Well Start Notification - Tacoma-Pierce County Health Department

Do you need to notify us of well construction starts, cancellations, or reschedule? Complete this form.

Only licensed well drillers or their representatives should complete this form.

Submit this form 2 business days before you start well construction or decommissioning. If you must start construction on a holiday, contact us at (253) 649-1926.

We charge an extra fee for inspections on holidays. Include your email address to receive a copy the form you submit.

Notification(Required)

Well Type(Required)

Individual

Public

Work being performed.(Required)

New Construction

Decommissioning

Deepening

Other

Drilling Name(Required)

Drilling Company(Required)

Driller Email Address(Required)

Client Name(Required)

First Last

Site Address(Required)

Street Address Address Line 2 City State ZIP Code

Parcel(Required)

Most recent gate code

Additional information needed for accessing site (specific gate for access; etc)

Start Date(Required)

Estimated Start Time(Required)

DOE Start #(Required)

To receive a copy of your submission, please fill out your email address below and submit.

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