North Dakota Industrial Commission

Department of Mineral Resources

Oil and Gas Division

UIC

Class VI

Underground Injection Control

Program Description
TABLE OF CONTENTS

I. INTRODUCTION..................................................................................................................1

II. OVERVIEW OF THE STATE UIC PROGRAM..................................................................2

III. AGENCY ORGANIZATION AND STRUCTURE..............................................................4

A. General Responsibilities...............................................................................................4

B. Specific Responsibilities...............................................................................................5

IV. STATE UIC PERMITTING PROCESS................................................................................7

A. Class VI Injection Wells...............................................................................................7

1. Required Information for Storage Facility Permit ..............................................7

2. Public Participation and Technical Evaluation ...................................................9

3. Required Information for a Permit to Drill .........................................................9

4. Permit to Operate a Class VI Injection Well.....................................................10

5. Mechanical Integrity .........................................................................................11

6. Plugging and Abandonment..............................................................................11

7. Post-Injection Site Care and Facility Closure ...................................................11

8. Certificate of Project Completion .....................................................................12

9. Issuance of Certificate of Project Completion ..................................................12

10. Monitoring and Managing the Storage Facility ................................................13

11. Facility Closure .................................................................................................13

V. STATE COMPLIANCE MONITORING PROGRAM.......................................................14

A. Plan Review................................................................................................................14

B. Site Inspections...........................................................................................................14

C. Complaints..................................................................................................................15

D. Monitoring Program ...................................................................................................15

E. Annual Inspections .....................................................................................................16

F. Compliance Inspections..............................................................................................16

VI. NORTH DAKOTA ENFORCEMENT PROCEDURES.....................................................17

VII. REPORTS ............................................................................................................................18

VIII. FORMS ................................................................................................................................18

List of Figures

Figure 1. North Dakota Oil and Gas Division Organizational Charts .........................................6
NDIC Class VI UIC Program Description – June 2013 Page 1

NORTH DAKOTA

CLASS VI

UNDERGROUND INJECTION CONTROL

PROGRAM (1422) DESCRIPTION

North Dakota Industrial Commission

Department of Mineral Resources

Oil and Gas Division

I. INTRODUCTION

As mandated by the Safe Drinking Water Act of 1974 (as amended), the United States Environmental 

Protection Agency (EPA) has promulgated regulations establishing minimum requirements, technical 

criteria, and standards for State Underground Injection Control (UIC) programs to protect underground 

sources of drinking water (USDW). Under these regulations, the State of North Dakota received program 

implementation primacy in 1984, and has since operated in an EPA-approved UIC program.

On December 10, 2010 EPA finalized minimum federal requirements under the Safe Drinking Water Act 

(SDWA) for underground injection of Carbon Dioxide (CO2) establishing a new class of injection wells, 

Class VI. The Class VI rule is based on UIC regulatory framework, with modifications to address the 

unique nature of CO2 injection. The purpose for the Class VI rule is to ensure that geologic storage of 

CO2 is conducted in a manner that protects USDWs.

In order to gain primacy enforcement responsibility for Class VI injection wells, North Dakota will

demonstrate to the EPA that its UIC program is at least as stringent as the federal standards. As a result 

of meeting the federal stringency standard North Dakota Administrative Code (NDAC) Chapter 43-05-01 

has been amended and the North Dakota 1422 UIC program has been revised to include Class VI 

injection wells. 

This revised program description incorporates changes as required in federal regulations, but does not 

change the lead agency program administration status, nor the original intent of the UIC program.

Jurisdiction of Class VI injection wells will be administered by the North Dakota Industrial Commission, 

Department of Mineral Resources, Oil and Gas Division (Commission). This revision of the North 

Dakota 1422 UIC program is for the sole purpose of adding Class VI injection wells to the North Dakota 

1422 UIC program.
NDIC Class VI UIC Program Description – June 2013 Page 2

II. OVERVIEW OF THE STATE UIC PROGRAM

The UIC program is an important part of the overall State groundwater protection strategy. With 

increasing groundwater demands and the impacts of energy development on groundwater, the control of 

subsurface injection is vital to maintaining the quality of the State’s groundwater resources and to protect 

USDWs.

It is anticipated that during the first two years of the North Dakota Class VI UIC program, one permit 

application will be submitted to the Commission. The success of any proposed geological storage project 

in North Dakota will be based on the protection of USDWs, meeting all permitting requirements, and 

complying with all applicable State statutes and administrative rules. Permit applications and interest in 

underground storage of CO2 is expected to increase as a result of broadened regulatory authority, 

increased energy production, potential use of CO2 as a commodity, and a response to more stringent 

regulations governing CO2 emissions to the atmosphere which would make underground injection a 

viable option to the reduction of anthropogenic related CO2 emissions.

There are no Class I wells previously permitted for the purpose of geologic storage, no Class V 

experimental technology wells being used for experimental purposes that will continue injection of CO2

for the purpose of geologic storage, nor any Class VI wells previously permitted by EPA.

The lead agency of the North Dakota 1422 UIC program is the Department of Health. As the lead agency 

the Department of Health receives the annual program grant and coordinates the State 1422 UIC program, 

as designated by the Governor of the State. The Department of Health has authority over all Class I and 

V injection well activities. The North Dakota Geological Survey has authority over all Class III injection 

well activities. The Commission administers the 1425 UIC program regulating Class II injection well 

activities and receives a separate program grant from the EPA to administer the 1425 UIC program. The 

Commission has statutory authority to regulate Class VI injection well activities under North Dakota 

Century Code (NDCC) Chapter 38-22 and NDAC Chapter 43-05-01. Each State agency is responsible 

for administering the State program for the injection wells under its jurisdiction including, but not limited 

to, reports, permits, monitoring, compliance, and enforcement actions. 

The primary focus of the UIC program, promulgated under the authority of the SDWA is to protect 

USDWs. Under federal definition USDW means an aquifer or any portion of an aquifer that supplies any 

public water system or contains a sufficient quantity of ground water to supply a public water system and

currently supplies drinking water for human consumption or contains fewer than ten thousand milligrams 

per liter total dissolved solids and is not an exempted aquifer.

