Attch5_WellApplication.pdf

FORM OLWR-AP-YMD (REV 4/21)

APPLICATION FOR PERMIT TO DIVERT OR WITHDRAW

FOR BENEFICIAL USE THE PUBLIC WATERS OF THE STATE OF MISSISSIPPI

DEPARTMENT OF ENVIRONMENTAL QUALITY, OFFICE OF LAND AND WATER RESOURCES

PLEASE REPLY TO: YAZOO MISSISSIPPI DELTA JOINT WATER MANAGEMENT DISTRICT

P.O. BOX 129, STONEVILLE, MS 38776; (662) 686-7712

THIS APPLICATION IS FOR (Circle one): NEW PERMIT RENEWAL MODIFICATION REPLACEMENT

PERMIT No. (for Renewal/Modification/Replacement):____________________

THIS APPLICATION IS FOR (Circle one): GROUNDWATER – COMPLETE SECTIONS A, B, D

SURFACE WATER – COMPLETE SECTIONS A, C, D

BENEFICIAL USE (Circle one or more): 1) Irrigation 2) Fish Culture 3) Wildlife Management

ARE YOU REQUESTING STANDBY STATUS: YES NO (Standby status does not allow for withdrawal of groundwater.)

SECTION A (REQUIRED)

LANDOWNER: __________________________________________________ ____________________________ (Name) (E-mail address)

(Address)

(City) (State & Zip) (Telephone No.) (Mobile No.)

APPLICANT: (If different from Landowner):

(Name) (E-mail address)

(Address)

(City) (State & Zip) (Telephone No.) (Mobile No.)

LOCATION of diversion/withdrawal point (A suitable map with location marked MUST accompany this application):

County: _____________________________

LATITUDE: ___________________ LONGITUDE: _____________________ (Decimal degrees with at least four significant digits) (Example: Latitude: 33.4497, Longitude: -90.6456) Method used for coordinates: ________________________

Are there any additional surface water or groundwater permits used to irrigate this same acreage? YES NO

If yes, list permit number(s): __________________________________________

SECTION B (to be completed for GROUNDWATER SOURCE)

1. AQUIFER: ________________________________________

2. DESCRIPTION of proposed or completed well:

(a) Licensed Driller Name & Company: _______________________________________________________________________

(b) Depth of Well: __________________ feet

(c) Surface Casing Diameter: __________ inches

(d) Pump Capacity: _________________ gallons per minute

(e) LOCAL WELL NAME: _________________________________________________

(CONTINUED ON BACK)

FORM OLWR-AP-YMD (REV 4/21)

SECTION C (to be completed for SURFACE WATER SOURCE)

1. SOURCE of water is from _____________________________ which drains into ___________________________________ which drains into _________________________________________________________________________________________ (major stream or river)

2. DESCRIPTION of pump/diversion works: The pump is (Circle one): Fixed or Mobile

Pump: Type ________________________________ ; Diameter __________ inches; Max capacity _________ gallons per minute (turbine, jet, other)

Power Unit: Type _______________________________ ; Size ________________ horsepower; ________________ (electric, tractor, diesel, gasoline, butane, other)

SECTION D ACREAGE DATA (REQUIRED)

1. IRRIGATION: Total crop (row or rice) acreage: _________ acres

2. FISH CULTURE: Total water acreage: ________ acres

3. WILDLIFE MANAGEMENT: Total flooded or filled acreage: ________ acres How many of these acres are also used for Irrigation (listed in item 1 above)? _________ acres

4. REMARKS: ____________________________________________________________________________________________

For groundwater withdrawal applications a Required Water Efficiency Practices form and an Acknowledgement form MUST be completed and submitted with this application. A water use permit MUST be issued before initiating the drilling of a groundwater well.

Additional contact information (Agent, etc.):

(Name)

(Title)

(Address)

(City, State, Zip)

(Telephone No.) (Mobile No.)

(E-mail address)

This box is for office use only.

The ACCOMPANYING MAP is hereby declared a part of this application. The TEN DOLLAR ($10.00) permit fee is enclosed herewith.

I hereby attest that I am duly authorized and have legal capacity to execute and deliver this application and that the information provided is accurate to the best of my ability.

(Printed Name)

(Title)

(Signature) (Date)

Issued: Reissue Date: Expires: Permit No.

Lat: Long: Elev: Quad:

¼ of the ¼ of Section Township: Range: County:

Permit No. of Replaced Well: Aquifer: FIP Well No.

STAC: Basin No. Remarks:

Please Return to: Yazoo Mississippi Delta Joint Water Management District, PO Box 129, Stoneville, MS 38776 Fax 662-686-7712 Form: OLWR-RWEP-YMDAPP (4/21)

Required Water Efficiency Practices for MRVA Agricultural Groundwater Withdrawal Permits

Complete all sections that apply to your permitted beneficial use(s) or the application will not be accepted.

Check ‘P’ for proposed or ‘I’ for implemented for all methods that you have or intend to apply.

