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LEWIS COUNTY ENVIRONMENTAL SERVICES INDIVIDUAL WELL WATER AVAILABILITY VERIFICATION (Well Driller s Statement Form) (Please Print) Tax Parcel Number: Development Permit No.: PROPERTY LOCATION: Applicant
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How to fill out well driller39s statement form

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How to fill out a well driller's statement form:

01
Start by gathering all the necessary information. This includes the name and contact information of the well driller, the location of the well, and the date the well was drilled.
02
Next, provide details about the well itself. This may include the depth of the well, the diameter of the casing, the type of pump used, and any other relevant specifications.
03
Fill in the information regarding the water supply. This includes the water source, such as groundwater or surface water, and the estimated gallons per minute of water flow.
04
Indicate any additional equipment or installations related to the well, such as storage tanks or treatment systems.
05
If applicable, report any well construction issues or problems encountered during the drilling process.
06
Finally, sign and date the well driller's statement form to certify its accuracy.

Who needs a well driller's statement form?

01
Well drillers: This form is typically used by professional well drillers to document the details of the completed well and for regulatory compliance purposes.
02
Property owners: Individuals who own properties with wells may also need a well driller's statement form as part of the documentation required for permits, groundwater monitoring, or property assessments.
03
Regulatory authorities: Government agencies responsible for overseeing water resources and well drilling may request or require well driller's statement forms to ensure compliance with regulations and to maintain accurate records.
In conclusion, the well driller's statement form is necessary for both well drillers themselves and various stakeholders such as property owners and regulatory authorities who need accurate information about the well.
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The well driller's statement form is a document used to report information about well drilling activities.
Well drillers are required to file the well driller's statement form.
The well driller's statement form can be filled out by providing information about the location of the well, drilling methods used, and other relevant details.
The purpose of the well driller's statement form is to ensure that well drilling activities are properly documented and reported.
Information such as well location, drilling depth, casing details, and drilling methods must be reported on the well driller's statement form.
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