Well Pump and Pressure-Tank Service-Call Worksheet

Print or download this free worksheet to record visible symptoms, safe observations, equipment information, access conditions, and quote-comparison details before a service call. Nothing you enter is stored or transmitted.

Call to request service(863) 400-3070 Request service

Service availability varies by address, the issue, provider coverage, and current schedules.

Independent service-request website. Calls and forms may be shared with a third-party provider. The provider confirms availability, pricing, and service terms.

How to use this worksheet

Fill in what you know — you do not need every answer. Use the form on screen, then print or download a blank PDF. Nothing you enter here is stored, transmitted, or logged.

Safety boundary: observe from a safe distance. Do not remove electrical covers, handle wiring, open the pressure-switch housing, or try to pull the pump. Record only what is visible from outside the system.

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Section 2 — What the well feeds

What does the well supply?

Number of buildings or units supplied

Section 5 — Pressure and cycle observations (safe, external only)

Record only what you can observe safely without removing covers or touching wiring.

Pressure gauge reading — pump OFF (psi)

Pressure gauge reading — pump just turned ON (psi)

Rapid cycling — number of times pump starts per minute

How long does pump run before shutting off? (seconds or minutes)

Pressure switch label visible?

Yes — cut-in/cut-out settings visible on label No label visible Switch not accessible

Cut-in / cut-out settings (if visible on label, e.g., 30/50 psi)

Tank pre-charge pressure (psi) — from label or Schrader valve (pump off and system depressurized only)

Section 7 — Well history and paperwork

Paperwork available?

Previous pump or tank service?

Yes No Unknown

Service history summary (what was done, when)

Approximate well depth (feet, if known)

Approximate year well was drilled (if known)

Section 8 — Access and site conditions

Access conditions

Open access — no restrictions Locked gate — code or key needed Dogs on property Tenants must be notified before entry Property manager on site — ask for ___ Wellhead in a locked pump house or enclosure Wellhead in confined space or pit (do not enter) Electrical panel separate from wellhead

Access notes (gate code, contact to notify, etc.)

Wellhead location description

Section 12 — After service record

Service date

Provider / technician

Work performed

Parts replaced (make, model, specs)

Warranty expiration

Permit number (if applicable)

Water tested after service?

Yes — results: No — reason: Not applicable

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This worksheet records information for a service call. It does not diagnose equipment, size replacement parts, or constitute professional advice. Nothing you enter is stored, transmitted, or logged. Source framework: National Ground Water Association annual well-checkup guidance. Checked July 23, 2026.