CROPS:

One of the two alternatives listed below must be implemented within 1 year of issuance in order for your permit to remain valid for the full 5-year term:

1) Use of a sprinkler system or pivot to apply water by means of nozzles under pressure to the entire acreage associated with the permitted well ............................................................ P or I

2) At least three (3) of the following eleven (11) practices (check all that apply):

1. Precision land-forming and/or perimeter pads and pipes ............................................ P or I

2. Use of a Computerized Hole Selection design program for the entire acreage ................... P or I

3. Irrigation scheduling using either:

A. Soil moisture sensor data .................................................................................. P or I B. A water-level indicating device .................................................................. P or I C. Weather Station meeting NRCS EQUIP Manual Requirements for Practice 449 ............ P or I

4. Surge valve on all acres covered ................................................................................. P or I

5. Tail-water recovery system ................................................................................ P or I

6. Surface water (conjunctive use) ........................................................................... P or I

7. Zero grade or modified zero grade ....................................................................... P or I

8. Alternate wetting and drying (rice) ...................................................................... P or I

9. Multiple inlet water distribution .......................................................................... P or I

10. A timer or automatic shut off that can remotely or automatically shut off wells ................. P or I

11. A fixed flowmeter and report of annual metered water use to MDEQ by February 1st of each year (If implemented, please fill out Flowmeter section below.) ............................. P or I

AQUACULTURE:

At least one (1) of the two (2) alternatives below must be implemented within 1 year of issuance for your permit to remain valid for the full 5-year term:

1) 6/3 water management practices leaving three (3) inches available for rainfall capture for all pond acreage supplied by the permitted well .......................................................................... P or I

2) A fixed flowmeter and report annual metered water use to MDEQ by February 1st of each year (If implemented, please fill out Flowmeter section below.) ................................................... P or I

ENHANCEMENT OF WILDLIFE HABITAT:

At least one (1) of the two (2) alternatives below must be implemented within 1 year of issuance for your permit to remain valid for the full 5-year term:

1) A water control structure, such as a slotted board riser, that captures rainfall and runoff to the greatest extent practical. It is recommended that the structure be closed by (a) November 1 or

(b) as soon after harvest as possible, whichever is earlier .................................................... P or I

2) A fixed flowmeter and report annual metered water use to MDEQ by February 1st of each year (If implemented, please fill out Flowmeter section below.) ................................................... P or I

(CONTINUED ON BACK)

For Office Use Only

MS‐GW‐

Please Return to: Yazoo Mississippi Delta Joint Water Management District, PO Box 129, Stoneville, MS 38776 Fax 662-686-7712 Form: OLWR-RWEP-YMDAPP (4/21)

FLOWMETER (complete this section if you have installed an approved flowmeter and you intend to report annual water use to MDEQ by February 1st each year):

Meter Manufacturer: ____________________________________ Meter Serial Number: ____________________________

Meter Model Number/Name: _______________________________ Type of Meter: __________________________________

Totalizer Register Unit and Multiplier Factor (AF x .001, gal x 1000, etc): _____________________________________________

I hereby attest that the conservation methods selected above are, or will be, implemented and will be maintained on the land associated with this Groundwater Withdrawal Permit application. I further attest that I am duly authorized and have legal capacity to execute and deliver this form.

Print Name Title Signature Date

Groundwater Withdrawal Permit Application Acknowledgment Form For Groundwater Withdrawal Permits/Certificates of Coverage

(This form must be signed for the permit application to be considered.)

Since the 1980s, water levels in the Mississippi River Valley Alluvial Aquifer (MRVA) have declined significantly. Although the declines have been greatest in the central Delta, pumping in the other areas of the Delta affects the declines.

Under Mississippi Law, all water belongs to the citizens of the state, not to the landowner or the person using the water. A permit from the Mississippi Environmental Quality Permit Board is required before any person can drill a well and use waters of the state.

It is essential that all sections of the permit application be completed accurately. Applications having complete and correct applicant and landowner contact information are necessary for communicating with water users.

Mississippi Department of Environmental Quality (MDEQ) regulations require that the water use permit be issued PRIOR to drilling the well and that the licensed water well driller must submit a driller’s log for the well to MDEQ within 30 days of the date the well is completed. A copy should also be provided to the permit holder. The driller’s log is essential for obtaining accurate location and well construction data, which are necessary for effective aquifer management. It is a violation of state law for the permit applicant to allow the driller to drill the well before the permit is issued. Violators are subject to penalties of up to $25,000 per day.

State law requires MDEQ to prevent waste or unreasonable use of water. Acceptable agricultural water efficiency practices required by the permit are a tool for conserving water and preventing waste of water.

Efficient use of water also relieves pressure on the aquifer, allowing time for all alternative water supplies to be evaluated. The terms of the permit are reevaluated every 5 years based on actions needed to address aquifer conditions.

By no later than one (1) year from the date the permit is issued, the permit holder must submit documentation to MDEQ on a form and in a manner prescribed by MDEQ that the minimum number of required water efficiency practices specified in the permit special terms and conditions (attached) have been implemented.

Failure to comply may result in enforcement actions including penalties and/or denial of application or revocation of the permit.

MDEQ may perform an onsite compliance audit to determine whether the required minimum number of acceptable agricultural water efficiency practices specified in the permit special terms and conditions have been implemented. Failure to comply with the conditions may result in enforcement actions including penalties and/or revocation of the permit.

MDEQ is working with the United States Geological Survey (USGS) to enhance the USGS’s regional water availability model and use the enhanced model to help develop management strategies for addressing the Delta’s water quantity issues. The annual water use reports submitted to MDEQ under the voluntary metering program are critical to improving the accuracy of the model. Permit applicants are encouraged to participate in this program. To avoid a mandatory metering program, it is essential for MDEQ to continue to receive annual metered water use reports on 10% of the MRVA wells in each county by February 1 of each year.

MDEQ and the Delta Sustainable Water Resources Task Force are evaluating all available alternatives to assure that the Delta has adequate water resources for the future.

I hereby acknowledge that I have read and do understand the statements on this form and the attached special terms and conditions. I further attest that I am duly authorized and have legal capacity to execute and deliver this form.

Signature of Applicant Date