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Notice of Intent Form to Decommission a Well

A red asterisk () next to a field designates it as required.
International applicants cannot submit online. PleaseContact usfor assistance.
Please enter the original notice of intent number and well tag number, if available, for the well to be decommissioned in the fields below.

Property Owner Contact Information

In the space provided below, enter either the property owner's:
  1. business/organization name or
  2. first and last names.

Well Location Information

Quarter-Quarter Section
Does your project require drilling or decommissioning wells on mulitple, adjacent tax parcels within the same county? If so, enter the tax parcel numbers, seperated by a comma in the space provided below.

Well / Boring Project Information

The fees for decommissioning wells are based on the type of well being decommissioned. Resource Protection and Ground Source Heat Pump wells are $20 each. Water wells are $50 each. There are no fees for Environmental Investigation well or Geotechnical Soil Boring.
Washington State RCW 18.104.048 requires a minumum of 72 hours (3 days) prior notice before commencing work.

Drilling Company and Driller Information

Please select the drilling company and driller who will be performing the construction and/or decommissioning of the wells/borings in this notice.

Where should we send confirmation to?

Enter the email address where you would like your validation email sent.  

Anything else we should know?