Statutes, codes, and regulations
Wyoming Administrative Code
Agency 037 - Engineer, StateSubagency 0004 - Ground Water
Chapter 3 - PREPARING GROUND WATER FORMS
Section 3-3 - Statement of Completion and Description of Well. (Form U.W. 6)

037-3 Wyo. Code R. § 3-3

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Current through April 27, 2019
Section 3-3 - Statement of Completion and Description of Well. (Form U.W. 6)

Form U.W. 6, "Statement of Completion and Description of Well", is required by law to be submitted within 30 days after completion of the well, including pump or (in the case of a flowing artesian well) control valve. Most of the items are self-explanatory. The Permit No., Name of Well, Book No., Page No., and Name (s) and address (es) of the applicant (s) will be completed in the State Engineer's Office before the form is sent to the permittee. Other items should be completed as follows:

a. ITEMS 1 through 3 - These items should be shown as they are shown on the original permit unless ownership has been changed. An explanation of any ownership changes should be provided.

b. ITEM 4 -- "LOCATION OF WELL" - The location of the well within the 40-acre subdivision should agree with the original permit. If not, provide an explanation under "REMARKS".

  • (1) If a tie to the well is available at the time the form is submitted, it should be shown under "Bearing and Distance."
  • (2) If no tie is available, the distance, given in feet and in the cardinal directions, from the nearest corner of the public land survey should be shown on the form in the proper place.

c. ITEMS 5 through 12 -These items should be completed with information provided by the well driller and pump installer.

d. ITEM 13 - "TABULATION" -- If for irrigation, the land proposed to be irrigated should be shown. Designate ownership of land; federal, State, or private. If private, give names of owners. The tabulation should agree, basically, with the tabulation on the original permit. If the use of water is other than irrigation, show the area and point (s) of use within each 40-acre subdivision.

e. ITEM 14 - "PLAT" - Accurately show the well location, point (s) of use (s), and sketch the conveyance system on the plat. Because a plat certified by a licensed engineer or land surveyor will also be required when the well is adjudicated, this plat need only be a sketch and does not need to show ties if they are not yet available.

f. REMARKS - The means of conveying water to the lands or the point or points of use, should be described under "REMARKS". In addition, this space should be used to make a complete explanation of any situation that is not explainable in the main body of the form.

g. ITEM 15 -- "IF WELL IS TO BE ABANDONED, . . ." -- Items 1 through 8 and Item 12 should be completed on the form, and an explanation of why the well was abandoned should be entered under Item 15.

h. SIGNATURE - The form must be signed and dated by the owner or his agent. If the well is owned by more than one individual, only one need sign. If a company, corporation, agency, or municipality, is named as applicant, a designated official must sign. The official's title or agent's title should be noted under the signature.

037-3 Wyo. Code R. § 3-3