Document bB1oKMMzQJ22e5mZ7mvKake7k
UNITED STATES ENVIRONMENTAL PROTECTION AGENCY
REGION 8
(
)
1595 Wynkoop Street
Denver, CO 80202-1129
Phone 800-227-8917
www.epa.gov/regiono8
NOTICE OF INSPECTION
Date: /i.1/Z3
Notice of inspection is hereby given according to Section 1445(b) of the Safe Drinking Water Act (42 U.S.C 300fet seq).
Hour:
Firm Name: T,coJi
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Firm Address: J2-O (J 3'ttt.,flWI\'( ho tEIE-1, Otf SLU)6G
REASON FOR INSPECTION For the purpose of inspection records, files, papers, processes, controls and facilities, and
obtaining samples to determine whether the person subject to an applicable underground injection control program has acted or is acting in compliance with the Safe Drinking Water Act
and any applicable condition of permit or rule authorization.
Section 1445(b) of the Safe Drinking Water Act is quoted below:
Section 1445(b) (1): Except as provided in Paragraph (2)[ofthis section ofthe SDWA], the Administrator, or representatives ofthe Administrator duly designated by him, upon presenting
appropriate credentials, and a written notice to any supplier ofwater or other person subject to (A) a national primary drinking water regulation prescribed under section 300g-1 ofthis title,
(B) an applicable underground injection control program, or (C) any requirement to monitor an unregulated contaminant pursuant to subsection (a) ofthis section, or person in charge ofany of the property ofsuch supplier or other person referred to in clause (A), (B), or (C), is authorized to enter any establishment, facility, or other property ofsuch supplier or other person in order to
determine whether such supplier or other person has acted or is acting in compliance with this
subchapter, includingfor this purpose, inspection, at reasonable times, ofrecords, files, papers, processes, controls, andfacilities, or in order to test anyfeature ofa public water system,
including its raw water source. The Administrator or the Comptroller General (or any
representative designated by either) shall have accessfor the purpose ofaudit and examination
to any records, reports, or information ofa grantee which are required to be maintained under subsection (a) ofthis section or which are pertinent to anyfinancial assistance under this
subchapter.
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Inspector's Name & Title (Print)
Inspector's Signature
Original - Regional Office Copy Yellow Copy - Operator Copy
Inspection Form: U122197-10510 - Scout Energy Group V, Humpback Federal 16-24-8-17
U.S. Environmental Protection Agency, Region 8 Underground Injection Control Program
Inspector(s): Gary Wani, Chns Brown, Rachel Brookins
Operator Representative: ifl 't
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Tribal Representative: M)( P11'.4 vJco
Date: C 'Z7 I 23
Time: ii (1Ipm
_ _ _ _ _ _ _ _ _ _ _ _ _
Welt Type Welt Status, Date API No.
WELL
INFORMATION
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Enhanced Recovery (2R)
Prior Inspection
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Temporarily Abandoned, 06/07/2019 Last MIT (I)
SAPT, 2 Yrs, 01/06/2023, Pass
43-047-34879
Last MIT (II)
N/A
Oilfleld Name
Monument Butte
MAIP1, Date 1305 psi, 12/12/2014
Latitude! Longitude 40.098060/-109.947950
MAIP2, Date N/A
Indian Country
Uintah and Ouray
Cum Vol Limit U:!L:
JI Routine
o Emergency o Other:
INSPECTION TYPE:
0 Construction/Rework 0 MIT Witness
LI Complaint 0 Closure/P&A
WELL STATUS:
0 Under Construction
0 Active
tTemporary Abandon
DP&A'ed
0 Other:
_ _ _ _ _ _ _ _ _ _
Injection Tubing
WELLHEAD PRESSURES
If Dual injector, observe & record as (U)pper and (L)ower injection zones
Operator Gauge:'Digital I ElAnalog EPA Gauge: igitaI / oAnatog Comments
Range: b - oc'
Pressure (psi): 7'
ID & Range: o - 35cb' Pressure (psi): 3O
Annulus
Operator Gauge: oDigital / 1\naIog
Range: Q -3so
Pressure (psi): ,
Operator Gauge: DDigital I oAnalog
Bradenhead Range: Annulus Pressure (psi):
EPA Gauge: oDigital! oAnalog ID & Range: Pressure (psi):
EPA Gauge: oDigital / DAnalog ID & Range: Pressure (psi):
Comments
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Comments
_ _ _ _ _ _ _ _ _
Injection Rate
INJECTION RATES & VOLUMES
If Dual injector, observe & record as( U)pper and (L)ower injection zones
EBPD / DCFM
Comments
i
& rr ii. - -' ?
Is this the lifetime cumulative volume? DYes / DNo Cumulative
Injection IBBL / DMCF
Comments
Volume
Pump Shut-off Device
Device(s) Present: D SCADA (Digital) / flMurphy Switch (Analog) I DPhysical Pop-off Valve
Shutoff Setting (psi)
Comments
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DCN R8FQPForm -2023
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Inspection Form: UT22197-10510 - Scout Energy Group V, Humpback Federal 16-24-8-17
Photos Taken? DYes I o
PHOTOLOGS If Yes, provide Photo Log Addendum
GEOLOGY (ft KB)
Lowest USDW
Upper Confining Zone
Injection Zone
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_ _ _ _ _ _ _ _ _ _
Name
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Garden Gulch Shale
Top 3970'
_ _ _ _ _ _ _ _ _ _ _ _
Bottom
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4418'
((DiagramImage
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_ _ _ _ _ _ _ _ _ _ _
Surface Csg:
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Interm Csg 1:
Interm Csg 2:
Prod Csg:
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Liner:
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Tubing:
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Pen Interval:
Packer Depth:
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
CONSTRUCTION (ft KB) Top
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Bottom
ADDITIONAL COMMENTS
Inspector Signatur
DCN R8FQPForm -2023
Ci'
Inspector Signature
Inspector Signature
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