Notification of Well Plugging and Abandonment to WDEQ WQD

Use this form to notify the WDEQ Water Quality Division of well plugging and abandonment activities as required by Chapter 26 Section 11.


Date of Notification to WDEQ


Facility name and location address of the wells being plugged and abandoned.


State Program under which the wells were installed.


Permit or Project Number under which the wells were installed.


Contact name of your regulatory program contact person.


Provide some basic information regarding planned P&A activities.


Date well plugging and abandonment activities are expected to occur.


Name, company name, email address and phone number of the person submitting the plugging and abandonment notification.






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