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Annual Water Production - Water Year 2023
October 1, 2022 through September 30, 2023
INSTRUCTIONS: Completion of this form satisfies your requirement to report annual water production for your well outlined in District Rule 54.
This reporting period runs from October 1, 2022 through September 30, 2023. If your well is inactive, please fill in the APN and address info and skip down to Line 5. Enter N/A in 5b and check inactive in Box 6. If you reported meter readings last year, those records should be in District files. A meter reading and the date the meter was read must be provided for this year if you have an active well. If you have questions or need assistance completing this form, please call (831) 275-5680.
For help with reading your meter click HERE.
MPWMD ID:
*
APN:
*
Name
*
First
Last
Address
*
City
*
Zip
*
Email
*
Phone
###
-
###
-
####
1. Well Name or Number (if applicable)
2. Water Use type
Commercial
Domestic
Agriculture
Municipal
Other
Other if checked
3. Meter manufacturer and serial number
4. Meter Units
*
Gallons
Cubic Feet
Acre Feet
5a. Reading Date
*
MM
/
DD
/
YYYY
5b. Meter Reading
*
6. Well Status:
Active
Inactive
(wells that have not produced water in the last year are considered inactive)
7. Other wells on property
Active
Inactive
Abandoned
List other wells, if applicable
I certify this information to be correct and I am the owner or authorized agent of this well(s)
*
Yes
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