As described in State regulations, any underground water being used for drinking or domestic water or 

any underground water less than ten thousand milligrams per liter of total dissolved solids which has not 

been exempted, is a source of drinking water and is protected as such. However, after notice and 

opportunity for public hearing, the Commission may designate, identify, and describe in geographic or 

geometric terms, or both, which are clear and definite exempted aquifers or parts thereof using the 

following criteria:

1. It does not currently serve as a source of drinking water; and
NDIC Class VI UIC Program Description – June 2013 Page 3

2. The total dissolved solids content of the ground water is more than three thousand and 

less than ten thousand milligrams per liter; and 

3. It is not reasonably expected to supply a public water system. 

Other than EPA approved aquifer exemption expansions that meet the criteria for exempted aquifers, new 

aquifer exemptions will not be issued for Class VI injection well activities. Even if an aquifer has not 

been specifically identified by the Commission, it is an underground source of drinking water if it meets 

the definition above.

The North Dakota Class VI program requires all owners or operators applying to inject CO2 for the 

purpose of geologic storage to obtain a storage facility permit, a permit to drill (deepen, convert, or 

reenter), and a permit to operate prior to commencement of injection activities. Permit applications will 

be reviewed by the Commission and issued in accordance with NDCC Chapter 38-22 and NDAC Chapter

43-05-01. As a permitting requirement all Class VI injection wells will demonstrate and maintain 

mechanical integrity. The storage facility permit application requirements include, but are not limited to, a 

technical evaluation, an area of review and corrective action plan, a demonstration of financial 

responsibility, an emergency and remedial response plan, a proposed casing and cementing program, a

testing and monitoring plan, a plugging plan, and a post-injection site care and facility closure plan. The 

Commission will consult with the State Department of Health before issuing a storage facility permit. 

Any phase of the geologic storage project may be inspected for compliance by the Commission’s 

authorized agents. Injection activities may not commence until construction of the injection well is 

complete, a permit to operate has been obtained, and the storage facility is in full compliance.

Compliance monitoring will be conducted by the Commission. This monitoring will at a minimum 

include, on-site inspections conducted by the Commission’s authorized agents and a review of operating 

and monitoring reports submitted in compliance with reporting requirements pursuant to NDAC Section 

43-05-01-18.

If it is determined that the storage operator is in violation of any permit condition, appropriate 

enforcement action will be pursued by the Commission.

When a well is taken out of service it will be properly plugged and abandoned pursuant to NDAC Section 

43-05-01-11.5, approved by the Commission as a monitoring well, or approved by the Commission for 

temporary abandonment. 

North Dakota citizens are encouraged to actively participate in program development and the storage 

facility permit process through public comment and hearings.

The Commission will give written notification to any States, Tribes, and Territories of any permit 

applications for geologic storage of CO2 wherein the area of review crosses State jurisdiction boundaries, 

resulting in the need for trans-boundary coordination related to an injection operation.
NDIC Class VI UIC Program Description – June 2013 Page 4

III. AGENCY ORGANIZATION AND STRUCTURE

A. General Responsibilities

The Commission has the statutory authority to regulate Class VI injection well activities under NDCC

Chapter 38-22 and NDAC Chapter 43-05-01.

The Commission has the following responsibilities specific to their associated statutory authority:

1. Administer the rules and regulations as they pertain to subsurface injections.

2. Perform technical evaluations of injection well applications and prepare draft permits.

3. Issue, deny, amend, or cancel permits.

4. Witness, at the discretion of the permitting agency, any aspect of construction, testing, operation, 

and closure of injection well activities.

5. Perform on-site certification of permit requirements.

6. Review operation reports for permit or rule compliance.

7. Provide recommendations of compliance strategies and corrective action when violations occur.

8. Maintain a database of injection well information including quantity and quality of injected 

material, well construction, local geology, and the pertinent water resources that could be 

impacted.

9. Conduct public hearings or enforcement proceedings as required.

10. Respond to public inquiries and complaints regarding proposed or operating injection facilities.

11. Ensure that the regulated community and the public at large are informed about underground 

injection activities.

12. Initiate and pursue appropriate enforcement action when the permit or rule requirements are 

violated.

13. Maintain permit files including information on the geology and hydrology (e.g., depth, name, and 

quality of USDWs) in the vicinity of the injection wells along with other data submitted with the 

application.
NDIC Class VI UIC Program Description – June 2013 Page 5

B. Specific Responsibilities

North Dakota Industrial Commission, Department of Mineral Resources, Oil and Gas Division

The North Dakota Oil and Gas Division has jurisdiction over the conservation of oil and gas in the State. 

In addition to these responsibilities and upon EPA approval the Oil and Gas Division will administer all 

regulatory authority for Class VI injection well activities. The Oil and Gas Division is responsible for the 

following tasks and statutory obligations:

a. The administration of State statutes and administrative rules regulating the drilling and 

production of oil and gas in North Dakota. 

b. Administration of Class II UIC Program.

c. Administration of Class VI UIC Program.

The objectives of the Oil and Gas Division are to encourage and promote the development, production,

and utilization of oil and gas in the State in such a manner as will prevent waste, maximize economic 

recovery, and fully protect the correlative rights of all owners to the end that the landowners, the royalty 

owners, the producers, and the general public realize the greatest possible good from these vital natural 

resources. 

The North Dakota Class VI UIC program will be administered by the Carbon Capture and Storage (CCS) 

Supervisor. The CCS Supervisor will be a geologist or petroleum engineer able to perform all tasks 

associated with the administration of the program including, but not limited to permit evaluation, 

technical evaluation, onsite inspection, and compliance monitoring. The CCS Supervisor will be trained

in computer modeling and able to verify the accuracy of all required computer generated models.

