Get Form 55 71a

Filling out Form DWR 55-71A, titled 'Request to Change Well Information,' is essential for notifying the Arizona Department of Water Resources of any changes concerning well ownership or operations. This guide will provide you with clear and supportive steps to complete the form accurately online.

Follow the steps to successfully fill out the form online.

1. Press the ‘Get Form’ button to access the document and open it in your preferred editing software.
2. In the upper right-hand corner of the form, enter the well registration number assigned by ADWR when the well was registered or when applying to drill the well.
3. Complete Section 1 – Registry Information by providing the well owner's name, mailing address, and contact numbers. If the well owner represents a corporation or other entity, include a contact person's name.
4. Fill in the location of the well by providing a street address, a legal description of the property, latitude and longitude (if known), the county tax assessor’s parcel identification number, and the name of the county where the well is situated.
5. Indicate the type of request for the change in well information by checking the appropriate box in Section 1.
6. If you selected 'Change of Well Drilling Contractor,' complete Section 2, providing information for both the current and new well drilling contractors, including names and license details.
7. Complete Section 3 — Statement of Change of Well Ownership, if applicable, by supplying information for the previous and new well owners.
8. In Section 4, describe the changes concerning the well information and attach any supporting documents that will aid in understanding the modifications.
9. If desired, grant ADWR permission for property entry to take depth-to-water measurements in Section 5.
10. Sign and date the form in Section 6 to verify the information provided.
11. Save any changes. Once completed, you can download, print, or share the form as needed.

Complete your documents online for a streamlined and efficient process.