- Use a pencil. You may want to make changes.
- For each category listed on the left that is appropriate to your farmstead, read across to the right and circle the statement that best describes conditions on your farmstead. (Skip and leave blank any categories that don't apply to your farmstead.)
- Then look above the description you circled to find your "rank number" (4, 3, 2 or 1) and enter that number in the blank under "your rank."
- Directions on overall scoring appear at the end of the worksheet.
- Allow about 15 minutes to 30 minutes to complete the worksheet and figure out your risk ranking for well-management practices.
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Low risk, rank 4 |
Low to moderate risk, rank 3 |
Moderate to high risk, rank 2 |
High risk, rank 1 |
Your rank |
| Ash disposal |
| From farm burn barrel or incinerator |
Ash collected and disposed of at licensed landfill or municipal incinerator. |
Disposal of ash from dry combustibles only1, on farm or at dump, or spread on fields. |
Disposal of ash from mixed trash at dump or on farm1 away from well. |
Disposal of ash ash from mixed trash on farm1 in consistent location near well. |
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| Building/wood maintenance products |
| Adhesives, such as caulk, and solvent-based glues |
Used up or shared with someone else. Hazardous-waste contractor collection service used for leftover adhesives. |
Sludge or leftover product taken to licensed landfill or municipal incinerator. |
Disposal at dump.1 |
Disposal on farm.1 |
|
| Brush or spray gun cleaners (solvent-based) |
Cleaned in contained, ventilated area. Solvent-recycler collection service used for leftover cleaners. |
Cleaned in contained, ventilated area. Filtered cleaning solvents reused. Sludge taken to licensed landfill or municipal incinerator. |
Cleaned in uncontained, ventilated area, and used cleaning solvents disposed of at dump.1 |
Disposal of leftover cleaning solvents on farm.1 |
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| Lead-based paint |
Hazardous-waste contractor collection service used. |
Paint or sludge taken to licensed landfill or municipal incinerator. |
Disposal of sludge or paint at dump.1 |
Disposal on farm.1 |
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| Paint or stain (no lead) |
Used up or shared with someone else. Hazardous-waste contractor used for leftover paint or stain. |
Paint or sludge taken to licensed landfill or municipal incinerator. |
Disposal of oil-based paints or stains at dump. Latex-paint disposal on farm away from well.1 |
Disposal of oil-based paints or stains on farm.1 |
|
| Stripper or thinner for paint/finish |
Spills contained. Unused products used up. Hazardous-waste contractor collection service used for leftover stripper or finish. |
Stripper or stripper sludge taken to licensed landfill or municipal incinerator. |
Disposal of sludge, stripper or thinner at dump.1 |
Disposal on farm.1 |
|
| Surface cleaners (solvent-based) |
Used up or shared with someone else. Hazardous-waste contractor collection service used for leftover cleaners. |
Cleaners or sludge taken to licensed landfill or municipal incinerator. |
Disposal of sludge or cleaners at dump.1 |
Disposal on farm.1 |
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| Container disposal |
| Paper/cardboard pesticide container |
Returned to supplier or hazardous-waste collection service used. |
Empty container taken to licensed landfill, municipal incinerator or dump. |
Disposal of empty container on farm.1 |
Disposal of partially filled container on farm.1 |
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| Plastic pesticide container |
Triple-rinsed container returned to retail store for reuse or taken to licensed landfill or municipal incinerator. Rinsate applied to appropriate crop. |
Unrinsed container disposed of at licensed landfill, municipal incinerator or dump. |
Disposal of empty but unrinsed container on farm.1 Disposal of triple-rinsed container on farm. |
Disposal of partially filled container on farm.1 |
|
| Plastic container for oil or other vehicle product |
Product used up and container recycled. |
Empty containers taken to licensed landfill or municipal incinerator. |
Disposal of empty container at dump or on farm.1 |
Disposal of partially filled container on farm.1 |
|
| Household hazardous-product containers |
Taken to recycling facility or reused for similar product. |
Empty container taken to licensed landfill, municipal incinerator or dump. |
Disposal of empty container on farm. |
Disposal of partially filled container on farm. |
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| Pesticides |
| Unwanted or banned pesticides |
Unused pesticides returned to place of purchase. Hazardous-waste contractor collection service used. Participation in EPA banned-pesticide buy-back program if available. |
Pesticides sold for restricted or general purpose used up or taken to licensed landfill or municipal incinerator1 |
Disposal of unused pesticides at dump.1 |
Disposal of unused pesticides on farm.1 |
|
| Vehicle/metal equipment maintenance products |
| Used antifreeze |
Saved and taken to antifreeze recycling facility, or filtered and reused as water in other radiators. |
Collected and and disposed of at municipal sewage-treatment drain with permission of municipality. Taken to licensed landfill, municipal incinerator or dump. |
Disposal on farm away from well (including in septic system). |
Dumped near well. |
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| Waste oil and grease |
Taken to used-oil collection tank for recycling. |
Reused for lubrication. Burned for heat in an approved residential incinerator, or collected and disposed of at licensed landfill or municipal incinerator1 |
Disposal at dump.1 |
Disposal on farm.1 |
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| Waste-oil sludge (left over after burning) |
Hazardous-waste contractor service used. |
Collected and disposed of at licensed landfill or municipal incinerator.1 |
Disposal at dump.1 |
Disposal on farm.1 |
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| Spent organic solvent/parts cleaner |
Solvent-recycler collection service used for leftover cleaners. |
Filtered in ventilated area and reused. Sludge taken to licensed landfill or municipal incinerator. |
Disposal of solvents or sludge at dump. |
Disposal of solvents or sludge at farm.1 |
|
| Rust-removal products |
Used up or shared with someone else. Hazardous-waste contractor services used. |
Taken to licensed landfill, municipal incinerator or dump. |
Disposal of leftover product on farm away from well. |
Disposal of leftover or used product on farm near well.1 |
|
| Lead-acid battery |
Taken to battery recycler or battery store. |
Used batteries taken to licensed landfill or municipal incinerator1 or stored away from well. |
Used batteries taken to dump1 or stored near well. |
Disposal on farm near well.1 |
|
| Vehicle maintenance, drips and spills |
Contained on paved area with sawdust. Contaminated sawdust disposed of at licensed landfill or municipal incinerator. |
Contained on paved area with sawdust. Contaminated sawdust disposed of at dump. |
Occasional flushing onto farm property near well. |
Frequent flushing onto farm property near well. |
|
| Wood preserving |
| Application drips and spills |
Drips and spills contained. Applicator and drop cloths disposed of at licensed landfill or municipal incinerator. |
Drips and spills contained. Applicator and drop cloths disposed of at dump. |
Application without containment more than 100 feet from well. Applicator and drop cloths disposed of on farm. |
Application without containment within 100 feet of well. |
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| Disposal of unused preservatives |
Used up or shared with someone else. Hazardous-waste contractor collection service used for leftover preservatives. |
Disposal at licensed landfill or municipal incinerator.1 |
Disposal at dump.1 |
Disposal on farm.1 |
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| Use this total to calculate risk ranking in Equation 1. |
Total: |
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