The implementation of the North Dakota Class VI UIC program is funded through the CO2 storage 

facility administrative fund. In 2011 the Sixty-second Legislative Assembly of North Dakota

appropriated $532,000 from the State general fund to the Commission for deposit in its CO2 storage 

facility administrative fund for the purpose of hiring one full-time equivalent position for up to three years 

until fee income is sufficient to provide funding for the administration of the provisions of NDCC 

Chapter 38-22. A fee on each ton of CO2 injected for storage will be paid to the Commission and 

deposited in the CO2 storage facility administrative fund. The fee amount is set by Commission rule and 

based on the Commission’s anticipated expenses that it will incur in regulating the storage of CO2.

The estimated costs for the first two years of implementing the North Dakota Class VI UIC program will 

be approximately $200,000. These costs include the CCS Supervisors current salary, the computer 

reservoir modeling software license, the computer to run the computer modeling simulations, computer

reservoir modeling software training, the development of the risk based data management system 

(RBDMS) for CO2 storage, and all other indirect costs associated with the administration of the program.
NDIC Class VI UIC Program Description – June 2013 Page 6

North Dakota Industrial Commission, Department of Mineral Resources, Oil and Gas Division

June 2013

Figure 1. North Dakota Department of Mineral Resources, Oil and Gas Division Organizational Chart

North Dakota 

Industrial 

Commission

Department of Mineral 

Resources 

Director

Geological Survey

State Geologist

Oil and Gas Division

Assistant Director

 

Executive 

Staff Officer

RBDMS 

Manager

UIC 

Manager

Field 

Supervisor

Permitting 

and 

plugging 

Manager

Petroleum 

Engineer

Carbon 

Capture & 

Storage 

Supervisor

Geological 

Analyst

UIC 

Supervisor

Meter 

Specialist

Seismic Field 

Representative

District 

Supervisor

District 

Supervisor

District 

Supervisor

Reclamation 

Specialist

Field 

Inspectors 

Field 

Inspectors

Field 

Inspectors
NDIC Class VI UIC Program Description – June 2013 Page 7

IV. STATE UIC PERMITTING PROCESS

The Commission is responsible for the technical evaluation of CO2 injection well permit applications and 

drafting of permit provisions for Class VI wells. Before issuing a storage facility permit, the Commission 

will consult the North Dakota Department of Health. 

A. Class VI Injection Wells

Permit Requirements:

North Dakota Class VI injection wells may be used to inject CO2 into or withdraw CO2 from a storage

reservoir.

Each applicant will provide information outlined in NDAC Chapter 43-05-01 (Geologic Storage of CO2) 

and the permit application.

1. Required Information for Storage Facility Permit

At minimum, the Commission will evaluate the following information before issuing a draft 

permit:

a. A site map showing the boundaries of the storage reservoir and the location of all 

proposed wells, proposed cathodic protection boreholes, and surface facilities within 

the CO2 storage facility area; 

b. A technical evaluation of the proposed storage facility, including the following: 

(1) The name, description, and average depth of the storage reservoirs;

(2) A geologic and hydrogeologic evaluation of the facility area, including an 

evaluation of all existing information on all geologic strata overlying the storage 

reservoir, the immediate caprock containment characteristics and all subsurface 

zones to be used for monitoring; 

(3) A review of the data of public record, conducted by a geologist or engineer, for 

all wells within the facility area, which penetrate the storage reservoir or 

primary or secondary seals overlying the reservoir, and all wells within the 

facility area and within one mile [1.61 kilometers], or any other distance as 

deemed necessary by the Commission, of the facility area boundary;

(4) The proposed calculated average and maximum daily injection rates, daily 

volume, and the total anticipated volume of the CO2 stream using a method 

acceptable to and filed with the Commission; 

(5) The proposed average and maximum bottom hole injection pressure to be 

utilized at the reservoir. The maximum allowed injection pressure, measured in 

pounds per square inch gauge, will be approved by the Commission and 

specified in the permit;
NDIC Class VI UIC Program Description – June 2013 Page 8

(6) The proposed pre-operational formation testing program to evaluate the 

chemical and physical characteristics of the injection zone and confining zone 

pursuant to NDAC Section 43-05-01-11.2;

(7) The proposed stimulation program, a description of stimulation fluids to be used 

and a determination that stimulation will not interfere with containment; and

(8) The proposed procedure to outline steps necessary to conduct injection 

operations.

c. The extent of the pore space that will be occupied by CO2 as determined by utilizing 

all appropriate geologic and reservoir engineering information and reservoir 

analysis, which will include various computational models for reservoir 

characterization, and the projected response of the CO2 plume and storage capacity 

of the storage reservoir. The computational model will be based on detailed 

geologic data collected to characterize the injection zones, confining zones, and any 

additional zones; 

d. An emergency and remedial response plan pursuant to NDAC Section 43-05-01-13; 

e. A detailed worker safety plan that addresses CO2 safety training and safe working 

procedures at the storage facility pursuant to NDAC Section 43-05-01-13;

f. A corrosion monitoring and prevention plan for all wells and surface facilities 

pursuant to NDAC Section 43-05-01-15;

g. A leak detection and monitoring plan for all wells and surface facilities pursuant to 

NDAC Section 43-05-01-14. The plan will:

(1) Identify the potential for release to the atmosphere; 

(2) Identify potential degradation of ground water resources with particular 

emphasis on USDWs; and

(3) Identify potential migration of CO2 into any mineral zone in the facility area.

h. A leak detection and monitoring plan utilizing subsurface observation wells to 

monitor any movement of the CO2 outside of the storage reservoir. This may 

include the collection of baseline information of CO2 background concentrations in 

ground water, surface soils, and chemical composition of in situ waters within the 

facility area and the storage reservoir and within one mile [1.61 kilometers] of the 

facility area outside boundary. Provisions in the plan will be dictated by the site 

characteristics as documented by materials submitted in support of the permit 

application but will:

(1) Identify the potential for release to the atmosphere; 
NDIC Class VI UIC Program Description – June 2013 Page 9

(2) Identify potential degradation of ground water resources with particular 

emphasis on USDWs; and

(3) Identify potential migration of CO2 into any mineral zone in the facility area.

i. The proposed well casing and cementing program detailing compliance with NDAC 

Section 43-05-01-09;

j. An area of review and corrective action plan that meets the requirements pursuant to 

NDAC Section 43-05-01-05.1;

k. The storage operator will comply with the financial responsibility requirements 

pursuant to NDAC Section 43-05-01-09.1; 

l. A testing and monitoring plan pursuant to NDAC Section 43-05-01-11.4;

m. A plugging plan that meets requirements pursuant to NDAC Section 43-05-01-11.5;

n. A post-injection site care and facility closure plan pursuant to NDAC Section 

43-05-01-19; and

o. Any other information that the Commission requires. 

