Get Uniform Kentucky Well Maintenance And Plugging Record

Filling out the Uniform Kentucky Well Maintenance And Plugging Record is essential for documenting well maintenance, plugging, or modifications. This guide provides a clear, step-by-step approach to help you complete the form accurately and efficiently.

Follow the steps to complete the form correctly.

1. Press the ‘Get Form’ button to access the Uniform Kentucky Well Maintenance And Plugging Record form and open it for editing.
2. Begin by filling in the Kentucky Well ID (AKGWA) Number at the top of the form. Ensure this number is accurate as it uniquely identifies the well.
3. Provide the owner’s name and address. Include the city, state, and zip code to ensure documentation is directed correctly.
4. If required, fill in any necessary attachments. This includes a site plan or sketch map as well as the well location indicated on a topographic map or obtained via GPS.
5. Complete the site name and address fields if they differ from the owner’s information. Again, include the city, state, and zip code.
6. Indicate the facility type and any applicable Agency Interest numbers. Select the usage of the well from the well use options provided and specify the corresponding ID number if applicable.
7. Fill in the owner’s contact phone number for easy communication. Next, provide details regarding the well specifications including the drilling method and depth.
8. In the plugging activity section, detail the sealing materials used and the depth of the operation. Select the appropriate options that apply to your project.
9. Include comments if necessary, detailing any specific information relevant to the maintenance or plugging activity.
10. Finally, affirm the accuracy of the information by signing the document. Input the signature of the certified driller, their certification number, and the date signed.
11. Once you have completed all sections of the form, make sure to save your changes. You might also choose to download, print, or share the document as needed.

Complete your Uniform Kentucky Well Maintenance And Plugging Record online today!