Certification and Training Program

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DRINKING WATER OPERATORS

WASTEWATER OPERATORS

WATERWELL CERTIFICATION PROGRAM

MONITORING WELL DRILLERS CERTIFICATION TESTING

BACKFLOW PREVENTION

FLUORIDE CERTIFICATION

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           West Virginia Department of Health & Human Resources logo


Water Well Driller Forms

The following are a few of the various forms water well drillers will need while operating in the state of West Virginia. (Note: application for certification is available under the Certification Section).

Each of the following forms is available in a PDF format. To view this format, you must have Adobe Acrobat Reader which may be obtained free directly from Adobe. (Download Adobe Acrobat Reader from Adobe)

Application for Permit to construct, Modify or Abandon a Water Well or Install or Modify a Small Sewage Disposal System (SS-182)

This form is required for each project of those listed before the project is begun. The form must be completed and hand deliver to your local county Health Department.

Well Completion Report (SW258 EXAMPLE ONLY)

This form must be submitted following the completion of a water well construction. This document is presented online as an example only. You must acquire and submit the colored carbon sets from our office or your local County Health Department.

Bond Coverage Registration for Certified Water Well Driller (EW-88b)

This form must be submitted to our office at the time of initial certification for drillers. Bond coverage is for a period of one year. A new copy of the form (or a letter directly from the Bonding Agency) must be submitted yearly to remain in good standing and be considered for drilling permits.

Removal of Drillers from Bond Coverage (EW-88c)

This form must be submitted to our office if a driller is removed from bond coverage during the middle of the year term of there bond coverage. If this form is not submitted at the time a driller ceases to be covered, he will be considered covered regardless of his current employer or status.

Renewal Application for Certification

This form must be submitted to our office in order to renew your current Certification to drill water wells within the state of West Virginia. It should be completed and submitted prior to your existing Certification expiring.

Water Well Violation Report

This form must be submitted to our office. This form is used as the standard method of reporting violations of the Water Well Regulations and Design Standards.  Form to be used by water well drillers, the general public and by the county health departments to report violations when suspension or revocation of a driller's certificate is requested.

 

 


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