Get Well Driller (water Only) Supplemental Application - Concorde ...

Filling out the Well Driller (water Only) Supplemental Application is an essential task for individuals seeking to ensure compliance with local regulations. This guide will walk you through the process of completing the application online, making it as straightforward as possible.

Follow the steps to complete the application efficiently.

1. Click ‘Get Form’ button to obtain the application and open it in your preferred editor.
2. Begin with the applicant information section. Fill in your effective date, name, street address, city, state, and zip code. Ensure all information is accurate to prevent processing delays.
3. Indicate if there are limits on the depth of drilling by selecting 'Yes' or 'No.' If 'Yes,' specify the depth in the provided space.
4. Answer whether any township or utility company will be added as Additional Insured by selecting 'Yes' or 'No.' If you select 'Yes,' decline the option to add them.
5. Confirm if topographical surveys are conducted at the job site by selecting 'Yes' or 'No.' If 'No,' decline.
6. Confirm whether all well drillers are licensed by the State by selecting 'Yes' or 'No.' If 'No,' state who issued the license.
7. Provide the number of employees, owners, and/or managers certified by the National Ground Water Association in the specified categories.
8. Indicate whether all sources of potential falls are barricaded and appropriately warned with signage such as 'Caution - Open Trench' by selecting 'Yes' or 'No.' If 'No,' decline.
9. Complete the remaining questions regarding the number of employees and subcontractors, including their annual cost and the jobs they perform.
10. Finish by providing your annual sales and the average number of jobs per year. Ensure the applicant signature and date are completed.
11. Finally, include the producer name and address, reviewing all entries for accuracy.
12. Once completed, save your changes, and you may choose to download, print, or share the form as needed.

Ready to complete your forms? Start filling out the Well Driller (water Only) Supplemental Application online now!