HomeMy WebLinkAboutWell Water Quantity and Potability Certificate - Schedule GSchedule G
Certificate of Well Water Quantity and Potability
City of Maple Ridge Revised 2015-04-03
11995 Haney Place, Maple Ridge, BC V2X 6A9 Tel: 604-467-7311 Fax: 604-467-7461
Inspection Requests: inspectionrequests@mapleridge.ca
Web Site: www.mapleridge.ca Inquiries at: permits@mapleridge.ca
1. Quantity:
(a) I, ______________________________, a Professional Engineer registered with the Association of
Professional Engineers and Geoscientists of British Columbia, hereby certify:
(i) that I have caused tests to be performed on the well(s) located on the premises located at
__________________________________________________
(address)
and described as:
______________________________________
(legal description)
(ii) that, based on the said tests and my knowledge of the said premises, I am of the opinion that
the said well(s) will be capable of yielding at least 2,250 litres of water per day on a year round
basis.
Dated this _____________ day of __________________, 20___ .
______________________________________ (Affix Seal)
Professional Engineer
2. Potability:
I, ______________________________, a Professional Engineer registered with the Association of
Professional Engineers and Geoscientists of British Columbia, declare that based on the chemical
analysis of a sample of water taken from the above described well(s), I hereby conclude that the water
from the said well(s) is potable and meets acceptable Federal and or Provincial drinking water standards.
Dated this _____________ day of __________________, 20____ .
______________________________________ (Affix Seal)
Professional Engineer
3. Attachments:
Chemical and Bacteriological Analysis
Drillers Well Log
MOE Schedule 2 Requirements for Well Identification
Fraser Health Operating Permit (for anything other than a single family dwelling [SFD})
Engineers letter for compliance with Part 5 Section 78(2)(b)(ii) of the Water Act (other than SFD)