Figure: 30 TAC §230.3(c)

CERTIFICATION OF GROUNDWATER AVAILABILITY FOR PLATTING FORM
Use of this form: If required by a municipal authority pursuant to Texas Local Government Code, §212.0101, or a county authority pursuant to §232.0032, Texas Local Government Code, the plat applicant and the Texas licensed professional engineer or Texas licensed professional geoscientist shall use this form based upon the requirements of Title 30, TAC, Chapter 230 to certify that adequate groundwater is available under the land to be subdivided (if the source of water for the subdivision is groundwater under the subdivision) for any subdivision subject to platting under Texas Local Government Code, §212.004 and §232.001.The form and Chapter 230 do not replace state requirements applicable to public drinking water supply systems or the authority of counties or groundwater conservation districts under either Texas Water Code, §35.019 or Chapter 36.

Administrative Information (30 TAC §230.4)
1. Name of Proposed Subdivision:
2. Any Previous Name Which Identifies the Tract of Land:
3. Property Owner's Name(s):
Address:
Phone:
Fax:
4. Plat Applicant’s Name:
Address:
Phone:
Fax:
5. Licensed Professional Engineer or Geoscientist:
Name:
Address:
Phone:
Fax:
Certificate Number:
6. Location and Property Description of Proposed Subdivision:
7. Tax Assessor Parcel Number(s).
Book:
Map:
Parcel:

Proposed Subdivision Information (30 TAC §230.5)
8. Purpose of Proposed Subdivision (single family/multi-family residential, non-residential,
commercial):
9. Size of Proposed Subdivision (acres):
10. Number of Proposed Lots:
11. Average Size of Proposed Lots (acres):
12. Anticipated Method of Water Distribution.
Expansion of Existing Public Water Supply System? Yes No
New (Proposed) Public Water Supply System? Yes No
Individual Water Wells to Serve Individual Lots? Yes No
Combination of Methods? Yes No
Description (if needed):
13. Additional Information (if required by the municipal or county authority):

Note: If public water supply system is anticipated, written application for service to existing water
providers within a 1/2-mile radius should be attached to this form (30 TAC §230.5(f) of this title).

Projected Water Demand Estimate (30 TAC §230.6)
14. Residential Water Demand Estimate at Full Build Out (includes both single family and multi-family
residential).
Number of Proposed Housing Units (single and multi-family):
Average Number of Persons per Housing Unit:
Gallons of Water Required per Person per Day:
Water Demand per Housing Unit per Year (acre feet/year):
Total Expected Residential Water Demand per Year (acre feet/year):
15. Non-residential Water Demand Estimate at Full Build Out.
Type(s) of Non-residential Water Uses:
Water Demand per Type per Year (acre feet/year):
16. Total Water Demand Estimate at Full Build Out (acre feet/year):
17. Sources of Information Used for Demand Estimates:

General Groundwater Resource Information (30 TAC §230.7)
18. Identify and describe, using Texas Water Development Board names, the aquifer(s) which underlies
the proposed subdivision:




Note: Users may refer to the most recent State Water Plan to obtain general information pertaining to the state’s aquifers.  The State Water Plan is available on the Texas Water Development Board's Internet website at: www.twdb.state.tx.us

Obtaining Site-Specific Groundwater Data (30 TAC §230.8)
19. Have all known existing, abandoned, and inoperative
wells within the proposed subdivision been located,
identified, and shown on the plat as required under
§230.8(b) of this title?		 Yes No
20. Were the geologic and groundwater resource factors
identified under §230.7(b) of this title considered in
planning and designing the aquifer test required under
§230.8(c) of this title?		 Yes No
21. Have test and observation wells been located, drilled,
logged, completed, developed, and shown on the plat as
required by §230.8(c)(1) - (4) of this title?		 Yes No
22. Have all reasonable precautions been taken to ensure that
contaminants do not reach the subsurface environment and
that undesirable groundwater has been confined to the
zone(s) of origin (§230.8(c)(5) of this title)?		 Yes No
23. Has an aquifer test been conducted which meets the
requirements of §230.8(c)(1) and (6) of this title?		 Yes No
24. Were existing wells or previous aquifer test data used? Yes No
25. If yes, did they meet the requirements of §230.8(c)(7) of
this title?		 Yes No
26. Were additional observation wells or aquifer testing
utilized?		 Yes No
Note: If expansion of an existing public water supply system or a new public water supply system is the
anticipated method of water distribution for the proposed subdivision, site-specific groundwater data
shall be developed under the requirements of 30 TAC, Chapter 290, Subchapter D of this title (relating
to Rules and Regulations for Public Water Systems) and the applicable information and correspondence
developed in meeting those requirements shall be attached to this form pursuant to §230.8(a) of this
title.

Determination of Groundwater Quality (30 TAC §230.9)
27. Have water quality samples been collected as required by
§230.9 of this title?		 Yes No
28. Has a water quality analysis been performed which
meets the requirements of §230.9 of this title?		 Yes No

Determination of Groundwater Availability (30 TAC §230.10)
29. Have the aquifer parameters required by §230.10(c) of
this title been determined?		 Yes No
30. If so, provide the aquifer parameters as determined.
Rate of yield and drawdown:
Specific capacity:
Efficiency of the pumped well:
Transmissivity:
Coefficient of storage:
Hydraulic conductivity:
Were any recharge or barrier boundaries detected? Yes No
If yes, please describe:
Thickness of aquifer(s):
31. Have time-drawdown determinations been calculated as
required under §230.10(d)(1) of this title?		 Yes No
32. Have distance-drawdown determinations been calculated
as required under §230.10(d)(2) of this title?		 Yes No
33. Have well interference determinations been made as
required under §230.10(d)(3) of this title?		 Yes No
34. Has the anticipated method of water delivery, the annual
groundwater demand estimates at full build out, and
geologic and groundwater information been taken into
account in making these determinations?		 Yes No
35. Has the water quality analysis required under §230.9 of
this title been compared to primary and secondary public
drinking water standards as required under §230.10(e) of
this title?		 Yes No
Does the concentration of any analyzed constituent exceed
the standards?		 Yes No
If yes, please list the constituent(s) and concentration measure(s) which exceed standards:

Groundwater Availability and Usability Statements (30 TAC §230.11(a) and (b))
36. Drawdown of the aquifer at the pumped well(s) is estimated to be __________ feet over a 10-year
period and __________ feet over a 30-year period.
37. Drawdown of the aquifer at the property boundary is estimated to be __________ feet over a 10-
year period and __________ feet over a 30-year period.
38. The distance from the pumped well(s) to the outer edges of the cone(s)-of-depression is estimated to
be __________ feet over a 10-year period and __________ feet over a 30-year period.
39. The recommended minimum spacing limit between wells is __________ feet with a recommended
well yield of __________ gallons per minute per well.
40. Available groundwater is / is not (circle one) of sufficient quality to meet the intended use of the
platted subdivision.
41. The groundwater availability determination does not consider the following conditions (identify any
assumptions or uncertainties that are inherent in the groundwater availability determination):

Certification of Groundwater Availability (30 TAC §230.11(c))
Must be signed by a Texas Licensed Professional Engineer or a Texas Licensed Professional
Geoscientist.
42. I, __________________________________, Texas Licensed Professional Engineer or Texas
Licensed Professional Geoscientist (circle which applies), certificate number ____________________,
based on best professional judgment, current groundwater conditions, and the information developed
and presented in this form, certify that adequate groundwater is available from the underlying aquifer(s)
to supply the anticipated use of the proposed subdivision.
Date:                                                                  (affix seal)