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Underground Injection Control FormsWater, Wastewater & Wetlands: Underground Injection Control Forms
Information Applicable to All UIC Filings
UIC Well Type Descriptions Descriptions of the various types of UIC Class V wells that require a MassDEP Registration Number. UIC Class V Well Registration Application Fee Table This spreadsheet provides the UIC Registration application fees for the different types of UIC Class V wells. More information about Underground Injection Control Back to Underground Injection Control Forms index Water, Wastewater & Wetlands: Underground Injection Control Forms
Filing with eDEP
As an alternative to filing by mail, use the UIC forms in eDEP Online Filing to register your UIC well. Please note that the UIC forms in eDEP may be used to register all Class V UIC well types that require UIC registration, with the exception of closed-loop ground source heat pump (GSHP or geothermal) wells, which must be registered using the one-page application form. eDEP Basics Frequently asked questions, available forms, a tour of eDEP, contacts & feedback. eDEP Online Filing Create an eDEP Online account, complete and submit UIC registration application forms. eDEP UIC General Guidance General guidance on the use of eDEP. eDEP UIC Forms General Instructions General instructions on the use of UIC forms in eDEP. Instructions for Completing UIC Registration Applications and Modifications of UIC Registration Applications (BRP WS06 and BRP WS06 Modification or Well Conversion) Detailed instructions regarding the information required for completing the UIC eDEP Registration (BRP WS06) and eDEP Modification (BRP Modification or Well Conversion) application forms. Instructions for Completing UIC Well Completion of Construction Notification Form Detailed instructions regarding the required information for completing the UIC eDEP Well Completion of Construction Notification form. Instructions for Completing UIC Pre-Closure Applications (Registered UIC Well Pre-Closure Notification) Detailed instructions regarding the required information for completing the UIC eDEP Registered UIC Well Pre-Closure Notification form. Instructions for Completing UIC Well Post-Closure Notification Form Detailed instructions regarding the required information for completing the eDEP UIC Well Post-Closure Notification form. Instructions for Completing UIC Registered Well Monitoring Report Detailed instructions regarding the required information for completing the eDEP UIC Registered Well Monitoring Report. Back to Underground Injection Control Forms index Water, Wastewater & Wetlands: Underground Injection Control Forms
Filing with Downloadable Forms: Well Registration Application Forms
If you are unable to use the UIC forms in eDEP, you may use the corresponding forms below. BRP WS-06 UIC Registration - Open-Loop Ground Source Heat Pump Well The well owner and operator shall use this form to apply to the UIC Program for registration of an open-loop ground source heat pump (GSHP) well (geothermal well). This form is also to be used to apply for a modification of an existing UIC registration and to apply for pre-closure of a GSHP well that had not previously received a MassDEP-issued UIC registration number. Revised April 2012. UIC Registration Application for Closed-Loop Ground Source Heat Pump Well Revised June 2010. BRP WS06 UIC Registration - Water Purification Discharge Well Public water supply wel owners and operators: use this form to apply to the UIC Program for Registration of any subsurface discharge from a water purification system that is not required to obtain an Industrial Wastewater or Groundwater Discharge Permit. This includes public water supply, commercial, industrial, and greater than 1 unit residential discharges that qualify as UIC Class V discharges. This form shall also be used to apply for a Modification of an existing UIC Registration. August 2011. BRP WS06 UIC Registration - Public Water System Special Drainage Well Use this form to apply to the UIC Program for Registration of any subsurface discharge from UIC Class V special drainage well. This includes wells that received discharges from sample sinks, in-line analyzers, condensate floor drains, and emergency eye wash/shower stations. This form shall also be used to apply for a Modification of an existing UIC Registration. August 2011. BRP WS06 UIC Registration - Stormwater Discharge Well Use this form to apply to the UIC Program for Registration of any subsurface discharge of stormwater discharge. This form shall also be used to apply for a Modification of an existing UIC Registration. April 2012. BRP WS06 UIC Registration Use this form to apply to the UIC Program for Registration of any subsurface discharge from any of the UIC Class V well types that are not included in the well-type-specific BRP WS06 forms. See the instructions to this document for well types covered by this form. This form shall also be used to apply for a Modification of an existing UIC Registration. April 2012. BRP WS06d UIC Registration for Pre-Closure of Unauthorized Well Use this form to apply to the UIC Program for Registration for Pre-Closure of any unauthorized UIC Class V well type. This application form shall be submitted to MassDEP at least 30 days prior to the proposed closure activities. April 2012. BRP WS06d Pre-Closure of a Previously Registered UIC Well Use this form to apply to the UIC Program for Pre-Closure of any UIC Class V well for which a MassDEP UIC Registration Number was previously issued. April 2012. Back to Underground Injection Control Forms index Water, Wastewater & Wetlands: Underground Injection Control Forms
Filing with Downloadable Forms: Additional UIC Forms
UIC Class V Well - Completion of Construction Notification Form Use this form to notify MassDEP that the proposed UIC well construction activities have been completed. This notification form should only be submitted after you have received MassDEP approval of your original BRP WS06 UIC Registration application. August 2011. UIC Class V Well Post-Closure Notification Form Use this form to notify MassDEP that the proposed UIC well closure activities have been completed. This notification form should only be submitted after you have received MassDEP approval of your original BRP WS06 UIC Registration application form in which you applied for Pre-Closure or your BRP WS06d Pre-Closure application form. Revised August 2011. Notice of Plumbing Inspector Approval to Seal Floor Drain Revised August 2007. UIC Class V Well Stormwater Non-Exposure Form and Certification Statement This form shall be submitted with your BRP WS06 UIC Registration - Stormwater Discharge Well application form. This form shall also be submitted if any of the information that was entered on the previous submittal of this form has changed. April 2012. UIC Class V Well Motor Vehicle Rinse Water, Snow/Ice Melt or Rain Drip Non-Exposure Form and Certification Statement This form shall be submitted with your BRP WS06 UIC Registration application form if you selected the well type "Motor Vehicle - Rinse Water, Snow/Ice Melt or Rain Drip". This form shall also be submitted if any of the information that was entered on the previous submittal of this form has changed. August 2011. Proposal for Chemical Use in UIC Class V Well This form shall be submitted with your BRP WS06 UIC Registration application form if you proposed the addition of chemicals to the discharge to a UIC well. This form shall also be submitted if any of the information that was entered on the previous submittal of this form has changed. August 2011. |
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