Section 671.302  Contents of a Request

Each county or municipality requesting Agency review and confirmation under Section 14.3(b) of the Act shall complete a request form prescribed by the Agency and shall:

a)         Submit proof that the determination made pursuant to Section 671.201 describes the outer boundary of drawdown of the affected groundwater by the well under normal operational conditions.  Such proof shall include, but not be limited to, the following:

1)         Geologic logs and well construction details;

2)         Aquifer test data, if an estimation technique or pump test described in Section 671.201(a), (d), or (e) is used;

3)         Hydrogeologic information and the source of that information, if the estimation technique described in Section 671.201(c) is used; and

4)         Geologic maps and the source of those maps, if the procedure described in Section 671.201(f) is used.

b)         Submit the proposed ordinance to be adopted pursuant to Section 14.3(c) of the Act.

c)         If an estimation technique or pump test described in Section 671.201(c) through (f) is used, include the following certification by a registered professional engineer, certified professional geologist, or other person approved by the Agency under Section 671.303:

            I hereby certify that I am familiar with the information contained in this application, and that to the best of my knowledge and belief such information is true, complete, and accurate.