Environmental

PFAS Questionnaire

fileMaineInstallation MapENV Restoration Home

PFAS Private Drinking Water Well Questionnaire

The following information will assist the Navy in completing this off-base drinking water investigation. Please submit the questionnaire by choosing one of the following:

  1. Complete and submit the online form below, OR
  2. Completing the fillable PDF Questionnaire and emailing it to the Navy Public Affairs Officer at NAVFAC_ML_PAO@navy.mil, OR
  3. Print the PDF Questionnaire and mail to NAVFAC MIDLANT Public Affairs, Naval Station Norfolk, Bldg. Z-140, Norfolk, VA 23511
     

If your property uses groundwater for drinking and cooking, please respond to the questions below and submit the completed questionnaire online.

If you do not own this property, please complete questions 1 and 2 and submit the online questionnaire. If you do not have a drinking water well, please complete the questionnaire by answering "no" to question 3 and submitting online.

 

 
 
*
*
 
 
 
*
 
 
 YES
 NO
 
 
 YES
 NO
 
 
 YES
 NO
 
 YES
 NO
 
 
 YES
 NO
 
 
 YES
 NO
 
 YES
 NO
 
 
 YES
 NO
 
 
 YES
 NO

 

 

Share This Page

1322 Patterson Ave. SE, Suite 1000, Washington Navy Yard, D.C. 20374-5065

  • Please read this Privacy Policy
  • GILS NUMBER DOD-USN-000702
Connect with Us