Did you know that when you file your 56 form with the IRS, it's considered a "final return"? That means that you won't be able to make any more changes or corrections. So it's important to make sure everything is correct before submitting. In this blog post, we'll go over what needs to be included on your DWR 55 56 form, and how to submit it correctly. We'll also provide some tips on avoiding common mistakes made on this form. Stay tuned!
| Question | Answer |
|---|---|
| Form Name | Dwr 55 56 Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | Pitless, AZ, Centrifugal, azwater |
Arizona Department of Water Resources
Information Management Unit
P.O. Box 33589, Phoenix, AZ
(602)
Pump Installation Completion Report
Review instructions prior to completing form in black or blue ink.
The registered well owner should file this report with the Department within 30 days following installation of pump equipment.
** PLEASE PRINT CLEARLY **
FILE NUMBER
WELL REGISTRATION NUMBER
55 -
SECTION 1. REGISTRY INFORMATION
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Well Owner |
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Location of Well |
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FULL NAME OF COMPANY, ORGANIZATION, OR INDIVIDUAL |
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WELL LOCATION ADDRESS (IF ANY) |
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MAILING ADDRESS |
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TOWNSHIP (N/S) |
RANGE (E/W) |
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SECTION |
160 ACRE |
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40 ACRE |
10 ACRE |
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¼ |
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¼ |
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CITY / STATE / ZIP CODE |
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COUNTY ASSESSOR’S PARCEL ID NUMBER (MOST RECENT) |
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BOOK |
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MAP |
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PARCEL |
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CONTACT PERSON NAME AND TITLE |
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COUNTY WHERE WELL IS LOCATED |
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TELEPHONE NUMBER |
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FAX |
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SECTION 2. EQUIPMENT INSTALLED |
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DATE PUMP INSTALLED |
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Pitless Adaptor |
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CHECK ONE (SEE INSTRUCTIONS FOR DEFINITION) |
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Was a pitless adaptor installed? |
Yes |
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Pump Type |
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CHECK ONE |
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No |
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IF YES, DEPTH BELOW GROUND LEVEL THE DEVICE WAS INSTALLED |
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Air Lift |
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Rotary |
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FEET |
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Bucket |
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Submersible |
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Power Type |
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Centrifugal |
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Turbine |
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CHECK ONE |
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Jet |
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Other (please specify): |
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Diesel Engine |
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Natural Gas |
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Piston |
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Electric Motor |
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Windmill |
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Gasoline Engine |
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Other (please specify): |
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Hand |
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RATED PUMP CAPACITY |
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HORSE POWER RATING OF MOTOR |
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GALLONS PER MINUTE |
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SECTION 3. PUMP TEST |
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Pump Test Data |
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Method of Discharge Measurement |
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Method of Measuring Water Level |
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DATE WELL TESTED |
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CHECK ONE |
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CHECK ONE |
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Bailer |
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Air Line |
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STATIC WATER LEVEL (A) |
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Bucket – Barrel – Stopwatch |
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Electric Measuring Line (Sounder) |
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FEET BELOW LAND SURFACE |
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Current |
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Steel Tape |
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PUMPING WATER LEVEL (B) |
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Estimated – Air Lift |
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Other (please specify): |
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FEET BELOW LAND SURFACE |
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Gauge |
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DRAWDOWN [ (B) – (A) ] |
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Meter |
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FEET BELOW LAND SURFACE |
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Orifice |
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TEST PUMPING RATE |
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Volume |
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GALLONS PER MINUTE |
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Weir – Flume |
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DURATION OF PUMP TEST (Minimum 4 Hours) |
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Other (please specify): |
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HOURS |
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TOTAL PUMPING LIFT |
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FEET |
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FOR FLOWING WELL, |
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FT |
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MEASURED SHUT IN HEAD |
PSI |
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I HEREBY CERTIFY that the above statements are true to the best of my knowledge and belief according to A.R.S. §
SIGNATURE OF WELL OWNER
DATE
DWR