Production Report Form PLEASE TAKE NOTE: THE DISTRICT MUST HAVE A WELL REGISTRATION FORM ON FILE FOR EACH EXISTING WELL. FAILURE TO REGISTER ALL WELLS MAY RESULT IN CIVIL PENALTIES. Well registration forms are available in our office and on our website. www.pcgcd.org Instructions: Reports may be typed or hand written. Please submit by email, mail, or hand delivery to our office. Please make copies of this form if space allowed is inadequate for number of wells reported this quarter. Production Reports are due no later than 30 days from the last day of the quarter. well owner/ company name * phone number * email address: * water use: * Public/Rural/Municipal Industrial/Manufacturing Surface Impoundment/Pond Commercial (Business) Agricultural/Irrigation Mining Use Hydrocarbon Production Other (describe) year being reported: * quarter being reported * 1 2 3 4 water well name * was volume estimated or metered * estimated metered gallons pumped * water well name was volume estimated or metered estimated metered gallons pumped water well name was volume estimated or metered estimated metered gallons pumped water well name was volume estimated or metered estimated metered gallons pumped water well name was volume estimated or metered estimated metered gallons pumped water well name was volume estimated or metered estimated metered gallons pumped water well name was volume estimated or metered estimated metered gallons pumped water well name was volume estimated or metered estimated metered gallons pumped water well name was volume estimated or metered estimated metered gallons pumped water well name was volume estimated or metered estimated metered gallons pumped water well name was volume estimated or metered estimated metered gallons pumped water well name was volume estimated or metered estimated metered gallons pumped total gallons pumped: * Signature * Clear Date * *As required by District Rule 6.1(a) all non-exempt, oil & gas and mining water wells drilled or altered after October 26, 2010, shall be equipped with a meter or a flow measurement device. NOTE: The Texas Legislature has charged the Water District to Determine the Future condition of each aquifer. This information is necessary to determine the current demand and project future demands. reCAPTCHA If you are human, leave this field blank.
