Please fill out the following form to register a well site. Fields with an * are required. Name Home Mailing Address City Zip County of Abandoned Site Phone Email Legal Description of Abandoned Site (section, township and range) If possible, please provide driving directions to the site from an intersection or landmark Problem Description If possible, please attach pictures of site How did you hear about OERB's well site cleanup program? Magazine Ads Newspaper Ads Word-of-mouth TV Commercials Radio Commercials Outdoor Boards The Web Direct Mail Article or news report on the OERB Submit Success! Your well site has been submitted.