Existing Well Registration Request "*" indicates required fields HiddenApplication Number A. WELL OWNER INFORMATION(*) denotes a required field First Name:* Last Name:* Primary Phone:*Mailing Address:* City:* State:*TXALAKASAZARCACOCTDEDCFLGAGUHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPAPRRISCSDTNUTVTVAVIWAWVWIWYZip:* Email: (For fastest response of confirmation)* B. WELL LOCATIONWell Location Well Location Same as Section A Owner Address? Physical Address:* City:* State: Zip:* Use the url link below to find your well's latitude & longitude. Click on the link, enter your physical address, click the 'Show Location' button. Zoom in on the map using the '+', select the satellite imagery and move the pin to the location of your well. Copy the coordinates and enter them below. Google MapsLatitude (i.e. 30.123400)Longitude (i.e. -98.021234)C. WELL USE (Check One)Well use Exempt: (Residential/Domestic, Agricultural, Geothermal) Non-Exempt: (Commercial/Business, Public Water Supply, Retail Water Supply) D. WELL DETAIL (if known)Date Drilled: MM slash DD slash YYYY Driller--Select--5D Drilling & Pump Service, Inc.Aarts Water Well ServiceAction Water Well ServiceAdvanced Water Well TechnologiesAir-Rite Air Conditioning & HeatingApex Drilling, Inc.Aqua Pump and Well Services, IncAqua Utility ConstAquasource/Whisenant, IncAssociated Drilling Co.B&B DrillingBalcones Water Well ServiceBall Drilling Company, Inc.Bee Cave Drilling, Inc.Bible Water Well DrillingBrown's Water Well DrillingCentex Pump & SupplyCentral North ConstructionCentral North ConstructionCentral Texas DrillingD&R Water Well & Pump ServiceDart's Water WellDave's Well ServiceDavenport Drilling and PumpDavis Drilling CoDLT Drilling CoElite DrillingFlugrate ConstructionGeoprojectsGeothermal DrillingGlass and Tucker DrillingGlass Well ServiceH2O Development Corp.Hand DugHighland Drilling, Inc.Hill Country EcopowerHunt Water Well ServiceHydro Resources Mid ContinentHydro Resources-Mid ContinentJ & J Water Well and Windmill ServicesJ & J Water Well and Windmill ServicesJames Tucker DrillingJolander Well Drilling CoKutscher Drilling Ltd.L & L Drilling Co.Looptech Geothermal, LLCMcDearmon Water Well ServiceMcKinley DrillingMcKinleyDrillingMotal Well ServiceOwen Drilling Co.Precision Geothermal Drilling, L.L.C.Puddle Jumper Well CompanyR. Whisenant & Son, Inc.Raymond Whisenant & Son, Inc.Raymond Whisenant & Son, Inc.Raymond Whisenant & Son, Inc.Raymond Whisenant & Son, Inc.Sarris Geothermal DrillingSpring Branch Well ServicesStans Heating and AirTerra Power DrillingTexan WaterTom Arnold DrillingUnknownW.H. GlassWalden DrillingWell DoctorWestern Water WellsWhisenant & Lyle Water Services, Inc.Whisenant & Lyle Water Services, Inc.Whisenant & Lyle Water Services, Inc.Whisenant & Lyle Water Services, Inc.Wiley Water Well ServiceZavala DrillingWell Depth (feet):E. WELL RECORDSIf you have hardcopies of well records for your well (i.e. drillers log, State Well Report), please email them to staff3@haysgroundwater.com or mail to P.O. Box 1648, Dripping Springs, TX. 78620F. PREPARED BY (if different than owner)First Name: Last Name: G. COMMENTSComment By pressing the "Submit Well Registration" button below, you certify the following: I hereby register my water well with Hays Trinity Groundwater Conservation District for the purposes indicated on this form. I certify that I am the property owner/grantor or lessee/grantee or an Authorized Agent, and that the information provided on this form is true and correct to best of my knowledge. I will comply with HTGCD District Rules.HiddenConfirmation Message Δ
