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UNITED S7AlES ENVtRONMEN7AL PROlEC71ON AGENCY <br />WASHINGTON, DC 70x60 <br />~E PA INJECTION WEII MON170RlNG REPORT form Approved <br />OMB No. 7000-OD42 <br />Approvaleap/ress-3o-BB <br />YEAR MONTH ~ MONTH ~ MONTH <br />Injection Pressure IPSfj <br />Minimum <br />1 <br />. <br />Average <br />2 <br />. <br />3. Maximum <br />ction Rate (Gel/Min) <br />Inj <br />e <br />Minimum <br />1 <br />. <br />Average <br />7 <br />. <br />3. Maximum _ , <br />lar Pressure IPSI) <br />A <br />nnu <br />Minimum <br />1 <br />. <br />e <br />Avera <br />2 <br />g <br />. <br />3. Maximum <br />lume IGalj <br />V <br />i <br />on <br />o <br />Inject <br />iatel <br />nthl <br />M <br />y <br />o <br />1. <br />2. Yearly Cumulative <br />(F°~ <br />t <br />ure <br />Tempera <br />i <br />um <br />Mi <br />n <br />m <br />1. <br />era <br />e <br />A <br />v <br />g <br />2. <br />3. Maximum <br />pH. <br />i <br />i <br />mum <br />n <br />1. M <br />2. Average <br />g. Maximum <br />Other <br />_ <br /> <br /> <br /> <br /> <br /> <br />Name and Address of Perminee Permit Number <br />Name and Official Title (please type or print) Signature Date Signed <br />