March 26, 2021

Agreement for Requesting Temporary Emergency Water

Providing Bottled Water To Homes. For those residents with private water supplies, the DNR will provide the option of bottled water to be delivered in five gallon containers to those residents’ homes, through a state contract with Culligan. The DNR would need the residents to sign up for this service though the DNR and sign an access agreement with the state and vendor to begin receiving water in the coming week. Residents should not contact Culligan directly if they are requesting the state to pay for the bottled water.

To request a temporary alternative water supply from the DNR, please fill out an Agreement for Requesting Temporary Emergency Water and send to or:

Wisconsin Department of Natural Resources
Jenna Soyer – RR/5
PO Box 7923
Madison WI 53703

The Town of Campbell will make physical forms available at the town hall. The town will scan and email agreements to the DNR. The town hall can be accessed Monday, Wednesday and Thursday 8 a.m. – 4:30 p.m.; Tuesday 8 a.m. – 6 p.m.; and Friday 8 a.m. – 3 p.m.

Be sure to indicate on the agreement if you need a bottom-loading dispenser. Bottom-loading dispensers are generally provided to those who are unable to lift five gallon jugs.

Residents who are currently paying for their own bottled-water service should also fill out and submit an agreement in order to have the DNR take over coordination and payments of their service.