Wellhead Protection Forms - EH: Minnesota Department of Health

Wellhead Protection Forms

As required by the Minnesota Wellhead Protection Rule (Minnesota Rules, part 4720.5310, subpart 1), public water suppliers proposing new municipal wells must complete:

1) a preliminary delineation of the WHP area (WHPA) for the proposed well, and
2) an assessment of the impacts that existing land and water uses located within the area may have on the aquifer serving the well.

The preliminary WHPA and assessment are to be submitted to (and approved by) the Minnesota Department of Health with the construction plan for the proposed well. The purpose of this guidance is to assist water suppliers in delineating the preliminary WHPA and preparing the assessment.

As part of the delineation of a Wellhead Protection Area, community and nontransient noncommunity public water systems must complete an Aquifer Test Plan: Depending on the method of aquifer test employed, the following forms may also be used:


Updated Monday, September 08, 2014 at 07:51AM