Humboldt County, CA · Humboldt County
Monitoring Well and Boring Permit Application
This application is for C-57 licensed drillers seeking a Humboldt County permit to install, modify, or destroy monitoring wells or borings.
At a glance
- Issued by
- City of Humboldt County · Humboldt County, Humboldt County, California
- Notarization
- Not required: file this form without a notary.
- Official source
- humboldtgov.org
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
C-57 licensed drillers use this application to request a permit for monitoring well or boring work in Humboldt County. The form asks for site and contact details, investigation type, proposed work, installation or destruction methods, and suspected contaminants. Submit the completed application with fees and the listed supporting materials; regulated cleanup sites also require lead agency workplan concurrence.
Who needs it
A C-57 licensed driller must sign this application when requesting a permit to install, modify, or destroy wells or borings.
How to submit it
Submit the completed application and fees together to the Humboldt County Division of Environmental Health at the address shown on the form.
About notarization
The C-57 licensed driller signs and dates this application without a notary; no notarized attachment or related sworn step is listed.
How to submit this form
- 1
Download the Application
Download the Monitoring Well and Boring Permit Application PDF.
- 2
Complete the Application
Fill in the site, contact, investigation, and proposed well or boring work details.
- 3
Gather Supporting Materials
Include fees, a detailed overhead site plan, well construction details, and other applicable materials listed on the form.
- 4
Submit to the County
Send the application and fees together to the Humboldt County Division of Environmental Health at the address shown on the form.
Frequently asked questions
- Do I need a notary for the Monitoring Well and Boring Permit Application?
- No. The C-57 licensed driller signs and dates the application without a notary, and the form lists no notarized attachment or sworn step.
- How do I submit the Monitoring Well and Boring Permit Application?
- Submit the completed application and fees together to the Humboldt County Division of Environmental Health at the address shown on the form.
- What must accompany the application?
- The form lists a detailed overhead site plan and well construction details. Regulated cleanup sites also need lead agency workplan concurrence; off-site work may require an encroachment permit or access agreement.
- Who signs the application?
- The form requires the signature of the C-57 licensed driller and states that proxies are not accepted.