Office of Permitting and Compliance Forms and Documents

Upstream Oil And Gas Water Well Underground Injection Control Exploration and Production Waste

Upstream Oil and Gas 

 

Electronic Submission of Forms Memorandum 

  • Organization Report for Operators & Transporters (OR-1) – Online Form , User Guide
  • Oilfield Site Restoration Contractor Organization Report (OSR-OR-1) - Word , PDF
  • Estimated Economic Impact Statement - Word , PDF
  • Voluntary Unit Affidavit - Word
  • Austin Chalk Affidavit of Majority Working Interest (AMWI) - Word , PDF
  • Application for Permit to Drill for Minerals (MD-10-R-1) - Excel
  • Application to Amend Permit to Drill for Minerals (MD-10-R-A-1) - Excel
  • Pre-Entry Notice Affidavit (AFLN-1) - PDF
  • Application to Amend Operator - Multiple Wells (MD-10-R-AO) - Excel
  • Surface Owner Contact Information (SOCI) - Excel , PDF
  • Landowner Use Affidavit (LUA) - Word , PDF
  • Orphan Well Affidavit (OSR-A) - Word , PDF
  • Site Specific Trust Account Form (9604) - Word , PDF
  • Site Specific Trust Account Reassessment (9604-1) - Word , PDF
  • Drilling/Workover Rig Movement Notification Report - Word
  • Casing Test (CSG-T) - Word
  • Apparent Deviation (AD) - Excel , PDF
  • Work Permit (DM-4R) - PDF
  • Tubingless Completion Form (TC-1) - Excel , PDF
  • Application for Dual Completion (ADC) - Excel , PDF
  • Packer Setting Certificate (PS-1) - Word
  • Packer Leakage Test (PLT-1) - Word , PDF
  • State Potential Report (SDM2) - PDF
  • Well Completion or Recompletion Report (COMP) - PDF
  • Well History and Work Resume Report (WH-1) -  PDF
  • WH-1 Supplement for Hydraulic Fracturing -  PDF
  • Surface Commingling Application (29-D-1) - Word
  • Operators Certificate of Compliance and Authorization to Transport Oil From Production Facility (R-4) - Excel , PDF
  • Notification of Temporarily Inactive Well to be Omitted from Monthly Production Reports (PA-35) - Excel
  • Enhanced Recovery Annual Data Sheet (ERADS) - Excel , PDF
  • Enhanced Recovery Questionnaire (ERQ) - Excel , PDF
  • Reserve Pit Oilfield Waste Disposition (ENG-16) - PDF , Instructions
  • E&P Waste Containment Structure Notification (ENG-15) -  PDF
  • E&P Waste Unauthorized Discharge/Disposal Notification (ENG-15C) - PDF , Instructions
  • Reclaimed Oilfield Waste (ROW) Transportation Ticket (ENG-17) - Ordering Information     
  • Landowner Affidavit of No Objection for Passive Pit Closure - Word , PDF
  • Orphan Well Work Permit (OSR-WP) - Excel
  • Plug and Abandon Report (P&A) - PDF
  • Site Clearance Verification Application (SC-APP) - PDF
  • Site Clearance Verification Report (SC-VER) - PDF
  • 3D Seismic Application (STRP-3D) - Excel , PDF
  • Deep Well Application (STRP-DW) - Excel , PDF
  • Horizontal Well Application (STRP-HW) - Excel , PDF
  • Inactive Well w/ Similar Perfs Application (STRP-IA) - Excel , PDF
  • Orphan Well w/ Similar Perfs Application (STRP-OW) - Excel , PDF
  • Well Cost Statement (WCS) - Excel , PDF , Instructions
  • CA for Well Evaluation - PDF
  • CA for P&A - PDF

Water Wells

  • Water Well Notification Form (GWR-01) – PDF
  • Area of Concern Monthly Ground Water Usage Report (GW-03) – PDF
  • Water Well Registration LONG Form (GW-01) – PDF, Photo Requirement Memo
  • Water Well Registration SHORT Form (GW-1S) – PDF, Instructions, Photo Requirement Memo
  • Water Well Plugging and Abandonment Form (GW-02) – PDF, Photo Requirement Memo
  • Water Well Variance Request (GW-04) – PDF
  • Inactive Water Well Checklist (GW-05) – PDF
  • Water Well Transfer Document (WWT) – PDF
  • Ground Water Well Prior Notification Form Evaluation Checklist – PDF

Underground Injection Control

 

Want to meet with the Engineering Division? Submit a Meeting Request.

