Backflow Prevention/ Unconnected Residential Wells: No Longer Requires Notarized Signature

Backflow Prevention/ Unconnected Residential Wells:

A notarized signature is no longer required on the plumber's certification section that confirms the well is not connected.

Further explanation of WELL FORMS:

1. Page 1 of 1– If you are the ORIGINAL OWNER or OWNER THAT HAD THE WELL INSTALLED, just sign the form in front of a NOTARY, and mail back to the ECUA.

2. Page 1 of 2 and 2 of 2 – If you are NOT THE ORIGINAL OWNER, please have a LICENSED PLUMBER to verify that the well is NOT CONNECTED to the house plumbing.

3. If you do not have a WELL on your property or your WELL IS INOPERABLE, please give the ECUA a call at (850) 969 3346, (850) 969 3345, OR (850) 969 3347.


Form for Original Homeowner or Homeowner who Installed the well on the property.


Form for Homeowner who purchased a property with an existing well.


Form for Homeowners who have no well or whose well is inoperable