| Method of Measurement: | Airline | Probe | Tape | Other (Specify | ||
| Measurement From: | Ground | Top of Casing | Other (Specify | |||
| *** Take readings from the highest yielding well(s), using the same well(s) each time the water measurement is recorded. For additional wells, please follow the format listed below: | ||||||
| From 1-5 wells - take readings from ONLY 1 well | From 6-10 wells - take eradings from 2 wells | From 11-15 wells - take readings from 3 wells | From 16-20 wells - take readings from 4 wells |
Annual Specific Conductance: Units Well No. Date sampled: Temperature:
Ground Water 2
| Georgia Environmental Protection Division | |
| Water Withdrawal Permitting Program - Groundwater Unit | |
| Monthly Groundwater Withdrawal Report | Report Month/YR: |
| For permit holders who maintain a Groundwater Use Permit that allows withdrawal from multiple aquifers, please report usage from each aquifer | GW Withdrawal Permit Number: | 089-0011 | |||||
| seperately. Use the additional columns in the table below to list the aquifer name and the reported usage from that individual aquifer. | |||||||
| Day of Month | Aquifer 1 | Aquifer 2 | Aquifer 3 | Aquifer 4 | Aquifer 5 | County | Liberty |
| Permit # 089-0011 | Permit Holder: | DPW Environmental Division- FS | |||||
| 1 | |||||||
| 2 | Permit Address: | 1550 Veterans Parkway | |||||
| 3 | Building 1137 | ||||||
| 4 | Fort Stewart, Georgia 31314 | ||||||
| 5 | Contact Person: | Robert R. Baumgardt | |||||
| 6 | Send to: Georgia Environmental Protection Division | ||||||
| 7 | Drinking Water & Water Withdrawal Program | ||||||
| 8 | Engineering & Permitting - Groundwater Unit | ||||||
| 9 | 2 Martin Luther King Jr. Dr., S.E. | ||||||
| 10 | East Floyd Towers, Suite 1362 | ||||||
| 11 | Atlanta, GA 30334-9000 | ||||||
| 12 | Phone: (404) 463-1511 | ||||||
| 13 | E-mail: ground.water@dnr.ga.gov | ||||||
| 14 | I certify that all information contained on this form is | ||||||
| 15 | correct and true to the best of my knowledge. | ||||||
| 16 | |||||||
| 17 | _________________________________ ________________ | ||||||
| 18 | Signature Date | ||||||
| 19 | |||||||
| 20 | |||||||
| 21 | Print Name | ||||||
| 22 | |||||||
| 23 | |||||||
| 24 | Title | ||||||
| 25 | |||||||
| 26 | |||||||
| 27 | |||||||
| 28 | |||||||
| 29 | |||||||
| 30 | |||||||
| 31 | |||||||
| Total (MG)* | Email Address | ||||||
| Average (MGD)** | *: MG represents millions of gallons. | ||||||
| Grand Total from all aquifers: | 0.0000000 | MGD | **: MGD represents million gallons per day. | ||||
| Please submit data for each Groundwater Withdrawal Permit. Permits that were not used must still be reported by inputting zero's for each day. | Average is calculated by dividing total quantity of water | ||||||
| withdrawn by the number of days in the calendar month. | |||||||
| Enter Public Water System Identifier for water bought and/or water sold. Enter the monthly average (in MGD) of any water purchased or sold. | Average = (Total in MG / Days in month) | ||||||
| Sold water to PWSID: | |||||||
| Monthly ave water sold: | |||||||
| Purchased water from PWSID: | |||||||
| Monthly ave water purchased: | |||||||
| Georgia Environmental Protection Division | |||||||
| Water Withdrawal Permitting Program - Groundwater Unit | |||||||
| Monthly Groundwater Withdrawal Report - Continued |
Reported Month: Permit No.: Permit Holder Name:
| First Well Data | Static Water Level*** | ft | Elevation: | ft | Well No. | |
| Date Measured | Number of hours shutdown for Static Water Level: | hrs | ||||
| Pumping Water Level*** | ft | Elevation: | ft | Well No. | ||
| Date Measured | Number of continuous hours pumped for Pumping Water Level: | hrs | ||||
| Method of Measurement: | Airline | Probe | Tape | Other (Specify | ||
| Measurement From: | Ground | Top of Casing | Other (Specify | |||
| Second Well Data | Static Water Level*** | ft | Elevation: | ft | Well No. | |
| Date Measured | Number of hours shutdown for Static Water Level: | hrs | ||||
| Pumping Water Level*** | ft | Elevation: | ft | Well No. | ||
| Date Measured | Number of continuous hours pumped for Pumping Water Level: | hrs | ||||
| Method of Measurement: | Airline | Probe | Tape | Other (Specify | ||
| Measurement From: | Ground | Top of Casing | Other (Specify | |||
| Third Well Data | Static Water Level*** | ft | Elevation: | ft | Well No. | |
| Date Measured | Number of hours shutdown for Static Water Level: | hrs | ||||
| Pumping Water Level*** | ft | Elevation: | ft | Well No. | ||
| Date Measured | Number of continuous hours pumped for Pumping Water Level: | hrs | ||||
| Method of Measurement: | Airline | Probe | Tape | Other (Specify | ||
| Measurement From: | Ground | Top of Casing | Other (Specify | |||
| Fourth Well Data | Static Water Level*** | ft | Elevation: | ft | Well No. | |
| Date Measured | Number of hours shutdown for Static Water Level: | hrs | ||||
| Pumping Water Level*** | ft | Elevation: | ft | Well No. | ||
| Date Measured | Number of continuous hours pumped for Pumping Water Level: | hrs | ||||
| Method of Measurement: | Airline | Probe | Tape | Other (Specify | ||
| Measurement From: | Ground | Top of Casing | Other (Specify | |||
| Fifth Well Data | Static Water Level*** | ft | Elevation: | ft | Well No. | |
| Date Measured | Number of hours shutdown for Static Water Level: | hrs | ||||
| Pumping Water Level*** | ft | Elevation: | ft | Well No. | ||
| Date Measured | Number of continuous hours pumped for Pumping Water Level: | hrs | ||||
| Method of Measurement: | Airline | Probe | Tape | Other (Specify | ||
| Measurement From: | Ground | Top of Casing | Other (Specify | |||
| *** Take readings from the highest yielding well(s), using the same well(s) each time the water measurement is recorded. For additional wells, please follow the format listed below: | ||||||
| From 1-5 wells - take readings from ONLY 1 well | From 6-10 wells - take eradings from 2 wells | From 11-15 wells - take readings from 3 wells | From 16-20 wells - take readings from 4 wells |
Annual Specific Conductance: Units Well No. Date sampled: Temperature:
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