2. Public Participation and Technical Evaluation

During the technical evaluation of a storage facility permit application, staff may require 

additional information to assist in determining if a draft permit should be prepared. Upon 

completion of the evaluation the Commission will tentatively decide whether to prepare a draft 

permit or to deny the application. Before a draft permit is prepared, the Commission will consult 

the North Dakota Department of Health. If the Commission decides to prepare a draft permit, a 

public notice will be issued. The public notice of comment period and hearing will follow 

procedures as outlined in NDAC Chapter 43-05-01.

During the public comment period, any interested person may submit written comments on the 

draft permit or the storage facility permit application. All comments will be considered in 

making the final decision and will be addressed when a storage facility permit is issued.

The Commission will hold a public hearing on the storage facility permit application and draft 

permit. Notice of the public hearing will be published in a newspaper of general circulation in 

Bismarck, North Dakota, and in a newspaper of general circulation in the county where the land 

affected or some part thereof is situated at least 30 days prior to the hearing. The public notice 

will include information about the length of the comment period, contact person, and the address 

and phone number of the Commission, so interested parties can request copies of the storage 

facility permit application and the draft permit. After completion of the hearing and comment 

period a final decision will be rendered in the form of an Industrial Commission order. The 

Commission will issue a response to all formal comments received during the hearing process.

3. Required Information for a Permit to Drill
NDIC Class VI UIC Program Description – June 2013 Page 10

Following receipt of a storage facility permit, the storage operator will obtain a permit to drill, 

deepen, convert, operate, or, upon demonstration of mechanical integrity, reenter a previously 

plugged and abandoned well for storage purposes.

Application for permit to drill, deepen, convert, operate, or reenter a well will include at a 

minimum:

a. A plat certified by a registered surveyor showing the location of the proposed 

injection well;

b. The drilling, completion, or conversion procedures;

c. A well bore schematic;

d. A geophysical log through the storage reservoir; and

e. The proposed pad layout.

4. Permit to Operate a Class VI Injection Well

Within 30 days after the conclusion of well drilling and completion activities, a permit 

application will be submitted to operate an injection well and will include at a minimum:

a. A schematic diagram of the surface injection system and its appurtenances;

b. A final well bore diagram;

c. The well’s complete dual induction log or equivalent log through the storage 

reservoir;

d. An affidavit specifying the chemical constituents of the CO2 stream other than CO2

and their relative proportions and the source of the CO2 stream;

e. A cement bond log showing that the long string casing is cemented adequately so 

the CO2 is confined to the storage reservoir;

f. The results of the mechanical integrity test;

g. The final area of review;

h. Information on the compatibility of the CO2 stream with the fluids in the injection 

zone;

i. The results of the formation testing program;

j. The status of the corrective action on wells in the area of review;

k. All available logging and testing program data on the well; and

l. Any updates to the proposed plans required in the storage facility permit.
NDIC Class VI UIC Program Description – June 2013 Page 11

5. Mechanical Integrity

A Class VI injection well has mechanical integrity if there is no significant leak in the casing, 

tubing, or packer; and there is no significant fluid movement into an USDW through channels 

adjacent to the well bore. To evaluate the absence of significant leaks the storage operator will, 

following an initial annulus pressure test, continuously monitor injection pressure, rate, injected 

volumes, pressure on the annulus between tubing and long-string casing, and annulus fluid 

volume.

At least annually, the storage operator will use an approved tracer survey or a temperature or 

noise log to determine the absence of significant fluid movement.

To evaluate mechanical integrity, the storage operator will apply methods and standards generally 

accepted in the industry. When the storage operator reports the results of mechanical integrity 

tests to the Commission, the storage operator will include a description of the test and the method 

used. In order to properly evaluate mechanical integrity the Commission will review monitoring 

and other test data submitted since the previous evaluation.

The Commission may require additional or alternative tests if the results presented by the storage 

operator are not satisfactory to the Commission to demonstrate mechanical integrity.

6. Plugging and Abandonment

Prior to granting approval for well plugging, the storage operator is required to perform a final 

external mechanical integrity test. The storage operator will comply with the Commission 

approved plugging plan, required as part of the storage facility permit. The plugging plan will

include the following:

a. Appropriate tests or measures for determining bottomhole reservoir pressure;

b. Appropriate testing methods to ensure external mechanical integrity;

c. The type and number of plugs to be used;

d. The placement of each plug, including the elevation of the top and bottom of each 

plug;

e. The type, grade, and quantity of material to be used in plugging. The material will

be compatible with the CO2 stream; and

f. The method of placement of the plugs.

7. Post-Injection Site Care and Facility Closure

Upon permanent cessation of CO2 injection all wells not associated with the post-injection 

monitoring will be plugged and abandoned, all equipment associated with the storage facility will 

be removed from the site, and the surface will be reclaimed to the Commission’s specifications 

returning the land to as closely as practicable to original condition.

The storage operator will continue to conduct monitoring as specified by the post-injection site 

care and facility closure plan. The plan will include the pressure differential between preinjection and predicted post-injection pressures, the predicted position of the CO2 plume and 

associated pressure front at cessation, a description of the post-injection monitoring, a schedule 
NDIC Class VI UIC Program Description – June 2013 Page 12

for submitting post-injection monitoring results, and the duration of the post-injection monitoring 

timeframe.

The storage operator may apply for project completion once the final assessment is complete, 

USDWs are no longer endangered, and upon full compliance with all Certificate of Project 

Completion requirements. 

