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PAPERWORK REDUCTION ACT
<br /> The public reporting and record keeping burden for this collection of information is estimated to average 49 hours per response for a Class I
<br /> hazardous facility, and 47 hours per response for a Class I non-hazardous facility. Burden means the total time, effort, or financial resource
<br /> expended by persons to generate,maintain,retain,or disclose or provide information to or for a Federal Agency.This includesthe time needed
<br /> to review instructions; develop, acquire, install, and utilize technology and systems for the purposes of collecting, validating, and verifying
<br /> information, processing and maintaining information, and disclosing and providing information; adjust the existing ways to comply with any
<br /> previously applicable instructions and requirements;train personnel to be able to respond to the collection of information;search data sources;
<br /> complete and review the collection of information,and, transmit or otherwise disclose the information. An agency may not conduct or sponsor,
<br /> and a person is not required to respond to,a collection of information unless it displays a currently valid OMB control number.Send comments
<br /> on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing
<br /> respondent burden,including the use of automated collection techniquesto Director,Collection Strategies Division,U.S.Environmental Protection
<br /> Agency (2822), 1200 Pennsylvania Ave., NW.,Washington,D.C. 20460.Include the OMB control number in any correspondence. Do not send
<br /> the completed forms to this address.
<br /> Attachments to be submitted with the Completion report:
<br /> I.Geologic Information 4. Provide data on centralizers to include number,type
<br /> and depth.
<br /> 1. Lithology and Stratigraphy
<br /> 5. Provide data on bottom hole completions.
<br /> A. Provide a geologic description of the rock units pene-
<br /> trated by name,age,depth,thickness,and lithology of 6. Provide data on well stimulation used.
<br /> each rock unit penetrated.
<br /> III.Description of Surface Equipment
<br /> B. Provide a description of the injection unit.
<br /> 1. Provide data and a sketch of holding tanks,flow lines,
<br /> (1)Name filters, and injection pump.
<br /> (2)Depth(drilled)
<br /> (3)Thickness IV.Monitoring Systems
<br /> (4)Formation fluid pressure
<br /> (5)Age of unit 1. Provide data on recording and nonrecording injection
<br /> (6)Porosity(avg.) pressure gauges,casing-tubing annulus pressure
<br /> (7)Permeability gauges, injection rate meters,temperature meters,and
<br /> (8)Bottom hole temperature other meters or gauges.
<br /> (9)Lithology
<br /> (10)Bottom hold pressure 2. Provide data on constructed monitor wells such as
<br /> (11)Fracture pressure location,depth,casing diameter,method of cementing,
<br /> etc.
<br /> C. Provide chemical characteristics of formation fluid
<br /> (attach chemical analysis). V.Logging and Testing Results
<br /> D. Provide a description of freshwater aquifers. Provide a descriptive report interpreting the results of
<br /> geophysical logs and other tests. Include a description
<br /> (1)Depth to base of fresh water(less than 10,000 mg/I and data on deviation checks run during drilling.
<br /> TDS).
<br /> (2)Provide a geologic description of aquifer units with VI.Provide an as-built diagrammatic sketch of the injec-
<br /> name,age,depth,thickness, lithology,and average total tion well(s)showing casing,cement,tubing, packer,etc.,
<br /> dissolved solids. with proper setting depths.The sketch should include
<br /> well head and gauges.
<br /> II.Well Design and Construction
<br /> VII.Provide data demonstrating mechanical integrity
<br /> 1. Provide data on surface, intermediate,and long string pursuant to 40 CFR 146.08.
<br /> casing and tubing. Data must include material,size,
<br /> weight,grade,and depth set. VIII.Report on the compatibility of injected wastes with
<br /> fluids and minerals in both the injection zone and the
<br /> 2 Provide data on the well cement, such as type/class, confining zone.
<br /> additives, amount,and method of emplacement.
<br /> IX.Report the status of corrective action on defective
<br /> 3. Provide packer data on the packer(if used)such as wells in the area of review.
<br /> type, name and model,setting depth,and type of annular
<br /> fluid used. X.Include the anticipated maximum pressure and flow
<br /> rate at which injection will operate.
<br /> EPA Form 7520-9 Reverse
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