REQUEST FOR NON-PRODUCTION WELL CONSTRUCTION
Fill out this form, and then click the button to generate the printable form, then print the Non-Production Well Construction form from the resulting .pdf file. If you would like to print a blank Non-Production Well Construction form, simply leave the form blank and click the button to generate the printable Non-Production Well Construction form.

- The Non-Production Well Form must be completed and signed by the project owner or authorized representative. The form shall not be signed by the licensed driller.

- See R655-4-9 of the Administrative Rules for Water Wells for information and requirements for the approval process for non-production wells.

- See R655-4-12 and R655-4-15 of the Administrative Rules for Water Wells for drilling and construction information and regulations for non-production wells.

This permit may not be the only authorization needed to drill a well. The applicant is responsible for obtaining other permits/authorizations from federal agencies, other state agencies, and/or local jurisdictions as applicable. Moreover, if the applicant is not the landowner, it is the applicant's responsibility to ensure that approvals/permissions have been obtained to trespass and drill a well(s) on the property. This permit does not give authorization to trespass on private property.

Completed and signed Test Well applications can be sent to the applicable regional office for review and approval (See Contact Information).

Completed and signed applications for all other types of non-production wells can be sent to the applicable regional office or to the Well Drilling Program in the main SLC office (See Contact Information for mailing address, or email scanned version to waterrights_wells@utah.gov).

HINTS: Well locations in Public Land Survey coordinates can be derived from the "Tools" tab of the Division's Map Search or the Location Calculator.

Counties can also be identified on the Division's Map Search.

The Water Right Area in which the wells are located can be identified by turning on the "Water Right Areas" layer in the Division's Map Search.

The Adobe reader is required to print the Non-Production Well Construction form. It can be acquired at the following link.

 
   
 
 
Well Type :
Test    Monitor    Cathodic Protection    Closed Loop Heat Exchange
Piezometer    Inclinometer    Dewatering    Other:
Applicant's Name :
   
Mailing Address :
   
   
   
Project Address :
   
   
   
Contact Person : Phone :
       
Proposed Start Date : Anticipated Completion Date :
       
Well Driller who will perform the work: (if known) Proposed Number of Wells :
      
 
PROPOSE LOCATION OF WELLS:County : Water Right Area :
      
N/SN/SE/WE/WSectionSectionTownshipRangeBaseDiameterDepthProperty
DirectionDistanceDirectionDistanceCornerMeridian(inches)(feet)Parcel Number
Explanatory :