Get "abandoned Water Well Plugging Record" (iowa Dnr Form 542-1226) - Iowadot

Completing the Abandoned Water Well Plugging Record is essential for properly documenting the plugging of abandoned water wells. This guide will provide clear, step-by-step instructions to ensure that users fill out the form accurately and efficiently.

Follow the steps to complete the form accurately.

1. Press the ‘Get Form’ button to access and open the Abandoned Water Well Plugging Record in the online editor.
2. Fill in the owner section with the complete name and address of the well owner, including the city, zip code, state, and phone number.
3. In the well location section, provide the specific location details, including the quarter section, township, range (West or East), and county. Also, describe the exact well location on the property.
4. Complete the description section by entering the well depth, depth to water, casing diameter, year or decade constructed, and depth of casing. Additionally, check the box if it is a cistern.
5. Indicate the casing material by selecting from options such as steel, plastic, concrete, clay, brick, or stone. State the type of construction by choosing from drilled, driven, bored, dug, or augered.
6. If applicable, provide details for monitoring wells, including well ID, depth, and diameter.
7. Certify that the well has been plugged according to Iowa Administrative Code requirements by signing as the owner, and insert the date plugged.
8. If a certified well contractor plugged the well, ensure they fill out their signature, certification number, and date. If plugged by the owner with oversight, the county agent must sign and date the form.
9. Determine eligibility for grants-to-counties cost share by checking 'yes' or 'no' based on the county agent’s determination.
10. Submit one completed form for each well plugged within 30 days to the designated local county agent or the Water Supply Section if no agent is available.

Complete your documents online today to ensure compliance and proper documentation.