In accordance with the Texas Water Code, Chapter 36 and District Rules, all wells in Blanco County must be registered with our District. Use this form to apply for well registration.

Payment of the well registration fee is required to be included with your Well Registration Form.

Instructions (For Downloaded Form): 

• Download and fill out the form
• Sign
• Mail, hand deliver OR scan and upload completed form using the form below

Instructions (For Online Form):

• Complete and submit the online form below
• Electronically sign  
• Mail or hand-deliver a check per the fee schedule

Well Owner (required)

Current Mailing Address (required)

City (required)

Zip (required)

Daytime Phone (required)

Alternate Phone

Contact Person (if other than owner)

Phone

Email Address

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Location, Description, and Uses of Well

County Property ID (required)

Acerage

Gate Code

Latitude (required)

Longitude (required)

Address and Directions to Well (required)

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Well Information - only if known

Driller (required)

Drilling Date

Well Depth (ft)

Casing Material

Casing Diameter: (in.)

Bottom of Casing at: (ft)

Pump Depth (ft)

Pump Horsepower (hp)

Pumping Capability in GPM

Is Well Operational?

Yes

No

For existing wells, attach copies of Driller's Log and any Pump Data if available

Water Use (check all that apply) (required)

On site

Off-Site - and if checked provide location of use

Livestock or Wildlife

Domestic - and number of households served

Test Well

Public Water Supply

Other Uses

If off-site, provide location of use (required)

If domestic, provide number of households served (required)

If other, please specify

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New Well Spacing: To ensure compliance with District Rule 4.2 Well Spacing requirements for proposed new wells, the applicant must provide the distance in feet between a new well and the following:

Closest Property Line (required)

Other Wells (required)

Septic Tank (required)

Septic Leach Field (required)

Potential Pollution Sources (specify) (required)

Is the proposed well site located within the service area of a public water system or community water system?

Yes

No

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Owner’s or Registrant’s Sworn Statement I hereby swear or affirm that the information given herein is true and accurate to the best of my knowledge and belief, and that I will comply with the Rules of the Blanco Pedernales Groundwater Conservation District.

Your Signature (required)

Confirm e-Signature

Review Electronic Records and Signatures Policy (required)

Read our Electronic Record and Signature Disclosure

I agree to use electronic records and signatures

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