I.SUBMIT THE FOLLOWING AS A COMPLETE APPLICATION PACKAGE FOR A CLASS-V WELL:
A.Application Fee: Submit the non-refundable application fee for each well per LAC 43:XIX.Chapter 7.
B.Include the following as applicable:
1.One original and two copies of Form UIC-25;
2.Two original Form MD-10-R for each new well to be installed, or Two original Form MD-10-R-A for each existing well to be converted;
3.One original Certified Location Plat showing the location of each Class-V well location;
4.Injected Fluid Analysis:
a.An analysis of the injected fluid must be submitted with the Application. Any laboratory analysis must be a signed original from a Louisiana Department of Environmental Quality certified laboratory. In certain cases, the Material Safety Data Sheet (MSDS) sheet may be acceptable.
b.For wells that are not part of a groundwater remediation project, include a certified statement that the injected fluid is an exempt waste under the Resource Conservation and Recovery Act (RCRA).
5.Geologic map and cross-section of USDW and, if injection is below the USDW, maps and cross-section of the Injection Zone;
6.Surface sketch to scale showing locations of:
a.Water source well(s) or other source,
b.Class-V and any other Injection Wells,
c.General flow (piping) diagram from source to Class-V well; indicate all gauges, water taps, pressure relief and drain valves,
d.Pertinent buildings and/or other permanent landmarks,
e.All surrounding property lines; show names of adjacent property owners,
f.All water wells (including known abandoned wells) and other injection wells on the property and immediately adjacent property.
7.Schematic of the Class-V well showing:
a.Casing diameter, specifications, material (PVC, steel, etc.), and depth,
b.Screen type, length, material, slot or opening size,
c.Injection tubing size inside casing (if any),
d.Hole diameter (bit size),
e.Amount and type of cement used and depths to top and bottom of cement,
f.Wellhead showing all fittings,
g.Discharge line diameter and connection to wellhead,
h.Well house (if any).
II.REQUIREMENTS OF A PERMIT APPLICATION FOR CLASS-V INJECTION WELL:
A.Operating a Class-V well without a permit is a violation of Statewide Order No. 29-N-1 (LAC 43:XVII, Subpart 1) and may subject the well owner to enforcement action including fines as provided by La. R.S. 30. No fines will be imposed on the owner of an existing unpermitted injection well provided the owner submits an application for a permit. However, repairing, stimulating, plugging or performing other work on a Class-V well without a work permit (Form UIC-17) may subject the well owner to a fine.
B.The Class-V well must be constructed according to guidelines established by the Louisiana Department of Transportation and Development (LDOTD) for a similar type water well by a licensed water well contractor.
C.After completing the Class-V well, a permanent, weather-proof sign not less than 1 foot by 2-foot in size must be erected within ten feet of the well, which, at a minimum shows the Well Name and Office of Conservation issued Well Serial Number. If the Class- V well is enclosed within a well house, the sign may be inside the well house, if it is prominently visible upon entering.
After completing the Class-V well, complete and submit the Form UIC-42, Well History and Work Résumé Report.
D.When abandoning, the well must be plugged in accordance with Office of Conservation guidelines in effect at the time of abandonment. Plugging requirements will be those of the LDOTD.
The Injection & Mining Division can be reached by telephone at 225-342-5515 or email Injection-Mining@la.gov. Submit the completed application form with all required attachments to:
Mailing Address |
Street Delivery Address |
Office of Conservation |
Office of Conservation |
Injection & Mining Division |
Injection & Mining Division |
PO Box 94275 |
LaSalle Building |
Baton Rouge, LA 70804-9275 |
617 North Third Street, Suite 817 |
|
Baton Rouge, LA 70802-5428 |