8. Certificate of Project Completion

a. After CO2 injections into a reservoir cease and upon application by the storage 

operator, the Commission will consider issuing a certificate of project completion.

b. The certificate may only be issued after public notice and hearing. The Commission 

will establish notice requirements for this hearing.

c. The certificate may only be issued after the Commission has consulted with the 

State Department of Health.

d. The certificate may not be issued until at least ten years after CO2 injections end.

e. The certificate may only be issued if the storage operator:

(1) Is in full compliance with all laws governing the storage facility.

(2) Shows that it has addressed all pending claims regarding the storage facility's

operation.

(3) Shows that the storage reservoir is reasonably expected to retain the CO2 stored 

in it.

(4) Shows that the CO2 in the storage reservoir has become stable. Stored CO2 is 

stable if it is essentially stationary or, if it is migrating or may migrate, that any 

migration will be unlikely to cross the storage reservoir boundary.

(5) Shows that all wells, equipment, and facilities to be used in the postclosure 

period are in good condition and retain mechanical integrity.

(6) Shows that it has plugged wells, removed equipment and facilities, and 

completed reclamation work as required by the Commission.

9. Issuance of Certificate of Project Completion:

a. Title to the storage facility and to the stored CO2 transfers, without payment of any 

compensation, to the State.

b. Title acquired by the State includes all rights and interests in, and all responsibilities 

associated with, the stored CO2.

c. The storage operator and all persons who generated any injected CO2 are released 

from all regulatory requirements associated with the storage facility.

d. Any bonds posted by the storage operator will be released.
NDIC Class VI UIC Program Description – June 2013 Page 13

e. Monitoring and managing the storage facility is the State's responsibility to be

overseen by the Commission until such time as the federal government assumes 

responsibility for the long-term monitoring and management of storage facilities.

10. Monitoring and Managing the Storage Facility:

a. Upon issuance of project completion the Commission is responsible for the longterm monitoring and managing of the storage facility.

b. The State is responsible for the continued long-term monitoring of the site overseen 

by the Commission until the federal government assumes responsibility.

11. Facility Closure:

a. The State is responsible for the plugging and abandonment of all remaining 

monitoring wells. It is the Commission’s obligation to assure that these monitoring 

wells will be plugged in a manner which will not allow for movement of injection or 

formation fluids that endanger USDW.
NDIC Class VI UIC Program Description – June 2013 Page 14

V. STATE COMPLIANCE MONITORING PROGRAM

A. Plan Review

The Commission will verify that the storage facility construction, completion, operation, 

maintenance, and closure procedures are performed according to approved plans and 

specifications, and meet all permit or regulatory requirements.

Verification of Class VI injection well activities is accomplished by reviewing appropriate plans 

and reports, performing on-site inspections, responding to complaints, and, where necessary, 

referring noncompliance to legal counsel for appropriate enforcement action.

Review of plans and reports may include but are not restricted to:

1. Revisions to construction plans filed after permit issuance.

2. Well completion reports including results of required logging and other testing.

3. Results of injectivity and pump tests, mechanical integrity tests, and any other required 

tests.

4. Bottomhole pressure reports and updated evaluations of the effects of injection on the 

injection zone, including fluid volume, injection rate, and injection pressure data.

5. Work over plans and work over reports describing construction or maintenance.

6. Revisions to plugging plan and reports of completion of plugging, and other site closure 

activities.

7. Any other plans or test results connected with the proper construction, operation, and 

maintenance of the well and associated surface facilities.

B. Site Inspections

Site inspections to verify or witness construction, operation, and maintenance procedures may be 

conducted as necessary when certain construction operations begin, or in response to a complaint 

or other indication that a problem may exist. Construction elements and testing that may be 

witnessed by the Commission and it authorized agents, include:

1. Well pad and site construction

2. All drilling operations

3. Setting and cementing surface casing.

4. Cementing long string casing.

5. Well logging and coring operations.

6. Pressure testing of tubing and casing.

7. Formation pressure tests, injectivity tests, or pump tests.

8. Installation and maintenance of instrumentation.
NDIC Class VI UIC Program Description – June 2013 Page 15

9. Work required by any corrective action plan.

10. Well workovers.

11. Placement of monitoring wells or other equipment.

12. Any plugging procedures.

13. Mechanical Integrity testing.

In addition, geologic storage facilities may be inspected at any time by the Commission and its 

authorized agents. 

C. Complaints

Complaints alleging improper construction, completion, operation, or maintenance at a storage 

facility will be investigated by the Commission. Response to complaints may consist of:

1. Establishing the nature and authenticity of the complaint.

2. Reviewing appropriate records, reports, and files.

3. Establishing contact with the operator to verify the complaint and discuss corrective 

action.

4. Performing a site inspection to determine if a problem exists.

5. Referring the complaint, after verification through appropriate investigation and 

documentation to legal counsel.

D. Monitoring Program

The compliance monitoring program will be overseen by the Commission for all Class VI 

injection well activities. The objective of the monitoring program is to verify attainment of and 

maintain compliance with provisions of permits, rules, and any other additional permit conditions 

or stipulations. The objectives are achieved by:

1. Conducting inspections of storage facilities.

2. Reviewing self-reporting, monitoring, record keeping, and certain operating and 

maintenance activities.

3. Investigating unauthorized injection activities and unauthorized facilities.

4. Participation in appropriate water quality sampling programs.

5. Responding to citizen complaints.

Site inspections will be conducted by the Commission’s authorized agents. The inspections will 

be conducted at the discretion of the Commission for all permitted CO2 storage facilities in order 

to:

1. Determine the probability of a violation and indicate problems that may be causing or 

lead to violations.
NDIC Class VI UIC Program Description – June 2013 Page 16

2. Assist in identification of existing problems or prevent potential problems from

developing.

3. Update the Commission records on the facility and verify operational procedures.

4. Maintain a regulatory presence with the storage operator and all landowners impacted by 

the geologic storage project.

