Well Registration eForm

Parcel Number required This field is required Lattitude This field is required Longitude This field is required Township 6S 7S 8S 9S 10S 11S 12S 19S Range 10E 11E 17E 18E 19E 20E 21E 22E Section This field is required Proposed Starting Date Required Proposed Starting Date Required Field Date Property Owner/Agent Name This field is required Mailing Address This field is required Phone Number This field is required Well Location Street Address required This field is required City Required Alachua Archer Gainesville Hawthorne High Springs Island Grove Lacrossee Micanopy Melrose Newberry Waldo This field is required State required This field is required Zip Code Required 32601 32603 32605 32606 32607 32608 32609 32611 32615 32618 32622 32631 32640 32641 32643 32653 32654 32666 32667 32669 32694 This field is required Well Contractor Name required This field is required Well Contractor License Required This field is required Proposed Casing Diameter Required This field is required Proposed Casing Depth Required This field is required Proposed Total Depth Required This field is required Aquifer Required Floridan Intermediate Surficial Unknown This field is required Casing Type Required Black Iron Galvanized PVC Other (Please Specify) Specify your own value:     This field is required Category Required New Construction Modification Abandonment Existing This field is required Construction Method Required Cable Tool Rotary Jetted Auger Other (Please Specify) Specify your own value:     This field is required Intended Well Use Required Private Well Public Supply Irrigation Industrial Monitor Other (Please Specify) Specify your own value:     This field is required Additional Comments This field is required Signatures required This field is required

A well registration form can also be printed, filled out and mailed to ACEPD.

If you are submitting well registrations for multiple wells on one parcel please fill out the form for one well and submit the details of the other wells in the comments field or email them along with a location map to Betty Rosenblatt.

I do hereby agree to comply with the provisions of the Alachua County Unified Land Development Code Chapter 406 Article 11 and the Murphree Wellfield Code (Alachua County Code Chapter 355).

Questions can be directed to Betty Rosenblatt, at (352) 264-6814.

A well completion report must be submitted to ACEPD upon completion of the well. They can be emailed to Betty Rosenblatt or mailed to ACEPD at 408 W University Ave. Suite 106, Gainesville, FL 32601.  The well completion reports must also be submitted to the St. Johns River Water Management District.

The well completion report can be obtained from the well contractor. Existing well owners can submit the well completion report with this form.