Well Permit Application & Instructions
Where to mail the application:
Anaheim Public Utilities
201 S. Anaheim Boulevard Number 1101
Anaheim, CA 92805
The permit is not valid until signed by the City’s Authorizing Agent and a permit number is assigned. All accompanying documentation and payment with a check, made payable to the City of Anaheim, must be included with each application. Allow 5 business days for processing. Any questions you may have regarding Anaheim Public Utilities Well Permit Program should be directed to Jonathan Sanks (714-765-4117).
A well permit is valid for no more than 6 months after issuance.
All fields in the application must be completed as follows:
- 48-Hour Notification: Applicant shall notify Environmental Services and the City’s Water Inspector at least 48 hours prior to conducting field activities.
- Applicant’s Name, Company, Address, City, State, Zip Code, Phone and Email Address: The person completing the application is to fill out this information as the applicant.
- Applicant’s Signature/Date: Applicant must be authorized to sign on behalf of property owner or well owner and agrees to comply with applicable well construction/destruction standards.
- Company, Address, City, State, Zip Code, Phone, and Email Address: This information is to be completed as it relates to the well owner.
- Depth: Specify, in feet, the depth to which the well is to be drilled or the depth of the well destroyed.
- Diameter: Specify the cased diameter of the well in inches.
- Estimated Date of Destruction: Specify the estimated date, using month and year, when the well or boring will be abandoned or destroyed.
- Location Map: In the space provided, draw the nearest cross-streets and identify location of well(s) to be drilled. Submit 2 copies of a site plan that shows the location(s) of the proposed well(s). If existing wells are present on the site, these wells are also to be included on the site plan.
- Location of Well: Include a site specific address where available. If not available, list applicable cross-streets and approximate site address.
- Screen Intervals: Specify the range of the proposed screen interval or the existing range of the screened interval for each well in feet, if applicable.
- Type of Permit: Check borings, well installation, or well destruction. If permits for both installation and destruction are needed, then separate permits for each are to be submitted.
- Type: Specify the type of well that is to be constructed or destroyed, such as:
- Irrigation well
- Well ID: This represents a unique well identification for each well. For example, MW-6 or VM-13.
- Well Owner: This needs to be an individual’s name, either the well owner or representative of the well owner, but not a company name.
By the execution of a well permit, the well permit applicant acknowledges and agrees to all of the following:
- As the permit activities (i.e., activities related to well drilling, installation, or destruction) are strictly a private undertaking, the well permit applicant bears full responsibility for its completion or any liability arising thereunder. The permit activities (i.e., activities related to well drilling, installation, or destruction) shall be accomplished without cost or expense to city.
- In the performance of any well drilling, installation, or destruction, the well permit applicant shall at its own cost and expense comply with all statutes, ordinances, regulations, and requirements of all governmental entities, including federal, state, county. or municipal, whether now in force or hereinafter enacted. In addition, all of applicant's work (or that of applicant's consultant's) shall conform to applicable local, county, state, and federal laws, rules, regulations, and permit requirements.
- The permit activities (i.e., activities related to well drilling, installation, or destruction) are strictly a private undertaking and the permit activities do not in any manner imply anyone acting for or on behalf of the applicant is acting in the course and/or scope of official city business or on behalf of the city; nor does it in any manner establish or imply an employer-employee, or an agency relationship between the applicant (or any of its representatives) or any third party and the city.
- The well permit applicant (a) is the owner of the property where the well is to be installed, or; (b) is legally authorized to install the well. The property, or the owner’s representative, must sign the well permit form.
- Well permit applicants acknowledges responsibility for the ultimate destruction of their well, per California Well Standards.