7520-2a Compliance Evaluation

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United States Environmental Protection Agenc y
Office of Ground Water and Drinking Water
Washington, DC 20460

OMB No. 2040-0042

Approval Expires 12/31/2018

I. Name and Address of Reporting Agency

United States Environmental Protection Agency

UIC Federal Reporting System

Part II: Compliance Evaluation
(This information is solicited under the
authority of the Safe Drinking Water Act)
III. State Contact (name, telephone no.)

II. Date Prepared (month, day, year)

IV. Reporting Period (month, year)
From

To

October 1, 20

Class and Type of Injection Wells
II
Item
Total
Wells

A

HC

2D

2R

2H

III

IV

V

Number of Unauthorized
Injection Violations

2. Number of Mechanical Integrity Violations

Summary
of

ER

Number of Wells with Violations
1.

V.

I

SWD

Total
Violations

B

Violations

3. Number of Operation and
Maintenance Violations
4. Number of Plugging
and Abandonment Violations
5. Number of Monitoring and
Reporting Violations
6. Number of Other Violations
(Specify)

Total
Wells

A

Number of Wells with
Enforcement Actions
1. Number of Notices of Violation
2. Number of Consent Agreements

VI.

3. Number of Administrative Orders

Summary
of
Enforcement

Total
Enforcement

B

Actions

4. Number of Civil Referrals
5. Number of Criminal Referrals
6. Number of Well Shut-ins
7. Number of Pipeline Severances
8.

VII.
Summary
of
Compliance

Number of Other Enforcement Actions
(Specify)

Number of Wells
Returned to Compliance

A. This Quarter
B. This Year

VIII.
Number of Cases of Alleged Contamination of a USDW
Contamination
IX.
MIT Resolved

Percent of MIT Violations Resolved in 90 Days

X. Remarks/Ad Hoc Report (Attach additional sheets)
Certification
I certify that the statements I have made on this form and all attachments thereto are true, accurate, and complete. I acknowledge that any
knowingly false or misleading statement may be punishable by fine or imprisonment or both under applicable law.
Signature and Typed or Printed Name and Title of Person Completing Form

EPA Form 7520-2A (12-31-15)

Replaces EPA Form 7520-2 which is obsolete

Date

Telephone No.

Definitions and Instructions

All reporting is cumulative over the fiscal year, and includes activities
from October 1 – September 30. All fields should contain a value. Do
not leave blank fields. Enter 0 if there are no wells affected or no
activities that occurred pertaining to the information requested. Enter
NA if the field or section is not applicable to the submitter (e.g., the
well type is not overseen by the submitter). Enter U if the information
is unknown or not captured; fields designated as U require explanation.
A Class I, II, III, IV, or V injection well with a violation of a permit or
rule requirement is said to be in noncompliance. Note: A well with
certain types of violations may also be in significant noncompliance.
(See Form 7520-2B (reverse) for definitions of SNC violations.)
Section V. Summary of Violations
(Includes all noncompliance; significant and non-significant)
A. Total Wells: For each well class, enter the number of wells with
one or more violations in this federal fiscal year to date. Enter each
well only once. Include all wells with violations, even those with
violations that have been returned to compliance.
B. Total Violations:
Items 1-6: For each well class, enter the number of times each
violation type has been identified this federal fiscal year to date.
Section VI. Summary of Enforcement
A. Total Wells: For each well class, enter the number of wells with
one or more violations that have been addressed by the specific type of
enforcement action in this federal fiscal year to date. Enter each well
only once.
B. Total Enforcement Actions:
Items 1-8: For each well class, enter the number of times wells with
one or more violations have been addressed by the specific type of
enforcement action indicated in the row, in this federal fiscal year to
date. (Count each draft and final Administrative Order.)
Section VII. Number of Wells Returned to Compliance
A “Well Returned to Compliance” is a well that has all underlying
violations resolved and compliance has been verified by the primacy
program. Note: An enforcement action alone (e.g., well shut-in) does
not constitute a “return to compliance;” however, plugging and
abandonment does constitute a return to compliance.
A. For each well class, enter the number of wells returned to
compliance through the second quarter for midyear reporting and
through the fourth quarter for end of the year reporting.
B. For each well class, enter the number of wells returned to
compliance through the second quarter for midyear reporting and
through the fourth quarter for end of the end of year reporting.
Section VIII. USDW Contaminations
For each well class, enter the number of times a well in noncompliance
has allegedly contaminated an underground source of drinking water
(USDW) this federal fiscal year to date.

Section IX. Percent of MIT Violations Resolved in 90 Days
For each well class, enter the percentage of MIT violations resolved
within 90 days as of the end of the reporting period.
• Mechanical Integrity violations are as defined in Section V, under
“Mechanical Integrity.”
• Resolved is defined as returned to compliance (per Section VII).
• MI violations not associated with loss of mechanical integrity
(such as reporting) are not counted under this section.
• Violations occurring WITHIN 90 days of September 30 should be
included in reporting for the following federal fiscal year.
To calculate the percentage:
• Add up the total number of MIT violations that occurred within a
one year period prior to 90 days before the end of the fiscal year
reporting cycle i.e., 6/30.
• Add up the number of these violations that were resolved within 90
days as of 3/31(for midyear reporting) or as of 9/30 (for end of year
reporting).
• Calculate the percentage of total MIT violations that were resolved
in 90 days or less.
Example for Midyear reporting:
• Number of violations that occurred from 7/1 – 3/31 = 8
• Number of these violations resolved within 90 days as of 3/31 = 2
• Percentage of MIT violation resolved within 90 days = 25%
Example for End of Year reporting:
• Number of MIT violations that occurred from 7/1 – 6/30 = 10
o 8 from midyear plus 2 additional (4/1 to 6/30)
• Number of these violations resolved within 90 days as of 9/30 = 5
o 2 (from midyear) + 3 (from 4/1 to 6/30)
• Percentage of MIT resolved within 90 days by 9/30 = 50%
Paperwork Reduction Act
The public reporting and record keeping burden for this collection of
information is estimated to average 6 hours per response. Burden
means the total time, effort, or financial resource expended by persons
to generate, maintain, retain, or disclose or provide information to or
for a Federal Agency. This includes the time needed to review
instructions; develop, acquire, install, and utilize technology and
systems for the purposes of collecting, validating, and verifying
information, processing and maintaining information, and disclosing
and providing information; adjust the existing ways to comply with
any previously applicable instructions and requirements; train
personnel to be able to respond to the collection of information; search data sources; complete and review the collection of information;
and, transmit or otherwise disclose the information. An agency may
not conduct or sponsor, and a person is not required to respond to, a
collection of information unless it displays a currently valid OMB
control number. Send comments on the Agency’s need for this
information, the accuracy of the provided burden estimates, and any
suggested methods for minimizing respondent burden, including the
use of automated collection techniques to Director, Collection
Strategies Division, U.S. Environmental Protection Agency (2822),
1200 Pennsylvania Ave., NW., Washington, D.C. 20460. Include the
OMB control number in any correspondence. Do not send the
completed forms to this address.
EPA Form 7520-2A (11-15-31) Revised