Commonly Requested Underground Injection Control Forms and Checklists

Federal UIC Permit Application

Federal Part A Form Application and Instructions

Injection Well Monthly Report — (If you have Acrobat Reader Version 5 or higher, you can complete the form using the hand tool. Click on the hand on the Tool Bar. When the hand is over an area that will accept data, it changes to an I-bar.)

Checklists and Inspection Forms

Class I UIC Permit Checklist Underground Injection Control Site Inspection
Class V Injection well information  
EPA Forms (Forms 7520 series)
Part I: Permit Review and Issuance/ Wells in Area of Review Part II: Compliance Evaluation
Part II: Compliance Evaluation Significant Noncompliance Part IV: Quarterly Exceptions List
Part III: Inspections Mechanical Integrity Testing Application To Transfer Permit
Permit Application Summary of UIC Grant Utilization
Injection Well Monitoring Report Completion Form For Injection Wells
ANNUAL DISPOSAL/INJECTION WELL MONITORING REPORT WELL REWORK RECORD
COMPLETION REPORT FOR BRINE DISPOSAL, HYDROCARBON STORAGE, OR ENHANCED RECOVERY  
PLUGGING AND ABANDONMENT PLAN INVENTORY OF INJECTION WELLS