Official Government Website

Well Construction and Drilling Forms

Geothermal Resource Well Forms

For forms with two versions available, use the PDF version to print and complete offline, and use the DOC version to complete online and print.

Form NumberForm NamePDFDOCXLS
4003-1Application for Permit to Drill for Geothermal ResourcesPDF  
4003-2Application for Permit to Alter a Geothermal WellPDFDOC 
4003-3Application for Permit to Convert a well to a Geothermal Injection Well

Note: Also requires permitting through UIC Program.
PDF DOC 
4003-5Geothermal Resources Surety BondPDFDOC 
4003-7Notice of Intent to Abandon a WellPDFDOC 
4003-9Report of Abandonment of a WellPDFDOC 
4010-1Monthly Injection Report for Geothermal Wells

Note: Other forms may be used with prior approval by the Department.
 DOC 
4010-2Monthly Energy Report for Geothermal Wells

Note: Other forms may be used with prior approval by the Department.
 DOC 
 Monthly Injection/Monthly Energy Report Spreadsheet  XLS

For more information, visit the Well Construction page.

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