Primacy states and EPA direct implementation programs can select and download UIC summary reporting forms from the list provided. Completed summary forms should be submitted directly to the EPA national program.
Each file includes instruction for completing the form.
You will need Adobe Reader to view some of the files on this page. See EPA’s About PDF page to learn more.- Part I: Permit Issuance and Review/Wells in Area of Review - EPA Form 7520-1 (PDF)(2 pp, 152 K)
- Part II: Compliance Evaluation - EPA Form 7520-2A (PDF)(2 pp, 306 K)
- Part II: Compliance Evaluation - EPA Form-7520-2B (PDF)(2 pp, 129 K)
- Part III: Inspections Mechanical Integrity Testing - EPA Form 7520-3 (PDF)(2 pp, 189 K)
- Part IV: Quarterly Exceptions List - 7520-4 (PDF)(2 pp, 232 K)