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2. If the U.S. Army has recently tested your domestic well for PFAS, and you would like to share your test results with Yakima County, please complete the form below. 

   Your information will help us identify and map where PFAS has been discovered. While we won’t identify specific addresses or parcels in our mapping, please be aware that Yakima County records are subject to the Public Records Act and may be disclosed if requested. 

4. First Name
5. Last Name
7. Address
8. City
10. Phone Number
11. Email Address
15. Complete Well Depth
17. Reported PFAS levels
19. Other Well Information
21. Well Documentation

    Please upload any well documents you would like us to review. 

Leave This Blank:


23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit

* indicates a required field