E. Annual Inspections

1. Observations of injection site, facilities, and monitoring wells.

2. Review of records to determine history of performance and compliance.

3. Evaluation of the operation and maintenance of the storage facility.

4. A review of all Class VI permit conditions.

5. A review of all site specific permit conditions.

F. Compliance Inspections

Compliance follow-up inspections may be conducted at any time to:

1. Determine existence of a violation.

2. Provide basis for enforcement action.

3. Define type of violation.

4. Provide data to assist in determining cause of violation.

Site inspections and examination of storage operator records will be conducted under the 

authority of NDCC Chapter 38-22 and NDAC Chapter 43-05-01.
NDIC Class VI UIC Program Description – June 2013 Page 17

VI. NORTH DAKOTA ENFORCEMENT PROCEDURES

Any person violating NDCC Chapter 38-22, NDAC Chapter 43-05-01, any condition of a permit, 

or any rule or order of the Commission is subject to enforcement action. The Commission is 

responsible for initiating, pursuing, and resolving formal enforcement actions. 

Prior to taking formal enforcement action the Commission may:

1. Notify the alleged violator of deficiencies and such written notice may require corrective 

action.

2. Draft and issue a notice of violation to the alleged violator.

Formal enforcement proceedings may include:

3. Issuance of a letter detailing recommendations for corrective action and establishing a 

compliance period in which action will be taken.

4. Issuance of an administrative order by the Commission specifying corrective action and 

compliance schedule.

5. Signing of a stipulation between the Commission and the alleged violator establishing a 

compliance schedule for corrective action.

6. Conducting an administrative hearing (formal or informal) pursuant to NDCC Chapter 

38-22 and NDAC Chapter 43-05-01. 

7. Any enforcement proceedings may result in modification, revocation, or suspension of 

any permit issued under authority of the Class VI UIC program.

If further enforcement action is required:

8. The State may seek civil penalty up to $12,500 a day under NDCC Section 38-22-18.

Overall enforcement strategy of the Commission is based on the following concerns:

Priority No. 1: Remove any potential pollution problem as soon as possible.

Priority No. 2: Prevent such problems from causing any further damage.

Priority No. 3: Ensure that proper corrective or cleanup actions are taken.

Priority No. 4: Ensure that same type of violation will not occur again.

Priority No. 5: Seek civil penalty for violation.

The Commission will attempt to handle all minor violations through informal means or through 

use of correspondence between technical staff and the alleged violator. The Commission along 

with the State Department of Health will have, as its main concern, those violations which may 

have significant effects on the environment of the State of North Dakota and which may endanger 

valuable resources, such as USDWs.
NDIC Class VI UIC Program Description – June 2013 Page 18

VII. Reports

The owner or operator will submit all required reports, submittals, and notifications under NDAC 

Chapter 43-05-01 to EPA in an electronic format approved by EPA, as required under NDAC

Section 43-05-01-18 Subsection 5. Additional State regulations require the owner or operator to 

submit reports, submittals, and notifications to the Commission. In order to assure both the State, 

as the primacy authority, and EPA, as the oversight authority, have consistent data throughout 

program implementation, the Commission agrees to submit to EPA or allow EPA viewing access 

to all Class VI reports, submittals, and notifications submitted to the State. The Commission will 

assist the EPA in owner or operator compliance with NDAC Section 43-05-01-18 Subsection 5

by submitting to EPA or allowing EPA viewing access to all required reports, submittals, and 

notifications under NDAC Chapter 43-05-01 through the Commission’s database to EPA in an 

electronic format approved by EPA. 

A. Quarterly Reports

Class VI UIC program quarterly reports will be submitted to the regional administrator, in 

accordance with the following schedule: 

B. Annual Report

Class VI UIC program annual reports will be submitted to the regional administrator by 

December 1. The report is for the period of October 1 through September 30 (federal fiscal year) 

and will consist of the following: 

1. A well inventory consisting of the facility name and ID, location, well type, and well 

status. 

2. A summary of the major program activities during the fiscal year as identified in the 

work plan. 

VIII. FORMS

Quarterly and annual reporting will be performed using EPA Forms. The Commission will 

utilize its Risk Based Data Management System (RBDMS) database throughout program 

implementation. RBDMS CO2 will allow the Commission to track all program reports,

streamline permitting and reporting, and maintain all permit files associated with the Class VI 

program. Application and reporting forms to be used during program implementation follow this 

page.

Quarter

October. November, December 

Report Due

January 30 

January, February, March April 30 

April, May, June 

July, August, September

July 30 

October 30

 
Is the facility located on any histiric or archaeological sites? Yes No

Range

Is this facility located on Indian Land? Yes No

Proposed Facility Location Qtr-Qtr Section Township

Zip Code

STORAGE FACILITY INFORMATION

County

F L F L

Qtr-Qtr Section

N

W

L

Facility Location Address City

Proposed Injection Well Location County

Propsed Monitoring Well Location

COMMENTS

Thickness

F

Geologic Name of Injection Zone

Township

Title

Approval Date

By

NDIC Order No.

Permit Number and Storage Facility File Number

CARBON DIOXIDE STORAGE FACILITY PERMIT APPLICATION

Feet

FOR STATE USE ONLY

Geologic Name of Top Confining Zone

Feet

PSI PSI/Ft

Feet Feet

Gradient

Depth to Base of Fresh Water Zone

Type of Geological Structure 

Geologic Name of Lowest Known Fresh Water Zone

INDUSTRIAL COMMISSION OF NORTH DAKOTA

OIL AND GAS DIVISION

600 EAST BOULEVARD DEPT 405

BISMARCK, ND 58505-0840

SFN _________ (06-2013)

APPROVAL MUST BE OBTAINED BEFORE WORK COMMENCES.

PLEASE READ INSTRUCTIONS BEFORE FILLING OUT FORM. PLEASE SUBMIT THE ORIGINAL AND TWO COPIES.

Operator Address

Operator

Storage Facility Name NDIC Case No.

