Plum Creek Conservation District Well Registration

Instructions:       

This form is used for registration only and shall be filled out as completely as possible.  In accordance with the Texas Water Code, Chapter 36 and District rules, all wells in Plum Creek Groundwater Conservation District must be registered with the District.  

Check one:             This will be a new well

                                  This well existed prior to

Well Inspection:

District staff shall inspect each well registered with the District.  Property access for inspections is authorized by Texas Water Code, Chapter 36.123 and shall be scheduled with the well owner and conducted in accordance with District Rule 21. Inspections may include confirming well location, measuring water level, confirming pumping capability, water sampling, geological survey, or any other well-related inspection activity deemed necessary by the District.

Well Owner

Well Owner:  

Mailing Address: 

City:    State:     Zip Code: 

Daytime Phone: Alternate Phone:

Contact Person (if other than owner):

Phone:

Location, Description, and Uses of Existing or Proposed Well

This well is located on the property of:

Number of contiguous acres of water rights owned at well site:

This well is miles (north,south) of the city or town of and on Rd.

The survey names and numbers can be found on the Caldwell County appraisal District website.

Survey Name: Survey #: Abstract #:

Use of Well: Domestic Irrigation Public Supply Livestock

                        Industrial  Injection  Other (Please Specify Below)

Name of Driller: Date Drilled:

Total Depth: ft.   Pump Depth: ft. Water Bearing Formation:

Casing Diameter: inches   Horsepower of Pump:   GPM:

Owner’s or Registrant’s Sworn Statement

By checking this box

                I hereby swear and affirm that the information given herein is true and accurate to the best of my knowledge and belief, and that I am aware of, knowledgeable of, and will comply with all District Rules.