Tehama County Groundwater Sustainability Agency Well Registration Form

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

     

    General Information

    To properly adopt, implement, and administer the Basin’s Groundwater Sustainability Plans (GSPs), the Tehama County Groundwater Sustainability Agency (GSA) has determined that it needs to obtain the following information from all owners and users of groundwater extraction wells within the GSA Area. As a result, the GSA requires all owners and users of groundwater extraction wells to register with the GSA no later than March 31, 2023.

    Please complete this form carefully, to the best of your ability, and contact the GSA for assistance if needed. Failure to properly and completely register could adversely affect your property as the information in the form will be used in the implementation of the GSPs and periodic updates. Failure to properly register wells may result in increased well fees.

     

    Complete the Fillable Form below:

    For questions or assistance in completing this form, please consult the Tehama County GSA website to view a sample well registration form.

    Further inquiries can be directed to Justin Jenson, Deputy Director of Public Works – Water Resources at jjenson@tcpw.ca.gov or 530-690-0700 ext. 201.

     

    1. Property Owner Information

    a. Primary contact person (note if owner or user below):






     

    b. Address of Property Using Groundwater:


     

    c. Additional contact(s):

    This information is optional.





    -





     

    2. Current Type of Water Use Information (Check all that apply):

    If you selected Agriculture or Other/Combination, please fill out the following information:



     

    3. Annual Water Use Information (Please fill out carefully and completely)

    Domestic/Residential Users Only (select one):

    If you selected "...more than 2 acre-feet per year for domestic purposes," please fill out the following information:

    A good estimation of use is 6.5 acre feet per year per acre of irrigated land including lawn.

     

    Agricultural Users Only:

    My annual production in acre feet for each of the following years (Jan – Dec) is approximately:






    My acreage and crop type in production for each of the following years (Jan to Dec) is:







     

    Commercial/Industrial Users Only:

    My annual production in acre feet for each of the following years (Jan – Dec) is:






     

    4. Well Information (indicate "unknown" as applicable):

    Multiple wells can be listed by submitting a separate form for each.





     


     





     

    Water Meter Data