Wellhead Protection
Forms
Preliminary Wellhead Protection Area Guidance (PDF:
123.18 KB, 4 pages)
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.
Aquifer Test Plan (PDF:
82.90 KB, 2 pages)
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:
Aquifer Test Information (PDF:
44.65 KB, 2 pages)
Aquifer Test Data Form (PDF:
48.54 KB, 2 pages)
