Tehama County Groundwater Sustainability Agency Well Registration Form

    Antelope, Bend, Bowman, Corning, Los Molinos, Red Bluff, South Battle Creek

     

    General Information

    In June 2022, the Tehama County Flood Control and Water Conservation District Board of Directors adopted Resolution No. 9-2022 setting the annual fee of $0.29 per acre to fund the creation, implementation, and administration of a county-wide well registration program. The $0.29 per acre fee is solely for well registration and the necessary data management. Data collected through the well registration program will be used to support the development of a well size/use type based funding method to provide long-term funding for the Groundwater Sustainability Agency. The fee is in place for three years but for those that register their wells prior to April 10 there will be an exemption from future registration fees for the remaining years.
    To qualify for exemption there are five minimum requirements:

    • A) Well registration form must be submitted in person, by email through online registration or postmarked by April 10 in the given year; and

    • B) Well registration form must have the APN or address of the property that has the well or does not have a well, legibly identified so that there is no possibility of confusion as to where the well is located or what parcel claimed to have no well; and

    • C) Well registration form must have identified the well use as either residential, agricultural, or other; and

    • D) Parcels with well use identified as agriculture must identify either well size and typical annual volume, or current crop type and acreage used for each crop identified; and

    • E) Parcels with well use identified as other/combination must include a detailed description of what exactly the other/combination activity is.

     

    The information collected by filling out the survey is confidential and private, will be used only for the purposes of sustainable groundwater management, will improve information on groundwater in our region, and will not be disclosed unless required by law.

    Please complete all four sections. For most people, this survey will take less than 15 minutes to complete. All required information is noted with an asterisk. Please complete as much of the form as you can, to the best of your knowledge.

     

    Complete the Fillable Form below:

    For additional information, visit: https://tehamacountywater.org/gsa/. For assistance with completing this form call GSA staff at
    530-690-0700, email tehamagsa@tcpw.ca.gov, or visit our office at 1509 Schwab Street, Red Bluff, CA.

     

    Section 1 – Contact Information

    1-A1. Property Owner




    1-A2. Property Location Information




     

    Section 2 – Water Source

    2-A1. Does the parcel use groundwater from an onsite well?*

     

    2-A2. Does the parcel use water from a Public Water System?

    Municipal, mutual, or private water company servicing the parcel.

     

     

    (Continued from 2-A1) The parcel does use groundwater from an onsite well:

    2-B1. How many active wells are on the parcel?

    2-B2. Is/are the well(s) metered?

    A meter measures the amount of groundwater pumped.

    2-B3. How many inactive or inoperable wells are on the parcel?

    Wells that are not currently used to pump groundwater.


     

    Well Attributes

    Well #1 Information


    2-B4. What is the depth (in feet) of the well(s) on the parcel?

    2-B5. What is the diameter (in inches) of the well casing?

    How to Measure Your Well Casing Diameter: Place the end of your measuring tape on one side of the pipe and measure to the opposite side so that the tape evenly bisects the pipe.

    2-B6. Where on the parcel is the well located?


    Please describe the location OR attach a site map or aerial photo of the parcel with active well locations marked.

    Is your well metered?

    Is your well active?


     

    Do you have another well to add?

     

    Well #2 Information


    2-B4. What is the depth (in feet) of the well(s) on the parcel?

    2-B5. What is the diameter (in inches) of the well casing?

    How to Measure Your Well Casing Diameter: Place the end of your measuring tape on one side of the pipe and measure to the opposite side so that the tape evenly bisects the pipe.

    2-B6. Where on the parcel is the well located?


    Please describe the location OR attach a site map or aerial photo of the parcel with active well locations marked.

    Is your well metered?

    Is your well active?


     

    Do you have another well to add?

     

    Well #3 Information


    2-B4. What is the depth (in feet) of the well(s) on the parcel?

    2-B5. What is the diameter (in inches) of the well casing?