  • Class-I Injection Well Application (UIC-1) – PDF
    • Class I Permitting Process & Guidelines – PDF
    • Class I Cross-Section Guidance – PDF
    • Class I Structure & Isopach Map Guidance – PDF
  • Class-I Well Integrity Affidavit (UIC-6) – PDF
  • Injection Well Work Permit - Fillable (UIC-17) – PDF   Digital Signature accessible only when downloaded and opened in Adobe.
  • Injection Well Work Permit (UIC-17) – PDF
  • Injection Well Work History (UIC WH-1) – PDF
  • Injection Well Plug and Abandonment Report (UIC-P&A) – PDF
  • Affidavit of Casing Test (CSG-T) – PDF
  • Request for Expedited Review (IMD-1) – PDF
  • Class-II Injection Well Application for SWD, EOR, & COM (UIC-2) – PDF
    • UIC-2 SWD & EOR Application Guidance – PDF
    • UIC-2 Attachments (AOR Well List, FW Well List, Inj Fluid Well List) Template – PDF
    • Office of Permitting and Compliance - SWD Public Notice Template – PDF
    • UIC-2 COM Application Guidance – Word
    • Commercial Cross-Section Guidance – PDF
    • Office of Permitting and Compliance - COM Public Notice Template – PDF
  • Class-II Commercial Slurry Fracture Injection Well Application (UIC-2 SFI COM) – PDF
  • Class-II Request to Amend the Maximum Authorized Surface Injection Pressure (UIC-2 MASIP) – PDF
  • Class-II Well Integrity Affidavit (UIC-5) – PDF
  • Class-II Annular Saltwater Disposal Well Application (UIC-9) – PDF
  • Annual Disposal/Injection Well Monitoring Report (UIC-10) – PDF
  • Mechanical Integrity Noncommercial Class II Daily Monitor (UIC-11) – PDF
  • Community Saltwater Injection System Application (UIC-13) – PDF
    • Example of a Community Salt Water Disposal Well Working Agreement – PDF
    • Example of a Community Enhanced Recovery Well Working Agreement – PDF
  • Application for Subsurface Disposal of Reserve Pit Fluids (UIC-14) – PDF
  • Injection Well Work Permit - Fillable (UIC-17) – PDF   Digital Signature accessible only when downloaded and opened in Adobe.
  • Injection Well Work Permit (UIC-17) – PDF
  • Work Permit to Plug & Abandon a Well utilized for NORM disposal (UIC-30) – PDF
  • Class-II Injection Well Application to Change Disposal/Injection Zone (UIC-32) – PDF
  • Injection Pressure & Rate Monitoring Log (UIC-36) – PDF
  • Injection Well Work History (UIC WH-1) – PDF
  • Injection Well Plug and Abandonment Report (UIC-P&A) – PDF
    • P&A General Guidelines for SWD & EOR Wells – PDF
  • Affidavit of Casing Test (CSG-T) – PDF
  • Request for Expedited Review (IMD-1) – PDF
  • Class-II Hydrocarbon Storage Well Application (UIC-2 HSW) – PDF
  • Formation Storage Well Permit Application (UIC-2 FS) – PDF
  • Class-III Brine Extraction Well Application (UIC-3 BR) – PDF
    • Salt Dome Cross Section Guidance – PDF
    • Salt Dome Cavern Structure Maps Guidance – PDF
  • Salt Cavern Safety Inspection Form (UIC-4C) – PDF
  • Injection Well Work Permit - Fillable (UIC-17) – PDF   Digital Signature accessible only when downloaded and opened in Adobe.
  • Injection Well Work Permit (UIC-17) – PDF
  • Class-II E&P Waste Disposal in a Salt Cavern Application (UIC-43) – PDF
  • Salt Cavern Weekly Monitoring Log & Summary Report (UIC-50) – PDF
  • Class 5 Storage Well Application (UIC-55 SCS) – PDF
  • Injection Well Work History (UIC WH-1) – PDF
  • Injection Well Plug and Abandonment Report (UIC-P&A) – PDF
  • Affidavit of Casing Test for Salt Cavern Wells (CSG-TSC) – PDF
  • Request for Expedited Review (IMD-1) – PDF
  • Injection Well Work Permit - Fillable (UIC-17) – PDF    Digital Signature accessible only when downloaded and opened in Adobe.
  • Injection Well Work Permit (UIC-17) – PDF
  • Class-V Well Application (UIC-25) – PDF
