Page 1 Screener ID: 

DUE DATE: within 30 days of 

receipt 

YOUR RESPONSE IS REQUIRED 

BY LAW. Title 33, United States 

Code, requires businesses and other 

organizations that receive this 

questionnaire to answer the questions 

and return the report to the U.S. 

Environmental Protection Agency.

By the same law, you may claim 

confidentiality. See Instruction Guide 

for further information.

2008 COALBED METHANE 

INDUSTRY SCREENER

INSTRUCTIONS: 

• Please refer to the accompanying Instruction Guide for help in answering specific questions. Frequently 

asked questions regarding the screener can be found at http://www.epa.gov/guide/cbm

• More information is available from EPA’s contractor by electronic mail at cbmscreener@pgenv.com or by 

telephone at 1-800-764-4414

• If you would like an electronic version of the screener questionnaire, it is available on the EPA Website at 

http://www.epa.gov/guide/cbm

Item A ESTABLISHMENT NAME

Is the establishment name shown above in the mailing address correct? 

□ Yes

□ No – Enter establishment name

Item B CONTACT INFORMATION

If we have any questions about your response, who may we contact? 

Name: _____________________________________________________ 

Street Address: ______________________________________________ 

City, State, Zip Code: _________________________________________ 

Phone: __________________________ 

e-Mail: __________________________ 

OMB 2040-0279

(Expires February 29, 

2012) 
Page 2 Screener ID: 

Item C OPERATING STATUS IN 2008

At any time in 2008, did your establishment own or operate any coalbed methane wells? 

□ Yes → Go to Item D

□ No → Check the box, and return the survey to the address in the Instruction 

Guide.

Item D BUSINESS SIZE AND FINANCIAL DATA AVAILABILITY

1. In 2008, was your highest level of corporate ownership a small business? (See common 

size standards below or contact the telephone helpline at 1-800-764-4414 or e-mail 

cbmscreener@pgenv.com for additional assistance.) 

□ Yes 

□ No

NAICS Name of Industry Small Business Administration 

(SBA) Size Standard

211xxx Oil and Gas Extraction <500 employees

21211x Coal Mining <500 employees

213111 Drilling Oil and Gas Wells <500 employees

213112 Support Activities for Oil and Gas Operations <$6.5 million annual revenues

213113 Support Activities for Coal Mining <$6.5 million annual revenues

22111x Electric Power Generation <4 million megawatt-hours/year

221112 Fossil Fuels Electric Power Generation <4 million megawatt-hours/year

22112x Electric Power, Transmission, Control and 

Distribution

<4 million megawatt-hours/year

22121x Natural Gas Distribution <500 employees

32411x Petroleum Refineries <1,500 employees

486110 Pipeline Transportation of Crude Oil <1,500 employees

486210 Pipeline Transportation of Natural Gas <$6.5 million annual revenues

2. When will your financial data for fiscal year 2008 be available? 

(EPA will accept either audited or unaudited financial data.)

 Month: , 2009 

 

Item E NUMBER OF CBM PROJECTS

A project in this survey is defined as a well, group of wells, lease, group of leases, or some other 

recognized unit that your establishment operates as an economic unit when making production 

decisions. 

In 2008, how many CBM projects did your establishment own or operate? 

 Projects
Page 3 Screener ID: 

Item F CBM PROJECT INFORMATION

For each CBM project that you owned and/or operated in 2008, provide the following 

information. 

Note: Additional copies of this page are available at www.epa.gov/guide/cbm. If you have many projects, 

you may prefer to report this information in a tabular format. A spreadsheet version of this page is 

available at www.epa.gov/guide/cbm and may be used instead of providing one page per project. 

1. What is the name or identifier that you use for this project? → 

(If none exists, then assign identifiers A, B, C, etc.) 

2. Where is this project located:

Basin (e.g., Powder River): 

State (2-letter abbreviation): 

3. Did you buy or sell this project during 2008?

□ Yes → What month?

□ No 

4. What was the maximum number of CBM wells producing gas and/or water during 2008? 

Number:

5. What was the combined gas production from these wells to date in 2008? 

6. In 2008, how did you manage your produced water? Check all that apply.

□ Discharge to surface water (e.g., lake, river, stream, creek) 

□ Discharge to publicly owned treatment works 

□ Land application (with or without crop production) 

□ Underground injection

□ Evaporation or infiltration pond 

□ Livestock or wildlife watering

□ Trucked or transported off site to a third party 

□ No water produced by the project 

⁫ Thousands of Cubic Feet (Mcf)

⁫ Other – Enter other reporting units → ____________________
Page 4 Screener ID: 

7. In order to avoid asking you for detailed information about all of your projects, EPA intends 

to statistically select a limited number of projects to receive a Detailed Questionnaire. If this 

project is selected to receive a Detailed Questionnaire, where should we send the Detailed

Questionnaire? 

□ To the same contact person identified in Item B.

□ To the same contact person identified in the previous project. 

□ To the following contact person: 

Name: _____________________________________________________ 

Employer (for example, name of your establishment or consulting firm): 

______________________________________________________ 

Street Address: _______________________________________________ 

City, State, Zip Code: __________________________________________ 

Phone: __________________________ 

e-Mail: __________________________ 

REMARKS: Please use this space to clarify your responses, if appropriate. Please crossreference your remarks by identifying the survey section (and/or project) that you are referring to 

in your remarks. 

Please keep a copy and return the original to:

U.S. Environmental Protection Agency 

CBM Industry Screener 

c/o PG Environmental, LLC 

570 Herndon Parkway 

Suite 500 

Herndon, VA 20170 

THANK YOU.