Form ECY070-299 "Variance Request - Minimum Standards for Well Construction" - Washington

What Is Form ECY070-299?

This is a legal form that was released by the Washington State Department of Ecology - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2010;
  • The latest edition provided by the Washington State Department of Ecology;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form ECY070-299 by clicking the link below or browse more documents and templates provided by the Washington State Department of Ecology.

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Download Form ECY070-299 "Variance Request - Minimum Standards for Well Construction" - Washington

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Water Resources Program
Variance Request- Minimum Standards for Well Construction
WAC173-160-106(1) allows you to request a variance from the Department of Ecology
when
strict compliance with state well construction standards is impractical. The variance request must propose
comparable alternative specifications that will provide equal or greater human health and resource
protection than the minimum standards. You must apply for a variance in writing and receive approval
. (All fields must be completed.)
before constructing or decommissioning the well
Requested by:
Mailing Address:
City:
State:
Zip:
Daytime Phone:
Date:
Property Owner (if different):
Site Location:
¼
¼ Section:
Township:
Range:
E or
WWM
Tax Parcel Number:
Well Address:
Well Driller/Company (if known):
Check one:
Water Well
Resource Protection Well
Dewatering Well
What construction standard cannot be met?
Describe the reason why standard cannot be met. Include site map and distances from all known potential
sources of contamination if setback variance is being requested.
Describe the alternative construction method that will provide equal or greater protections than those
provided by the minimum standard.
(Attach additional pages if necessary.) Complete and return with your site map to the appropriate
regional office:
Northwest Regional Office Southwest Regional Office
Eastern Regional Office
Central Regional Office
ATTN: Noel Philip
ATTN: John Pearch
ATTN: Mark Ader
ATTN: Avery Richardson
1250 W Alder St.
th
3190 160
Avenue SE
PO Box 47775
N 4601 Monroe
Union Gap, WA 98903
Bellevue, WA 98008
Olympia, WA 98504
Spokane, WA 99205
425-649-7044
360-407-0297
509-329-3544
509-575-2639
Fax: 425-649-7098
Fax: 360-407-6305
Fax: 509-329-3529
Fax: 509-454-7830
nphi461@ecy.wa.gov
jope461@ecy.wa.gov
made461@ecy.wa.gov
aric461@ecy.wa.gov
ECY 070-299(Rev 04-2010) To request ADA accommodation including materials in a format for the visually impaired, call Ecology Water Resources Program
at 360-407-6872. Persons with impaired hearing may call Washington Relay Service at 711. Persons with speech disability may call TTY at 877-833-6341.
Water Resources Program
Variance Request- Minimum Standards for Well Construction
WAC173-160-106(1) allows you to request a variance from the Department of Ecology
when
strict compliance with state well construction standards is impractical. The variance request must propose
comparable alternative specifications that will provide equal or greater human health and resource
protection than the minimum standards. You must apply for a variance in writing and receive approval
. (All fields must be completed.)
before constructing or decommissioning the well
Requested by:
Mailing Address:
City:
State:
Zip:
Daytime Phone:
Date:
Property Owner (if different):
Site Location:
¼
¼ Section:
Township:
Range:
E or
WWM
Tax Parcel Number:
Well Address:
Well Driller/Company (if known):
Check one:
Water Well
Resource Protection Well
Dewatering Well
What construction standard cannot be met?
Describe the reason why standard cannot be met. Include site map and distances from all known potential
sources of contamination if setback variance is being requested.
Describe the alternative construction method that will provide equal or greater protections than those
provided by the minimum standard.
(Attach additional pages if necessary.) Complete and return with your site map to the appropriate
regional office:
Northwest Regional Office Southwest Regional Office
Eastern Regional Office
Central Regional Office
ATTN: Noel Philip
ATTN: John Pearch
ATTN: Mark Ader
ATTN: Avery Richardson
1250 W Alder St.
th
3190 160
Avenue SE
PO Box 47775
N 4601 Monroe
Union Gap, WA 98903
Bellevue, WA 98008
Olympia, WA 98504
Spokane, WA 99205
425-649-7044
360-407-0297
509-329-3544
509-575-2639
Fax: 425-649-7098
Fax: 360-407-6305
Fax: 509-329-3529
Fax: 509-454-7830
nphi461@ecy.wa.gov
jope461@ecy.wa.gov
made461@ecy.wa.gov
aric461@ecy.wa.gov
ECY 070-299(Rev 04-2010) To request ADA accommodation including materials in a format for the visually impaired, call Ecology Water Resources Program
at 360-407-6872. Persons with impaired hearing may call Washington Relay Service at 711. Persons with speech disability may call TTY at 877-833-6341.