    How to Measure Your Well Casing Diameter: Place the end of your measuring tape on one side of the pipe and measure to the opposite side so that the tape evenly bisects the pipe.

    2-B6. Where on the parcel is the well located?


    Please describe the location OR attach a site map or aerial photo of the parcel with active well locations marked.

    Is your well metered?

    Is your well active?


     

    Do you have another well to add?

     

    Well #4 Information


    2-B4. What is the depth (in feet) of the well(s) on the parcel?

    2-B5. What is the diameter (in inches) of the well casing?

    How to Measure Your Well Casing Diameter: Place the end of your measuring tape on one side of the pipe and measure to the opposite side so that the tape evenly bisects the pipe.

    2-B6. Where on the parcel is the well located?


    Please describe the location OR attach a site map or aerial photo of the parcel with active well locations marked.

    Is your well metered?

    Is your well active?

     

    2-B7. Would you be willing to have your well(s) monitored (depth to water in well) to better understand aquifer levels in your area?

    Monitoring provides important data that serves as a key input into decision-making processes. Groundwater monitoring could:

    • Track changes in groundwater levels

    • Identify existing or potential changes in flow due to groundwater withdrawal

    • Assess the effects of drought, surface water flow, and rainfall on groundwater levels

     

    2-B8. Does the parcel use groundwater from a shared well on a nearby parcel?

    If yes, what is the APN or address of the nearby parcel?

    2-C1. Does the parcel use surface water from a reservoir, stream, or other surface water diversion?

    Water on or collected from the surface of the ground, in contrast to water from underground. Surface water may be in or from lakes, streams, etc.

    2-C2. How much surface water is used each year?

    2-C3. Would you be willing to consider using excess surface water for the purpose of groundwater recharge?

    2-D1. Does the parcel use recycled water?

    2-D2. What is the name of the recycled water supplier?

    2-D3. How much recycled water is used each year?

     

    Section 3 – Water Use

    Measured or estimated groundwater use may be used to assess a Future Groundwater Sustainability Fee. The data collected through this survey will not automatically be used to estimate groundwater use for fee assessment purposes.

    Residential / Household Water Use

    3-A1. Are there residential dwellings on the parcel?

    3-A2. How many residential dwellings are on the parcel?

    3-A3. What is the primary source of water for residential use?

    If residential water use is based on a water meter reading or an invoice, please provide the annual usage.

    Landscape Irrigation Water Use

    3-B1. Is water used for landscape irrigation?

    3-B2. What is the primary source of water for irrigated landscape?

    Agricultural Irrigation Water Use

    3-C1. Is water used for agricultural irrigation?

    3-C2. What is the primary source of water for agricultural irrigation?

    3-C3. Estimate the amount of water used each year from the primary source.

    3-C4. Is agricultural water use based on water meter readings or an invoice?

    3-C5. What is the secondary source of water for agricultural irrigation?

    3-C6. Estimate the amount of water used each year from the secondary source.

    3-C7. a. Is secondary source use based on water meter readings?

    3-C7. b. Is secondary source use based on an invoice?

    Crop Area Information

    3-C8. Please provide the number of acres and crop type below (this includes irrigated pasture):




    Commercial, Industrial, Institutional, or other Non-Residential Use

    3-D1. Is water used for commercial, industrial, or other non-residential use?

    3-D2. Select the category that best describes the use:

    3-D3. Briefly describe the primary use of the operation.

    3-D4. What is the primary water source for commercial, industrial, institutional, or other non-residential use?

    3-D5. Estimate the total number of gallons of water used each year for commercial, industrial, institutional, or other non-residential use.

    3-D6. a. Is water use based on water meter readings?

    3-D6. b. Is water use based on an invoice?

    3-D7. Briefly describe the primary use of water:

    Section 4 – Additional Comments/Information

    4-A1. Do you have any concerns about groundwater or your well?

    4-A2. Please enter any additional comments or information regarding your groundwater use that you would like to provide

    4-A3. Please attach any supporting information you consider relevant.