Telephone Number

W

N

State Zip Code

Zip Code

Facility Mailing Address City State

Range County

Township

City

Qtr-Qtr Section Range

State

F L

Geologic Name of Bottom Confining Zone Thickness

W

Injection Interval

N

Bottom Hole Fracture Pressure of the Top Confining Zone

L

Top

Feet

F L F

Permit No.:

Permit No.:

Permit No.:

N/A

N/A

N/A

N/A

N/A

Permit No.:

PSD - Air Emissions from Proposed Sources

Other (specify)

Existing Environmental Permits

Permit No.:

UIC - Underground Injection of Fluids

NPDES - Discharge of Surface Water

RCRA - Hazardous Waste
Attach the proposed well casing and cementing program.

Include the following project plans: emergency and remedial response plan, worker safty plan, corrosion monitoring plan, 

leak detection and monitoring plan, area of review and coorective action plan, testing and monitoring plan, plugging plan, 

and post-injection site care and facility closure plan.

5.

Attach a legal description of land ownership within the area of review. List ownership by tract or submit in plat form.

Attach the proposed financial responsibility demonstration as required in Section 43-05-01-09 of the North Dakota

Administrative Code.

Attach a plat depicting the area of review and detailing the location, well name, and operator of all wells in the area of

review. Include: injection wells, producing wells, plugged wells, abandoned wells, drilling wells, dry holes, and water

wells. The plat shall also depict faults, if known or suspected. 

13.

11.

2.

6.

7.

4.

16.

I hereby swear or affirm that the information provided is true, complete and correct as determined from all available records.

Page 2

Signature Printed Name Title

SFN _______ (06-2013)

Date

1.

15.

12.

9.

Attach a list identifying all attachments.

10.

14.

3.

Name

Name

Name

Instructions

Above Signature Witnessed By

Witness Signature Witness Printed Name Witness Title

Attach a brief description of the proposed pre-operational formation testing program, the proposed stimulation program, 

and the proposed injection program.

Attach a description of the needed corrective action on wells penetrating the injection zone in the area of review.

Provide all computational modeling data associated with the area of review deliniation as required in Section 43-05-01-

05.1 of the North Dakota Administrative Code. Including type of reservior modeling software, type geologic modeling 

software and all data used to create the geologic model, and all input and output files in a Commission approved format. 

Attach all required technical evaluation materials pursuant to Section 43-05-01-05 of the North Dakota Administrative

Code. Including all maps, cross sections, data, information, and evaluations of the proposed storage facility.

The original and two copies of this application and attachments shall be filed with the Industrial Commission of North

Dakota, Oil and Gas Division, 600 East Boulevard, Dept. 405, Bismarck, ND 58505-0840.

Read Section 43-05-01-05 of the North Dakota Administrative Code to ensure that this application is complete.

Attach a printout of a map obtained at http://www.nd.gov/gis/apps/HubExplorer/ with surficial aquifers (under

hydrography) active, and proposed location plotted on printout.

Attach schematic drawings of the injection system and its appurtenances including proposed well bore and surface

facility construction.

The operator, facility name, field or unit, proposed injection well location, and any other pertinent information. 

SIC Codes: List in descending order of 1st

significance the four 4-digit "Standard Industrial 

Classification Manual" which best describes 

your facility in terms of the principal products or 

nservices you produce or provide. Also, specify 

each classification in words

2nd

3rd

4th

Name
TYPE

Title

Approval Date

By

UIC Number

Compression

Tension

Permit Number and Well File Number

APPLICATION FOR CARBON DIOXIDE STORAGE - FORM 25

Total Depth of Well (MD & TVD) Well Logs

Feet

FOR STATE USE ONLY

Permanent

Geologic Name of Top Confining Zone Thickness

F

Geologic Name of Injection Zone

WEIGHT

SETTING DEPTH CEMENT

SACKS OF

SIZE TOP OF CEMENT

Feet

PSI/Ft

@

Feet

Feet

PSI

Gradient

BPD @

TOP DETERMINED BY

CASING, TUBING, AND PACKER DATA (Check

Estimated Maximum Injection Rate and Pressure

PSI

Depth to Base of Fresh Water Zone

Estimated Average Injection Rate and Pressure 

INDUSTRIAL COMMISSION OF NORTH DAKOTA

OIL AND GAS DIVISION

600 EAST BOULEVARD DEPT 405

BISMARCK, ND 58505-0840

SFN _________ (06-2013)

APPROVAL MUST BE OBTAINED BEFORE WORK COMMENCES.

PLEASE READ INSTRUCTIONS BEFORE FILLING OUT FORM. PLEASE SUBMIT THE ORIGINAL AND TWO COPIES.

INJECTION WELL INFORMATION

Address

Operator

Proposed Tubing

Liner

Proposed Packer Setting Depth Model

Feet

TOP BOTTOM SACKS OF CEMENT

Storage Facility Name

Newly Drilled

Yes

Commercial Storage

No

Telephone Number

County

State Zip Code

W

Range County

Township

City

At Surface Qtr-Qtr Section Range

Long String

L

Bottom Hole Location

F N

N

Geologic Name of Bottom Confining Zone Thickness

Geologic Name of Lowest Known Fresh Water Zone

Intermediate

W

(Lbs/Ft)

If Existing)

Injection Interval

Surface

NAME OF STRING

F

BPD

Bottom Hole Fracture Pressure of the Top Confining Zone

L

Top

F L

PSI

Qtr-Qtr Section

Feet

Feet

Township

L

Storage Facility File No.

Converted

Injection Well Type
Attach a Sundry Notice - Form 4 (SFN 5749) detailing the proposed procedure.

Attach a list identifying all source wells, including location.

5.

Attach a legal description of land ownership within the area of review. List ownership by tract or submit in plat form.

9.

Attach the proposed pad layout including cut and fill diagrams

Attach a quantitative analysis from a state-certified laboratory of fresh water from the two nearest fresh water wells.

Include legal descriptions. 

Attach a plat depicting the area of review and detailing the location, well name, and operator of all wells in the area of

review. Include: injection wells, producing wells, plugged wells, abandoned wells, drilling wells, dry holes, and water

wells. The plat shall also depict faults, if known or suspected. 

