Underground Injection Control (UIC) Application Forms

This page contains the application forms for registering, modifying, closing or submitting monitoring reports for a UIC well

Information Applicable to All UIC Filings

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 ask.UIC@state.ma.us

Filing your application online with eDEP

Additional Resources for Filing your application online with 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. 

  • UIC Registered Well Monitoring Report Form   

    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.

Additional Resources for Forms for Registering a UIC Well

Forms for Closing a UIC well

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

 

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