Document wrd5pzaLoXoBp8Yk1KdgV7rE3
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
I4i'
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: UT22197-04271 - Scout Energy Group V, IP, Federal 33-9H-9-17
U.S. Environmental Protection Agency, Region 8 Underground Injection Control Program
Inspector(s): Gary Wang, Chris Brown, Rachel Brookins
Operator Representative: Tribal Representative:
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Date: I 21 i&3
Time: L(.: b5' am
_ _ _ _ _ _ _ _ _ _ _ _ _ _
Well Type Well Status, Date API No. OlIfleld Name Latitude! Longitude Indian Country
Enhanced Recovery (2R)
WELL INFORMATION _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Prior Inspection 05/03/2016
Temporarily Abandoned, 10/18/2019 Last MIT (I)
SAPT, 2 Yrs, 7/14/2021, Pass
43-013-31108 Pleasant Valley
Last MIT (II) MAIP1, Date
N/A
/
1556 psi, 12/12/2014 '1
40.044023 / -110.008895
MAIP2, Date N/A
Uintah and Ouray
Cum Vol Limit U:/L:
Routine 0 Emergency 0 Other:
INSPECTION TYPE: D Construction/Rework
0 MIT Witness
0 Complaint 0 Closure/P&A
WELL STATUS:
0 Under Construction
0 Active
7Temporary Abandon
DP&A'ed
DOther:
_ _ _ _ _ _ _ _ _ _
Injection Tubing
WELLHEAD PRESSURES
If Dual injector, observe & record as (U)pper and (L)ower injection zones
Operator Gauge: Digital / DAnalog EPA Gauge: DigitaI / oAnalog Comments
Range: c -3'oo
ID&Range: O -'3o
Pressure (psi):Z1 -7
Pressure (psi): z-
Tubn Casing Annulus
Operator Gauge: EJDigital! oAnalog Range: 0 Pressure (psi):
EPA Gauge: oDigital / DAnalog ID & Range: Pressure (psi):
Comments
Operator Gauge: oDigital / DAnalog
Bradenhead Range: Annulus Pressure (psi):
EPA Gauge: IJDigital / LJAna!og ID & Range: Pressure (psi):
Comments
_ _ _ _ _ _ _ _ _ _
Injection Rate
INJECTION RATES & VOLUMES
If Dual injector, observe & record as( U)pper and (L)ower injection zones
BPD / DCFM
Comments el( i
-ca1 ?/l
Cumulative Injection Volume
Pump Shut-off Device
Is this the lifetime cumulative volume? LIYes I DNo
BL / DMCF
Comments
1;',
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Device(s) Present: 0 SCADA (Digital) I DMurphy Switch (Analog) / DPhysical Pop-off Valve
Shutoff Sethng (psi)
Comments
14. W
DCN R8FQPForm-2023
Page 1 of 2 - This form was printed on 6/20/2023
Inspection Form: UT22197-04271 - Scout Energy Group V, IP, Federal 33-9H-9.17
Photos Taken?
DYes I 1No
PHOTOLOGS If Yes, provide Photo Log Addendum
GEOLOGY (ft KB)
Lowest USDW
_ _ _ _ _ _ _ _
Upper Confining Zone
Injection Zone
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Name
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Garden Gulch Shale
Top 3344'
_ _ _ _ _ _ _ _ _ _ _ _
Bottom
_ _ _ _ _ _ _ _ _ _ _ _ _
3840'
_ _ _ _ _ _ _ _ _ _ _
CONSTRUCTION (ft KB)
Top
_ _ _ _ _ _ _ _ _ _ _
Surface Csg:
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Interm Csg 1:
Interm Csg 2:
Prod Csg:
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Liner:
_ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Tubing:
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Pen Interval:
Packer Depth:
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Bottom
((Diagramlmage
ADDITIONAL COMMENTS
Inspector Signatil
DCN R8FQPForm -2023
Inspector Signature
Inspector Signature
Page 2 of 2 - This form was printed on 6/20/2023