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IL. PROG
NOTICE OF INSPECTION
UNITED STATESENVIRONMENTAL PROTECTION AGENCY REGION 8, 1595 Wynkoop Street DENVER, Co 80202-1129 Phone 800-227-8917 http://www.epa.gov/region8
Notice of inspection is hereby ven accordng to Section 1445(b) of the Safe
Drinking Water Act (42 U.S.C. 300f et seq.) Hour:
Firm Name: MtOL clA -A4'1
Firm Address:_ It Z\ 2 () t)\5
...
J/A51 4 7
REASON FOR INSPECTiON:
For the purpose of inspecting records, flies, 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 contion of perrntt or rule authorization.
SECTION 1445(b) of the SAFE DR1NRING WATER ACT is quoted below:
Section 1445(b)(i): Except as provided in Paragraph (2),
the Admini,strator, or' representatives of the Administrator
duly designated by him, upon presenting appropriate
credentials, and a written notice to. any supplier of water
or other person subject to. (a), or person subject (A) a national primary drinking water regulation prescribed under Section 14 12(B) an applicable Underground Injection Control Program, or (C) any requirement to monitor an unregulated contaminant pursuant to subsection (a), or person in charge of any of the property of such supplier or other person referred to in clause (A), (B), or (C), is authorized to enter any establishment, ... facility, or other property of such supplier or other person in order to determine whether such supplier or other person has acted or is acting in compliance with this title, including for this purpose,
inspection, at reasonable times, of records, files, papers, processes, controls, and facilities, or in order to test any feature of a public water system, including its raw water source. The Administrator or the Comptroller General (oi: any representative designated by either) shall have thcess f or the purpose of audit and examination to any records, reports, or information of a grantee which are required to be maintained under subsection (a) or which are pertinent to any financial assistance under this title.
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inspectors Name & Title, (Print)
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
rnspec1
Signature
EPA RB 56O-i (8-89)
Origlnel - Reginal Office Copy Yet lo4 Copy - Oprtor Copy
Inspector(s):
Inspection Form: UT20000-02469 - Middle Fork Energy Uinta; WVU Federal 16
U.S. Environmental Protection Agency, Region 8 Underground Injection Control Program
Operator Representative: G e
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Date: 7 I
Tnbal Representative:
'VAwb'
Time: tV9
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Well Type
Enhanced Recovery (2R)
WELL INFORMATION _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Prior Inspection 06/20/2017
Well Status, Date Active 12/31/2002
Last MIT (I)
SAPT, 5 yrs, 01/13/2023
API No. Olifleld Name
43-047-15447
Wonsit Valley
Last MIT (II) MAIPI, Date
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
2080
psi,
04/071997
Latitude / Longitude Indian Country
40.128854 / -1 09.5332693 Uintah & Ouray
MAIP2, Date Cum Vol Limit
Permit Issued
Rule Authorized
jr
am / pm
1Routine 0 Emergency 0 Other:
INSPECTION TYPE:
0 Construction/Rework 0 MIT Witness
0 Complaint
0 Closure/P&A
WELL STATUS:
LI Under Construction
Active
0 Temporary 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: oDigital / DAnalog EPA Gauge: oDigitat / oAnalog Comments
Range: 0
ID & Range: O -3 o.o
Pressure (psi):
Pressure (psi):1,
Operator Gauge: igitaI I DAnalog EPA Gauge: oDigital / oAnalog Comments
Range:
ID & Range:
$
Annulus Pressure (psi): -&f.;
Pressure (psi):
Operator Gauge: oDigital / oAnalog
Bradenhead Range: Annulus Pressure (psi):
EPA Gauge: flDigital / oAnalog ID & Range: Pressure (psi):
Comments
_ _ _ _ _ _ _ _ _ _
Injection Rate
INJECTION RATES & VOLUMES
If Dual injector, observe & record as( U)pper and (L)ower injection zones
1pPD / DCFM
Comments
Is this the lifetime cumulative volume? DYes / DNo
Cumulative
Injection 'BBL I DMCF
Comments
Volume
Shut-off Device
Device(s) Present: 0 SCADA (Digital) I DMurphy Switch (Analog) I DPhysical Pop-off Valve
Shutoff Setting (psi)
Comments
DCN R8FQPForm -2023
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Inspection Form: UT20000-02469 - Middle Fork Energy Uinta; WVU Federal 16
Photos Taken? DYes /INo
PHOTOLOGS If Yes, provide Photo Log Addendum
GEOLOGY (ft KB)
_ _ _ _ _ _ _ _ _ _ _
CONSTRUCTION (ft KB)
-
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Lowest USDW
_ _ _ _ _ _ _ _ _ _ _ _ _ _
Upper Confining Zone Injection Zone
Name
_ _ _ _ _ _ _ _ _ _ _ _
Top
_ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _
Bottom
_ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _
Surface Csg:
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Interm Csg 1:
Interm Csg 2:
Prod Csg:
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Liner:
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Tubing:
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Pen Interval:
Packer Depth:
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Top
Bottom
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
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ADDITIONAL COMMENTS
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Inspector Signature
DCN R8FQPForm-2023
LAWRENCE
Digitally signed by LAWRENCE
GRANATO (Affiliate)
GRANATO (Affiliate) Date: 2023.07.28 06:47:09 -06'00'
Inspector Signature
Inspector Signature
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