7520-8 Injection Well Monitoring Report

OMB No. 2040-0042

Approval Expires 12/31/2018

United States Environmental Protection Agency
Washington, DC 20460

Injection Well Monitoring Report
Year

Month

Month

Month

Injection Pressure (PSI)
1. Minimum
2. Average
3. Maximum
Injection Rate (Gal/Min)
1. Minimum
2. Average
3. Maximum
Annular Pressure (PSI)
1. Minimum
2. Average
3. Maximum
Injection Volume (Gal)
1. Monthly Total
2. Yearly Cumulative
Temperature (F °)
1. Minimum
2. Average
3. Maximum
pH
1. Minimum
2. Average
3. Maximum
Other

Name and Address of Permittee

Name and Official Title (Please type or print)

EPA Form 7520-8 (Rev. 12-11)

Permit Number

Signature

Date Signed

Paperwork Reduction Act
The public reporting and record keeping burden for this collection of information is estimated to average 25
hours per quarter for operators of Class I hazardous wells, 16 hours per quarter for operators of Class I nonhazardous wells, and 30 hours per quarter for operators of Class III wells.
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 7520-8 Reverse