Application for Well Registration

Application for Well Registration

Harris-Galveston Subsidence District
1660 W. Bay Area Boulevard
Friendswood, TX 77546-2640
Phone: (281) 486-1105 Fax: (281) 218-3700

Rule 5.1 Registration of New Wells:

A) All new wells must be registered by the well owner, well operator, or water well driller prior to being drilled. Registration may be by mail or telephonic document transfer, using a form provided by the District. The District staff shall review the registration and make a preliminary determination on whether the well meets the exclusions or exemptions provided in Rule 5.7, and shall inform the registrant of their determination within five business days. If the preliminary determination is that the well is excluded or exempt, the registrant may begin drilling immediately upon receiving the approved registration.

B) It shall be a violation of these rules for a well owner, well operator, or water well driller to drill any well without the approved registration form filed with the District.

Well Owner:
Correspondent:
Mailing Address:
City:	State: Zip:
Attention:
Phone Number:	Ext.:
Fax:
Drilling Company:
Contact:
License #:
Phone:
Fax:
Proposed well size:
Street address of proposed site:

Select intended use:

Public Supply - Wells used for retail or wholesale water supply. (Examples: cities, water districts, private utilities, apartments, mobile home parks, etc.)

Commercial/Domestic - Wells used by commercial or business establishments for potable or sanitary needs. (Examples: offices, warehouses, churches, schools, duplexes, etc.)

Industrial - Wells used as part of an industrial process or in the manufacturing of a product. (Examples: boiler feed, paper manufacturing, chemical process feed, etc.)

Agricultural Irrigation - Wells used in production of food or fiber commodities grown for resale or commercial purposes. Includes wholesale nursery growers.

Other - Wells used for other non-exempt uses such as livestock watering, filling ponds or lakes, or irrigation of golf courses, landscapes, parks, etc.

Single-Family Residential - Wells connected to one single-family dwelling and used for typical domestic and sanitary needs.

Single-Family Irrigation - Wells used for landscape irrigation at one single family residence but not connected to and serving the dwelling.

Geothermal - Wells used for a geothermal heat exchanger. Specify whether closed-loop, reinjection, or pump and dump.

Provide detailed description of intended use. If commercial or industrial, describe type of business, number of employees, type of product produced or sold, etc. If for new house or development, include construction start date. If agricultural, include crop type and acreage.

Describe any other water supply available at this location. For example, is there a municipal water line available for potable service or a canal or other raw water source for non-potable uses?

Does the "well owner" own any other well in Harris or Galveston county? YesNoIf yes, explain:

Is this well replacing an existing well? YesNoIf yes, give well no. of well being replaced and length of time owned or leased:

If this well is a replacement well, what will be the status of the old well? Not a Replacement WellCappedPluggedIn UseIf status of old well is "In Use", explain:

The use of the well may be limited some time in the future if some other source of water becomes available.

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