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Get Dnr Switchboard 2008-2024

Only Name of Person or Firm Doing Filling & Sealing License # Street or Route Date of Filling & Sealing (mm/dd/yyyy) Date Received Telephone Number ( City State ZIP Code Noted By Comments ) Signature of Person Doing Work Date Signed Well / Drillhole / Borehole Filling & Sealing Form 3300-005 (R 4/08) Page 2 of 2 Instructions Well Filling and Sealing Wisconsin Administrative Code (NR811, NR 812, and NR 141 requires well owners to permanently fill and seal any unused wells/drillholes.

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