TE_F-20_Ground_Water_Reports.xlsx

XLSX spreadsheet 37 KB Posted

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Base Operations and Maintenance Support Services (BOMSS)
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W9124M-18-R-0001
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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 ReportReport Month/YR:
For permit holders who maintain a Groundwater Use Permit that allows withdrawal from multiple aquifers, please report usage from each aquiferGW 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 MonthAquifer 1Aquifer 2Aquifer 3Aquifer 4Aquifer 5CountyLiberty
Permit # 089-0003Permit Holder:DPW Environmental Division- FS
1
2Permit Address:1550 Veterans Parkway
3Building 1137
4Fort Stewart, Georgia 31314
5Contact Person:Robert R. Baumgardt
6Send to: Georgia Environmental Protection Division
7Drinking Water & Water Withdrawal Program
8Engineering & Permitting - Groundwater Unit
92 Martin Luther King Jr. Dr., S.E.
10East Floyd Towers, Suite 1362
11Atlanta, GA 30334-9000
12Phone: (404) 463-1511
13E-mail: ground.water@dnr.ga.gov
14I certify that all information contained on this form is
15correct and true to the best of my knowledge.
16
17_________________________________ ________________
18Signature Date
19
20
21Print Name
22
23
24Title
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withdrawn by the number of days in the calendar month.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 DataStatic Water Level***ftElevation:ftWell No.
Date MeasuredNumber of hours shutdown for Static Water Level:hrs
Pumping Water Level***ftElevation:ftWell No.
Date MeasuredNumber of continuous hours pumped for Pumping Water Level:hrs
Method of Measurement:AirlineProbeTapeOther (Specify
Measurement From:GroundTop of CasingOther (Specify
Second Well DataStatic Water Level***ftElevation:ftWell No.
Date MeasuredNumber of hours shutdown for Static Water Level:hrs
Pumping Water Level***ftElevation:ftWell No.
Date MeasuredNumber of continuous hours pumped for Pumping Water Level:hrs
Method of Measurement:AirlineProbeTapeOther (Specify
Measurement From:GroundTop of CasingOther (Specify
Third Well DataStatic Water Level***ftElevation:ftWell No.
Date MeasuredNumber of hours shutdown for Static Water Level:hrs
Pumping Water Level***ftElevation:ftWell No.
Date MeasuredNumber of continuous hours pumped for Pumping Water Level:hrs
Method of Measurement:AirlineProbeTapeOther (Specify
Measurement From:GroundTop of CasingOther (Specify
Fourth Well DataStatic Water Level***ftElevation:ftWell No.
Date MeasuredNumber of hours shutdown for Static Water Level:hrs
Pumping Water Level***ftElevation:ftWell No.
Date MeasuredNumber of continuous hours pumped for Pumping Water Level:hrs
Method of Measurement:AirlineProbeTapeOther (Specify
Measurement From:GroundTop of CasingOther (Specify
Fifth Well DataStatic Water Level***ftElevation:ftWell No.
Date MeasuredNumber of hours shutdown for Static Water Level:hrs
Pumping Water Level***ftElevation:ftWell No.
Date MeasuredNumber of continuous hours pumped for Pumping Water Level:hrs
Method of Measurement:AirlineProbeTapeOther (Specify
Measurement From:GroundTop of CasingOther (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 wellFrom 6-10 wells - take eradings from 2 wellsFrom 11-15 wells - take readings from 3 wellsFrom 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 ReportReport Month/YR:
For permit holders who maintain a Groundwater Use Permit that allows withdrawal from multiple aquifers, please report usage from each aquiferGW 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 MonthAquifer 1Aquifer 2Aquifer 3Aquifer 4Aquifer 5CountyLiberty
Permit # 089-0011Permit Holder:DPW Environmental Division- FS
1
2Permit Address:1550 Veterans Parkway
3Building 1137
4Fort Stewart, Georgia 31314
5Contact Person:Robert R. Baumgardt
6Send to: Georgia Environmental Protection Division
7Drinking Water & Water Withdrawal Program
8Engineering & Permitting - Groundwater Unit
92 Martin Luther King Jr. Dr., S.E.
10East Floyd Towers, Suite 1362
11Atlanta, GA 30334-9000
12Phone: (404) 463-1511
13E-mail: ground.water@dnr.ga.gov
14I certify that all information contained on this form is
15correct and true to the best of my knowledge.
16
17_________________________________ ________________
18Signature Date
19
20
21Print Name
22
23
24Title
25
26
27
28
29
30
31
Total (MG)*Email Address
Average (MGD)***: MG represents millions of gallons.
Grand Total from all aquifers:0.0000000MGD**: 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 DataStatic Water Level***ftElevation:ftWell No.
Date MeasuredNumber of hours shutdown for Static Water Level:hrs
Pumping Water Level***ftElevation:ftWell No.
Date MeasuredNumber of continuous hours pumped for Pumping Water Level:hrs
Method of Measurement:AirlineProbeTapeOther (Specify
Measurement From:GroundTop of CasingOther (Specify
Second Well DataStatic Water Level***ftElevation:ftWell No.
Date MeasuredNumber of hours shutdown for Static Water Level:hrs
Pumping Water Level***ftElevation:ftWell No.
Date MeasuredNumber of continuous hours pumped for Pumping Water Level:hrs
Method of Measurement:AirlineProbeTapeOther (Specify
Measurement From:GroundTop of CasingOther (Specify
Third Well DataStatic Water Level***ftElevation:ftWell No.
Date MeasuredNumber of hours shutdown for Static Water Level:hrs
Pumping Water Level***ftElevation:ftWell No.
Date MeasuredNumber of continuous hours pumped for Pumping Water Level:hrs
Method of Measurement:AirlineProbeTapeOther (Specify
Measurement From:GroundTop of CasingOther (Specify
Fourth Well DataStatic Water Level***ftElevation:ftWell No.
Date MeasuredNumber of hours shutdown for Static Water Level:hrs
Pumping Water Level***ftElevation:ftWell No.
Date MeasuredNumber of continuous hours pumped for Pumping Water Level:hrs
Method of Measurement:AirlineProbeTapeOther (Specify
Measurement From:GroundTop of CasingOther (Specify
Fifth Well DataStatic Water Level***ftElevation:ftWell No.
Date MeasuredNumber of hours shutdown for Static Water Level:hrs
Pumping Water Level***ftElevation:ftWell No.
Date MeasuredNumber of continuous hours pumped for Pumping Water Level:hrs
Method of Measurement:AirlineProbeTapeOther (Specify
Measurement From:GroundTop of CasingOther (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 wellFrom 6-10 wells - take eradings from 2 wellsFrom 11-15 wells - take readings from 3 wellsFrom 16-20 wells - take readings from 4 wells

Annual Specific Conductance: Units Well No. Date sampled: Temperature:

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