This form is for use by individuals not served by a public water system experiencing problems with their water supply and agencies receiving calls from those individuals.


How is this information going to be used?

This information is intended to inform state and local agencies on drought impacts on household water supplies. The Household Water Supply Shortage Reporting System was first created as part of our emergency response efforts to previous droughts, and we are continuing to gather information relating to shortages of household water from private well or surface water sources. Collection of data is not to be construed as application for local, state or federal assistance. Individuals interested in financial assistance will be directed towards appropriate resources.


Data Collection Entails:

  • Contact information for Household experiencing water shortage
  • Water Shortage Problem Information and Location
  • Financial Resources Available
  • Well Log Data (optional)
  • Reporting Agency or Local Government Information

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For Agency Users