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DocuSign Envelope ID:6BC32598-B737-464E-898A-81 F1 F7131339133
<br /> Instructions for Completing Attachments to Form 7520-6(Class V Wells)
<br /> The Underground Injection Control (UIC)program, as promulgated under the Safe Drinking Water Act(SDWA), is designed to
<br /> prevent injection activity from allowing the movement of fluid containing any contaminant into underground sources of drinking
<br /> water(USDWs), if the presence of that contaminant may cause a violation of any primary drinking water regulation or may
<br /> otherwise adversely affect the health of persons as found at Title 40 of the Code of Federal Regulations(40 CFR)section
<br /> 144.12.Any applicant for a permit under this program shall have the burden of showing that their proposed construction,
<br /> operation, maintenance, conversion, plugging, abandonment, and injection activity, does not endanger USDWs.
<br /> The attachments below have been constructed to provide applicants with clear expectations as to what information EPA needs
<br /> to make a determination that an applicant's proposed activities will not endanger USDWs.
<br /> Pre-Application Coordination
<br /> Coordination between the UIC program and the permit applicant prior to submittal of the permit application is an important step
<br /> for efficient and effective permitting. Early discussions will ensure that the applicant is aware of all the permit application
<br /> requirements, including state specific requirements found at 40 CFR part 147. These discussions may also help the applicant
<br /> plan how to invest time and resources needed to develop a comprehensive and complete permit application.
<br /> Applicants are encouraged to contact their EPA regional UIC program for a pre-application coordination meeting.
<br /> When completing each attachment,please be sure to specify the units reported, e.g., of depth,pressure, temperature, etc.
<br /> Attachment A. Map(s)and Area of Review
<br /> Part I.Well Location(s)
<br /> For Individual Permits: If the surface location provided in the accompanying 7520-6 form does not adequately describe the
<br /> well location (i.e., due to deviation, directional, or horizontal drilling), please describe the well's orientation and provide the
<br /> top-and bottom-hole coordinates, as appropriate. If any monitoring wells are proposed as part of this permit application,
<br /> provide coordinates for all monitoring wells.
<br /> For Area Permits (40 CFR§ 144.33): Provide information similar to what is outlined above for individual permits for each
<br /> well (existing or proposed)to be covered by this permit. In addition, provide a description of the proposed permitted area.
<br /> At a minimum, this area should include all the proposed or existing wells known at the time of permit application submittal.
<br /> For circular areas, this description should consist of a defined-radius from a singular point whose coordinates have been
<br /> given. For polygonal areas, use a series of coordinates describing the vertices or corners of the area. Submit a
<br /> Geographic Information System (GIS)file, if available.
<br /> Part 11.Area of Review Size Determination (40 CFR§ 146.6)
<br /> For All Permits. Give the method (fixed radius or equation)and, if appropriate, all calculations used to determine the size
<br /> of the area of review(AOR). If you are uncertain as to which method to use, consult with your regional EPA office.
<br /> The AOR must be a minimum radius of one-fourth (1/4) mile from the well bore, including a well's lateral, or the proposed
<br /> area permit boundary for area permits, unless the use of an equation is approved by the Director.
<br /> Part III. Map(s) (40 CFR§ 144.31)
<br /> Submit a topographic map (or other map if a topographic map is unavailable)extending one mile beyond the facility
<br /> property boundary showing:
<br /> • project injection well(s), well pad(s)and/or project area,
<br /> • applicable area of review,
<br /> • all outcrops of injection and confining formations,
<br /> • all surface water intake and discharge structures, and
<br /> • all hazardous waste treatment, storage,or disposal facilities.
<br /> Consult with your EPA regional office for the definition of the facility property boundary.
<br /> Within the one-fourth (1/4)mile beyond the facility property boundary or the AOR,whichever is larger, the map will also
<br /> show the:
<br /> • name and location of all production wells, injection wells, abandoned wells, dry holes, and all water wells, noting their
<br /> types (public water system, domestic drinking water, stock, etc.),
<br /> • springs and surface bodies of water,
<br /> • mines(surface and subsurface)and quarries, and
<br /> • other pertinent surface features, including residences,schools, hospitals, and roads.
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