  • Class V Remediation Area Permit Application (UIC-25R) – PDF
    • Instruction for Class V Permit Waver (Exemption Request) – PDF
  • Class V Remediation Repermit Application (UIC-25R Repermit) – PDF
  • Class V Stratigraphic Test Well Permit Application (UIC-25 Strat Test) – PDF
    • Instruction for Form UIC-25 Strat Test – PDF
  • Class-V Well History and Work Resume Report (UIC-42) – PDF
  • Class V Stratigraphic Test Well History and Work Resume Report (UIC-42 Strat Test) – PDF
  • Class V Remediation Well History and Work Resume Report (UIC-42R) – PDF
  • P&A Affidavit for Class V Remediation Projects Only (UIC-45) – PDF
  • Injection Well Plug and Abandonment Report (UIC-P&A) – PDF
  • Affidavit of Casing Test (CSG-T) – PDF
  • Request for Expedited Review (IMD-1) – PDF
  • Injection Well Work Permit - Fillable (UIC-17) – PDF    Digital Signature accessible only when downloaded and opened in Adobe.
  • Injection Well Work Permit (UIC-17) – PDF
  • Class VI Well Permit Application (UIC-60 CCS) – PDF
    • Class VI Application Submittal Instructions – PDF
    • Class VI Complete Application Materials – PDF
    • Class VI Cross-Section Standards – PDF
    • Class VI Structure and Isopach Map Standards – PDF
  • Injection Well Work History (UIC WH-1) – PDF
  • Affidavit of Casing Test (CSG-T) – PDF
  • Request for Expedited Review (IMD-1) – PDF
  • Additional Guidance Below
    • Final Class VI EPA Guidance Documents – Link
    • Class VI Environmental Analysis Guidance – PDF
    • Example PE and PG Certification Page for Class VI Application – PDF
  • RTS: Guidelines & Procedures for Disposal Wells Completed w/Tubing and Packer – Word
  • RTS: Guidelines & Procedures for Packerless Disposal Wells – Word
  • RTS: Guidelines & Procedures for UIC-14 Annular Disposal of Pit Fluids – Word
  • RTS: Guidelines & Procedures for UIC-9 Annular Saltwater Disposal Wells – Word
  • RTS: Time Drive Guidance – Word
  • RTS: Log Sheet – PDF
  • Cement Bond Logging Guidelines – PDF
  • Step Rate-Falloff Test Guidelines – PDF
  • Pressure Falloff Test Guidelines for Class I Wells – PDF
  • Pressure Falloff Test (PFOT) Report Summary Sheet — PDF , XLSX
  • Cone of Influence Calculation Guidance – PDF
  • Constitutional Considerations: "IT Decision" Questions – PDF
  • PE & PG Requirements for Class I and Class II Commercial SWD submittals (effective February 1, 2021) – PDF
  • Detailed Report of Wells in a Defined AOR – Link
  • Registered Water Well Search by Lat/Long – Link
  • LELAP Accredited Laboratories – Link
  • USDW Search – Link
  • Document Access – Link

Exploration and Production Waste

  • Commercial Facility Monthly Report of Waste Receipts (UIC-19) – PDF, Long Form PDF, Instructions
  • Commercial Facility Monthly Summation of Waste Receipts (UIC-19A) – PDF, Instructions
  • Commercial E&P Waste Facility Inspection & Test Report (UIC-20) – CES use only
  • Commercial Class-II Daily Monitor Log (UIC-21) – PDF, Instructions
  • Exploration & Production Waste Determination Request Form – PDF
  • Request to Transport E&P Waste to Commercial Facilities or Transfer Stations (UIC-23) – PDF
  • Waste Refusal Notification (UIC-26) – PDF
  • E&P Waste Shipping Control Ticket Ordering Information (UIC-28) – PDF
  • Organization Report for Off-Shore/Out-of-State Operators & Commercial Disposal Facilities ONLY (ENV-OR-1) – 2026 PDF, 2025 PDF
  • Laboratory Procedures for Analysis of E&P Waste (LABMAN) – PDF
  • Commercial E&P Waste Facility Permit Application (CF-APP) – Word, PDF
  • Affidavit of Operator-Owned/Leased Space – Word, PDF
C&E Secretary Dustin Davidson
Powered by Cicero Government