Well Construction & Drilling Forms

Well Construction


Low Temperature Geothermal Resource Wells

Note: Use Application for Drilling Permit under Well Permit Forms above for Low Temp Geo application.



Geothermal Resource Wells

The forms below have 2 variations to meet your needs. To modify and submit an electronic version, select the Word Document icon. To print the form and complete by hand, selct the PDF icon.

  • Form 4003-1   PDF
    Application for Permit to Drill for Geothermal Resources
  • Form 4003-2   Word doc   PDF
    Application for Permit to Alter a Geothermal Well
  • Form 4003-3   Word doc   PDF
    Application for Permit to Convert a well to a Geothermal Injection Well. (Also requires permitting through UIC Program)
  • Form 4003-5   Word doc   PDF
    Geothermal Resources Surety Bond
  • Form 4003-7   Word doc   PDF
    Notice of Intent to Abandon a Well
  • Form 4003-9   Word doc   PDF
    Report of Abandonment of a Well
  • Form 4010-1 - Monthly Injection Report for Geothermal Wells. (Other forms my be used with prior approval by the Department)
  • Form 4010-2 - Monthly Energy Report for Geothermal Wells. (Other forms my be used with prior approval by the Department)

Injection Well Forms

Deep Injection Wells


Shallow Injection Wells


Additional Information: