Forms & Applications

Welcome to the SRBC library of forms and applications. Online Applications are now available for withdrawals, consumptive water use, and Approval By Rule for water use for natural gas development. Use the links below to access the online application tool.

In limited cases, SRBC will accept paper applications. If you have not already done so, you are strongly encouraged to call SRBC at 717-238-0425 before downloading and submitting paper applications. To download a document, simply click on the desired application below.

All forms and applications are in Adobe Acrobat Portable Document Format (PDF). If the documents are not viewable with your browser, click the button to download a free copy of Adobe Acrobat Reader.

(Acrobat and the Acrobat logo are trademarks of Adobe Systems Incorporated.)

New and Updated Forms and Applications

• Consumptive Use Reporting
• Online Applications
• Certification of Notification (Form 55) (PDF)
• Guidelines for Completing Public Notice Requirements
• Proposed amendments to Regulatory Program Fee Schedule open for public comment until June 3, 2013
• Regulatory Program Fee Schedule (PDF) Fee schedule, Adopted by Resolution No. 2012-06, June 7, 2012, and effective July 1, 2012.

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General Information

• Project Information (72) (PDF)
• Project Information (72) (Word)

• Public Water Supply Information (24P) (PDF)
• Public Water Supply Information (24P) (Word)

Pending Applications & Approved Projects

Reporting

• NEW Consumptive Use Reporting
• Monitoring Report and Consumptive Water Use Payment Schedule
• Post-Hydrofracture Report Event Online Submittal

Public Notice

• Guidelines for Completing Public Notice Requirements

Certification of Notification

• Form 55 (PDF)
• Form 55 (Word)

Approval By Rule - 18 CFR 806.22(f)

• Approval by Rule Online Application
• Sample public water supply commitment letter
• Sample docket holder commitment letter
• Consumptive Use Metering Plan

Groundwater Withdrawal Instructions and Application

• Groundwater Withdrawal Instructions and Application (24G) (PDF)
• Groundwater Withdrawal Instructions and Application (24G) (Word)

Surface Water Withdrawal Instructions and Application

• Surface Water Withdrawal Instructions and Application (24S) (PDF)
• Surface Water Withdrawal Instructions and Application (24S) (Word)
• Metering Plan Preparation Guidance For Surface Water Withdrawals

Consumptive Water Use Instructions and Applications

• Consumptive Water Use Instructions and Application (24C) (PDF)
• Consumptive Water Use Instructions and Application (24C) (Word)
• Consumptive Water Use Application -- Golf Course Supplemental Information (24C) (PDF)
• Consumptive Water Use Application -- Golf Course Supplemental Information (24C) (Word)
• Consumptive Water Use Pond Evaporation Calculation (74) (PDF)

Signage Requirements

• Natural Gas Shale and Natural Gas Well Signage/Posting

Approval Transfer Forms

• Request for Transfer or Re-issuance of Approval (PDF)
• Project Information (72) (PDF)
• Project Information (72) (Word)
• 18 CFR Section 806.6 - Transfer of Approvals (PDF)

Project Fee Schedule

• Proposed amendments to Regulatory Program Fee Schedule open for public comment until June 3, 2013
• Regulatory Program Fee Schedule (PDF) Fee schedule, Adopted by Resolution No. 2012-06, June 7, 2012, and effective July 1, 2012.

• Application Fee Policy for Mine Drainage Withdrawals (PDF) The commissioners approved the policy at its quarterly business meeting on June 18, 2009.