Well Construction Complaint Form
This form should be completed to report suspected illegal well construction activity. Reporting such activities assists the Department in investigating potential violations and pursuing appropriate enforcement actions involving landowners or well constructors. Please use the map controls or enter latitude and longitude coordinates to identify the location of the well on the map. Accurate location information is important and assists the Department in reviewing and responding to your complaint.
Well Construction Complaint
Complaint Date:
Type of Complaint:
Status of Well:
Nature of
the Complaint:
Location of the Well
You may click on map to get latitude/longitude.
Latitude:
Longitude:
Address Type:
Street1:
Street2:
City:
Location
Description:
Identification of the Well
If known, provide identifying information about the well:
Well Report:
Well Label: L
Contact
Complaints can be anonymous. Would you like to provide your contact information for follow-up?
Remain Anonymous?
First Name: Last:
E-Mail:
Contact Phone:
Add Photos
Limit to 32mb
Load Photo1:
Load Photo2:
Load Photo3:
.
Tax Lots