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Forms and Applications:
Utah Underground Injection Control (UIC) Program

Contact UIC Program staff before completing these forms or applications to ensure that the appropriate one is used or required.

General Forms

These forms are applicable to owners / operators of all Class I, III, IV and V injection wells.

    Class I Forms and Applications

    Permit application fees apply to Class I injection wells. Read more

    Class III Forms and Applications

    Permit application fees apply to Class III injection wells. Read more

    Class IV Forms


    Class V Forms and Applications

    Note: Permit fees will be based on $100 per hour of staff time in reviewing permit application and preparing permit.

    Permit application fees apply to Class V Aquifer Storage and Recovery injection wells. Read more

    • Class V Pre-Closure Notification Form

    Class V Inventory Information Forms

    Beginning on July 1, 2012 a UIC inventory review fee of $200 will be required at the time the UIC Inventory Information Form is submitted. Read more

    Owners or operators of all Class V injection wells, existing and new, must submit inventory information according to Section R317-7-6.4(C) of the Utah Administrative Rules for the Underground Injection Control Program. Required information includes: facility name and location; name and address of legal contact; ownership of facility; nature and type of injection wells; and operating status of injection wells. Inventory information must be submitted prior to injection for new wells.

    The Utah UIC Inventory Information Form is designed to assist owners or operators to comply with this requirement and to collect sufficient information regarding proposed injection activity for new wells such that authorization-by-rule status can be assessed.

    Inventory Information Form Name Form and Instructions
    General DOCX | PDF
    Storm Water Drainage Wells | More Info DOCX | PDF
    Subsurface Environmental Remediation Wells DOCX | PDF
    UIC-Regulated Large Underground Wastewater Disposal Systems (LUWDS)— >5000 gpd DOCX | PDF
    Veterinary, Kennel, Pet Grooming Wastewater Disposal Systems DOCX | PDF


    Contact Dusty Earley with questions or comments.