Wells@ – WEB FORM

AW Number *

Ranch Name **(please fill out a separate form for every ranch that has a question/issue)** *

AGL/Global ID

Email Address or Phone Number *

This ranch was previously enrolled under a different Operation (AW) or AGL/Global *

• Yes
• No

If "Yes," provide prior ranch info here: *

This ranch shares 1 or more wells with another ranch *

• Yes
• No

If “Yes,” provide info for the sharing ranch here: *

I received an “out of compliance” or other reminder email from the Water Board or Preservation, Inc. *

• Yes
• No

If YES, check here to confirm that you read the entire email to learn why you are out of compliance and/or what corrective actions to take. PLEASE read the entire email that you received. Many of these emails provided a description of the compliance problem, and instructions on how to fix it. Please read the entire email and confirm that you actually require assistance before completing this form. *

• Yes, I confirm that I read through the information provided and require additional assistance.

Please select all that apply:

• Notice from Water Board or Preservation, Inc. said I did not complete Irrigation Well sampling for this ranch
• Notice from Water Board or Preservation, Inc. said I did not complete Domestic Well sampling for this ranch
• Notice from Water Board or Preservation, Inc. said I did not complete Drinking Water Notifications for this ranch
• I completed all required well sampling for this ranch but results are not showing up on GeoTracker
• I did not complete all required well sampling for this ranch and need to schedule sampling ASAP
• I need a copy of my well sampling report (lab results) for this ranch
• I enrolled in the Ag Order (ILP) or added this ranch to an existing enrollment after May 31st, 2022.

There is 1 or more well present on my ranch and counted in my eNOI, that I am unable to sample. Explain: *

Other issue related to drinking water notifications. Explain below.

Other issue related to well sampling completeness. Explain below.

Other issue related to lab results. Explain below.

Other issue not listed above. Explain below.

Submit