WELL DATA REPORT FOR INDUSTRIAL AND MUNICIPAL
INJECTION WELLS
Texas Commission on Environmental Quality
Radioactive Materials Division
Underground Injection Control Permits Team, Mail Code 233
P.O. Box 13087
Austin, Texas 78711-3087
Operating company name and address:
Telephone:
Contact person:
I.
General Identification Data
A.
Permit number: WDW
B.
Plant well number:
C.
Geographical coordinates of injection well:
Latitude
deg
Longitude
II.
min
deg
min
D.
Well location (legal description):
E.
County:
F.
Location to nearest town:
sec North
sec West
General Data on Well Site
A.
Generalized description of waste stream injected (attach complete chemical analysis to
this form):
B.
Date well permitted (month/day/year):
C.
Date well put in service (month/day/year):
D.
Maximum permitted injection rate (gallons/minute):
E.
Maximum permitted injection volume (gallons/month or gallons/year):
F.
Average permitted injection rate (gallons/minute):
G.
Average permitted injection volume (gallons/month or gallons/year):
H.
Maximum permitted surface injection pressure (psig):
I.
operating parameters and special provisions not covered above and show calculation of
List other pertinent maximum surface injection pressure:
J.
Total depth of well:
K.
Name and depth of injection zone:
L.
Elevation of well (KB or GL):
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M.
III.
KB-to-ground level:
Geological Information
A. Lithology and Stratigraphy
1.
Geological description of rock units penetrated by well bore:
Name
Age
Depth
Thickness
TDS (avg)
Table 1: Geological Description of Rock Units
2. Description of injection unit (injection zone):
a)
Name(s):
b)
Depth drilled:
c)
Thickness (total/net):
d)
Lithostatic pressure gradient (psig) (Use 1.0 psi/ft unless justified
otherwise.)
e)
Fracture pressure (psig) (State how derived.):
f)
Average porosity and source:
g)
Permeability (md) and source:
h)
Bottom hole temperature:
i)
Lithology:
j)
BHP (original @ datum) (psig):
k)
BHP (present @ datum) (psig):
l)
Datum level KB
, GL
, MSL
*24 Hour shut-in pressure unless notified otherwise.
3. Chemical characteristics of formation fluid. Attach complete chemical analysis if
available:
4. Description of hydrology of fresh water and other potentially beneficial aquifers:
a)
Depth to base of usable quality water (3,000 mg/l TDS):
b)
Depth to base of usable quality water (10,000 mg/l TDS):
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c)
Geologic description of aquifer units:
Table 2: Geologic Description of Aquifer Units
Name
IV.
Age
(optional)
Depth (ft KB)
Thickness (ft)
Lithology
TDS (avg) (If
available)
Waste Characteristics
A. Number of waste streams to form composite injection stream:
B.
Plant products manufactured and process or operation which resulted in waste being
injected:
C.
Physical/chemical description (from complete chemical analysis attachment):
1.
TDS:
2. Specific Gravity:
3. pH:
4. Temperature:
D.
V.
Pre-injection waste treatment description:
Well Design and Construction
A. Casing and tubing
Casing and tubing
Size, weight, grade
Depth-GL
Surface casing
Intermediate casing
Long string casing
Injection tubing
Table 3: Casing and Tubing
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B.
Cement Data
Cement data
Type/class
Additives
Amount
Circulate
Surface Casing
Long string Casing
First stage
Second stage
Third stage
Other
Table 4: Cement Data
DV tool (stage cementing) setting depth (if applicable):
C.
Packer
1.
Type:
2. Name and model number:
3. Setting depth:
4. Type annular fluid used:
VI.
D.
Bottom hole completion:
E.
Well stimulation programs (last 5 years):
Description of surface equipment
A. Brief description of holding tanks and flow lines:
B.
Brief description of pond(s) lining material, monitor system, minimum freeboard, etc.
C.
Filters
1.
Type:
2. Name and model:
3. Capacity:
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D.
Injection pumps
1.
Type:
2. Name and model:
3. Capacity:
VII.
Monitoring Systems
A.
Injection pressure gauges (non-recording):
1.
Location:
2. Name & Model:
B.
Injection pressure recording meters:
1.
Location:
2. Name & Model:
3. Mechanical:
4. Electrical:
C.
Casing-tubing annulus pressure gauges (non-recording):
1.
Location:
2. Name & Model:
D.
Casing-tubing annulus recording meters:
1.
Location:
2. Name & Model:
3. Mechanical:
4. Electrical:
E.
Injection rate meters (non-recording):
1.
Location:
2. Name & Model:
3. Mechanical:
4. Electrical:
F.
Injection rate meters (continuous recording):
1.
Location:
2. Name & Model:
3. Mechanical:
4. Electrical:
G.
pH recording devices:
1.
Location:
2. Name & Model:
3. Mechanical:
4. Electrical:
H.
Temperature:
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Revised April 1, 2012
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5.
Location:
6. Name & Model:
7.
Mechanical:
8. Electrical:
VIII.
I.
Sampling procedure frequency and water quality parameter measured:
J.
Frequency of measuring reservoir pressure:
K.
Contingency plan for well failure during operation:
Logging Program (Open Hole) – Originals
Surface TD
Long String/Open Hole TD
Table 5: Logging Program
IX.
Well Malfunctions
Chronological listing of all major workovers and well malfunctions and brief description of
reasons for the well failure over the past five years:
X.
Diagrammatic sketch of injection well showing casing, cement, tubing, packer, etc., with proper
setting depths. Sketch should include wellhead and gauges. An 8 2 X 11 inch sketch is preferred.
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XI.
Re-permitting Only
A.
Maps
1.
Number of wells within 2 2 miles within 300 feet of the uppermost permitted
injection interval, and all wells within a 2-mile radius of the injection well:
Date reviewed
a)
Number of above wells that are plugged and abandoned:
b)
Number of wells inadequately plugged and abandoned or on which
records are incomplete. (Include available records):
c)
Number of above wells that are still producing:
2. Number of water wells within 2 2 miles:
B.
Plugging and abandonment plans:
C.
Pressure simulation covering a period from beginning of operation through the next ten
(10) years:
D.
New artificial penetrations
1.
Provide a tabulation of data on all penetrations required under XI.A.1. above of
operator; lease or owner; distance from injection well; well number; casing size;
setting depth and cementing data for surface, intermediate and long string casings;
and plugging data for the abandoned wells. In addition to this information, copies
of available casing and cementing records for those wells shown on the map in item
XI.A.1. which penetrate to within 300 feet of the uppermost permitted injection
interval and all wells within a 2-mile radius of the injection well shall be submitted
with appropriate Railroad Commission cementing affidavits. Tabulation shall be
keyed to map in XI.A.1. above.
2. Provide a schematic sketch of all penetrations requested under XI.D. above on Form
TDWR-0023A (attached).
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