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Well Permitting and Notice of Intention Forms

***ATTENTION - FORM UPDATES AND REQUIRED INFORMATION***

ADWR forms are periodically updated to include new information needed to issue a well permit or authorization to drill a well.  Please bookmark this page
and use this webpage to download the latest version of each form as needed.  Please do not reduce the size of the forms.  Effective immediately, only new forms will be accepted. 

Location of Groundwater Withdrawals

Driller and Well Applicants!  The ADWR form Notice of Intent (NOI) to Drill, Deepen, Replace or Modify a Well (DWR 55-40) has been modified to require drillers and applicants to indicate whether the water to be withdrawn from the proposed well will be used in the same groundwater basin where the well is to
be located.

To assist NOI applicants and drillers in locating groundwater basin and sub-basin boundaries, the Department’s Basin and Sub-Basin Designations—June 1984 has been added to the website.  This document describes the official boundaries of each of the 46 groundwater basins and 27 sub-basins of the state not included in the five initial Active Management Area (AMA) basins in narrative and map form.  Click here to download the official basin/sub-basin boundaries outside AMAs. 

To more easily determine what basin and sub-basin a proposed well may be located, ADWR recommends referring to the Statewide Map of Groundwater Basins and Sub-Basins showing all the basins and sub-basins of the state before refining your search of the official 1984 boundaries document. 
Click here to download
the Statewide Map of Groundwater Basins and Sub-Basins. 

 

Individual AMA boundary maps are available here to download.  Click here to download individual AMA Maps.

 

Geographic Location Requirements

Drillers!  The Well Driller Report and Log (form DWR55-55) and the Well Abandonment Completion Report (form DWR55-58) now require Latitude and Longitude measured by GPS or a more accurate type of survey.  Please provide this information on all reports.  Measurements must be reported in the
NAD83 datum and in degrees, minutes, decimal seconds (ddd°mm’ss.ss”).  The USGS Quad Map is no longer an acceptable method for determining and reporting geographic locations.

 

Landowner Authorizations

Drillers and Well Applicants!  The landowner on which any well is drilled, modified, or abandoned must approve the actions to be taken on their property.       All NOIs have signature blocks for these authorizations.  If you are filing the NOI electronically, or the landowner is not available to sign the original NOI, the form DWR 55-72 “Landowner Authorization to Drill or Abandon a Well on Landowner’s Parcel” can be used in place of a signature on the NOI.  Download the form below.

 

Permits, Forms and Applications

If you are drilling a NON-EXEMPT WELL within an Active Manaagement Area (AMA), please use the following list:
Reference Application Form Instructions Checklist
55-0001 Application for a Permit to Drill or Operate a Non-Exempt Well Within an AMA Pursuant to A.R.S. 45-599   
55-41 Notice of Intention to Deepen, Replace or Modify a Non-Exempt Well   
55-41A Notice of Intention to Drill a Non-Exempt Well pursuant to a Non-General Industrial Use Permit   
55-90 Well Construction Supplement      
  Non-Exempt Well Impact Waiver - 10 feet of Additional Drawdown      

 

If you are drilling any other type of well (inside or outside an AMA), please use the following list:
Reference Application Form Instructions Checklist
55-40 Notice of Intent to Drill, Deepen, Replace or Modify a Well
  Exempt Well Certification of Compliance with A.R.S. § 45-454(C) or Request for Exemption Pursuant to A.R.S. § 45-454(D)    
  Second Exempt Well for the Same Non-irrigation Use, At the Same Location, in an AMA Pursuant to § 45-454(I)    
  Exempt Well for Domestic Use Pursuant to § 45-596(F) & (G)    
55-43B Notice of Intent to Drill and Abandon an Exploration/Specialty Well
55-44A Notice of Intent to Drill, Deepen, or Modify a Monitor/Piezometer/Environmental Well
  Remediation Well Certification of Compliance with A.R.S. § 45-454(C) or Request for Exemption Pursuant to A.R.S. § 45-454(F)    
55-38 Notice of Intent to Abandon a Well
55-75 eNOI Password Request    

 

Miscellaneous forms:
Reference Application Form Instructions Checklist
55-36 Well Owner’s Notification of Abandonment  
55-39 Notice of Well Capping  
55-55 Well Driller Report and Well Log  
55-56 Pump Installation Completion Report  
55-57 Project Completion Report for Mineral Exploration Drilling  
55-58 Well Abandonment Completion Report  
55-65 Late Registration of a Well  
55-71A Request to Change Well Information  
  Online Change of Well Ownership    
55-72 Landowner Authorization to Drill or Abandon a Well on Landowner's Parcel    
  Public Land Survey: Understanding Cadastral Location/Legal Description    
  Legal Requirements for Septic Setbacks 45-596 F & G and R12-15-818    
  Request for an Extension of Time to Submit Information for an Application    
  One Hundred (100) Foot Separation between Proposed Well Location and Septic Systems or other Hazards