This report provides the findings and recommendations from a multi-year, collaborative scientific study, led by the Wisconsin Department of Natural Resources (DNR), that examined the impacts of groundwater withdrawals on three lakes in Wisconsin's Central Sands region: Pleasant, Long, and Plainfield Lakes. The study found lake level reductions due to groundwater pumping to be significant or near significant thresholds. As a result, the DNR provided recommendations to the Wisconsin State Legislature to implement a regional framework, such as a water use district, to address these impacts and impacts to other local water resources. Contributing authors of the Wisconsin DNR's Water Use Section: Ian Anderson, Nicole Clayton, Adam Freihoefer, Rachel Greve, Jeff Helmuth, and Aaron Pruitt. In addition to this report, seven appendices are available. Appendix A: Data Collection and Hydrostratigraphy (DOI: 10.5281/zenodo.5708747) Appendix B: Lake Ecosystem Characterization and Response (DOI: 10.5281/zenodo.5708751) Appendix C: Modeling Documentation (DOI: 10.5281/zenodo.5708760) Appendix D: Recharge (DOI: 10.5281/zenodo.5708768) Appendix E: General Lake Model (DOI: 10.5281/zenodo.5708771) Appendix F: Land Use in the Central Sands (DOI: 10.5281/zenodo.5708777) Appendix G: Groundwater Quantity Programs Summary (DOI: 10.5281/zenodo.5708785)