Underground Injection Control (UIC) Application Forms

For registering, modifying, closing or submitting monitoring reports for a UIC well.

Information Applicable to All UIC Filings

• Notice to UIC Registrants - Revised Regulations

  Changes to the regulations now require that all UIC registrations be filed electronically through eDEP.

• UIC Class V Well Category and 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

  Reference table for UIC permit fees, categorized by well type, property type, and fee amount. Revised June 2014.

Anyone seeking to modify an existing UIC registration, or provide updated information such as change of ownership and/or contact information, should contact the MassDEP UIC registration program to discuss MassDEP’s submittal information requirements. Email [e-mail].

Filing your application online with eDEP

• eDEP Instructions and Online Filing

  Instructions and frequently asked questions about online filing with eDEP.

• eDEP UIC General Guidance

  General guidance for electronic filing of UIC registration applications using eDEP.

• eDEP UIC Forms General Instructions 

  General instructions for filing UIC forms in eDEP.

Forms for Registering a UIC Well

• UIC Well Registration and Modification of an Existing Registration WS 06

  Instructions and forms needed to complete an application to register a UIC well or to modify an existing registration.

• Underground Injection Control Technical Compliance Forms

  A Technical Compliance Form and Certification Statement should be completed and attached to your WS 06 Registration application form. These forms are used by MassDEP and the applicant to determine whether a UIC registration for a proposed discharge may be approved. Technical compliance forms are not required if you are registering an existing UIC well for the purpose of closing the well.

• UIC Well Completion of Construction Notification Form

  Instructions and forms needed to notify MassDEP that construction of the well is complete. Discharges to UIC Class V well(s) cannot begin until this form has been submitted and approval is received.

• Instructions for Completing UIC Registered Well Monitoring Report

  Instructions and forms needed when submitting well monitoring reports (lab analysis) for a UIC well to MassDEP. Prior to submitting this form the applicant must have received approval and a UIC Registration Number for the installation of a UIC Class V well.

• UIC Application for Closed-Loop Ground Source Heat Pump Well

  As of December 2, 2016, the installation and operation of a Class V closed-loop or direct exchange Ground Source Heat Pump (GSHP) well no longer requires the filing of a UIC Registration application with MassDEP, provided that the well has been installed and is operating in accordance with MassDEP’s Guidelines for Ground Source Heat Pump Wells, and provided that the well is not used to produce water. This change is based upon amendments to the MassDEP Ground Water Discharge Permit Program regulations, 314 CMR 5.00, that were promulgated on that date.

Forms for Closing a UIC well

• UIC Well Pre-Closure Application WS 06d

  Instructions and forms needed to complete a Pre-Closure Application for a well that was previously registered by MassDEP

• UIC Well Post-Closure Notification Form

  Instructions and forms needed to complete a Post-Closure Notification. This form must be filed upon closure of a UIC Class V well.

• Notice of Plumbing Inspector Approval to Seal Floor Drain

  A plumbing inspector must approve the sealing of a floor drain, and this notice must be filed with MassDEP and the local Board of Health. Upon completion of all necessary work, the applicant shall then file a completed UIC Well Post-Closure Notification Form.

FAQs: Massachusetts Closure Guidance for UIC Wells (including shallow injection wells)

Frequently asked questions about closing UIC wells.

FAQs: Pre-Closure of a Previously Registered UIC Well

Frequently asked questions about the pre-closure of any UIC Class V well for which a MassDEP UIC Registration Number was previously issued. Revised August 2013.

Additional UIC Forms

• Request for Title 5 Inventory Information

  Example Excel workbook for maintaining your Title 5 Underground Injection Control (UIC) data (for use by local boards of health / health departments).