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.