Attach all available logging and test data on the well which has not been previously submitted.

2.

6.

7. Attach a brief description of the proposed injection program.

4.

If a Carbon Dioxide injection well is to be drilled, an Application for Permit to Drill - Form 1 (SFN 4615) shall also be

completed and accompanied by a plat prepared by a registered surveyor and a drilling fee.

The operator, well name and number, field or unit, well location, and any other pertinent data shall coincide with the

official records on file with the Commission. If it does not, an explanation shall be given. 

Attach a lithologic description of the proposed injection zone and the top and bottom confining zones.

17.

3.

Attach a description of the needed corrective action on wells penetrating the injection zone in the area of review.

16. Attach a diagram representing the traffic flow and the maximum number of trucks staged on site.

14.

12.

Attach a printout of a map obtained at http://www.nd.gov/gis/apps/HubExplorer/ with surficial aquifers (under

hydrography) active, and proposed location plotted on printout.

Attach schematic drawings of the injection system and its appurtenances including current well bore construction and

proposed well bore and surface facility construction.

15.

Attach a quantitative analysis from a state-certified laboratory of a representative sample of carbon dioxide to be injected.

13.

10.

Attach a list identifying all attachments.

8.

11.

Witness Signature Witness Title

Above Signature Witnessed By

Witness Printed Name

I hereby swear or affirm that the information provided is true, complete and correct as determined from all available records.

Page 2

Signature Printed Name Title

SFN _______ (06-2013)

Date

COMMENTS

18. Read Section 43-05-01-09 of the North Dakota Administrative Code to ensure that this application is complete.

19. The original and two copies of this application and attachments shall be filed with the Industrial Commission of North

Dakota, Oil and Gas Division, 600 East Boulevard, Dept. 405, Bismarck, ND 58505-0840.

Instructions

1.
N

F L

Operator

N W

F

Township Range County

F L

N W

Well Name 

L

If Directional, Top of Pay Qtr-Qtr Section Township Range

Proposed Bottom Hole Location Qtr-Qtr Section

L F

County

W

Township

F L F L

Telephone Number

City

At Surface

State Zip Code

Name of Surface Owner or Tenant

Address

Range County

Address City State

Well Number

Qtr-Qtr Section

PLEASE READ INSTRUCTIONS BEFORE FILLING OUT FORM.

PLEASE SUBMIT THE ORIGINAL AND ONE COPY.

INDUSTRIAL COMMISSION OF NORTH DAKOTA

OIL AND GAS DIVISION

600 EAST BOULEVARD DEPT 405

BISMARCK, ND 58505-0840

SFN 4615 (08-2008)

Zip Code

Date Approved

By

Permit and File Number API Number

33-

Permit Type

Field

Email Address(es)

Proposed

Comments

Acres in Spacing/Drilling Unit

' "

Spacing/Drilling Unit Setback Requirement Industrial Commission Order

APPLICATION FOR PERMIT TO DRILL - FORM 1

I hereby swear or affirm that the information provided is true, complete and correct as determined from all available records.

Signature Printed Name Title

Date

Ground Elevation

Type of Work Type of Well Approximate Date Work Will Start Confidential Status

Latitude of Well Head Longitude of Well Head NAD Reference Description of (Subject to NDIC Approval)

°' " °

Feet

Objective Horizons Pierre Shale Top

Feet Above S.L.

Size Weight Depth Cement Volume NOTE: Surface hole must be drilled with fresh water

Surface Casing - " Lb./Ft. Feet and surface casing must be cemented back to surface.

Proposed Size Weight(s) Longstring Total Depth Cement Volume Cement Top Top Dakota Sand

-

Sacks

Feet

Proposed Logs

Estimated Total Depth (feet) Drilling Mud Type (Vertical Hole - Below Surface Casing)

Feet MD Feet TVD

Feet TVD

Base of Last Salt (If Applicable)

Longstring Casing " Lb./Ft. Sacks

IF DIRECTIONAL - ALSO SUBMIT: Horizontal section plat and directional plot/plan.

Title

FOR STATE USE ONLY FOR STATE USE ONLY

Pool

This well is not located within five hundred 

WELL INFORMATION feet of an occupied dwelling.

Notice has been provided to the owner of any 

permanently occupied dwelling within 1,320 feet.

REQUIRED ATTACHMENTS - VERTICAL: Certified surveyor's plat, estimated geologic tops, proposed mud/cementing plans, $100 fee.

Feet

Feet Feet MD
APPLICATION FOR PERMIT TO DRILL – FORM 1

SFN 4615

1. Please refer to Section 43-02-03-16 of the North Dakota Administrative Code (NDAC)

regarding an application for permit to drill.

2. Well-site preparation other than surveying and staking is forbidden prior to approval of an

application for permit to drill.

3. Verbal approval may be given for site preparation by the Director in extenuating

circumstances although no drilling activity shall commence until the application is approved.

4. The application for permit to drill shall be accompanied by a bond pursuant to Section

43-02-03-15 NDAC or the applicant must have previously filed such bond with the

Commission, otherwise the application is incomplete.

5. Any incomplete application for permit to drill received by the Commission has no standing

and shall not be deemed filed until it is completed.

6. The application for a permit to drill a well shall be accompanied by an accurate plat certified

by a registered surveyor showing the location of the proposed well with reference to the

nearest lines of a governmental section.

7. The application for permit to drill a directional or horizontal well shall be accompanied by an

accurate plat certified by a registered surveyor showing the internal dimensions of the

spacing or drilling unit.

8. The application for permit to drill shall be accompanied by a drilling prognosis which shall

include the following: the proposed total depth (including measured depth if appropriate) to

which the well will be drilled, the estimated depth to the top of important geological markers,

the estimated depth to the top of objective horizons, the proposed mud program, the

proposed casing program including size and weight, the proposed depth at which each

casing string is to be set, the proposed amount of cement to be used, and the estimated top

of cement.

9. The application for permit to drill shall be accompanied by a permit fee of one hundred

dollars.

10. The approved application for permit to drill shall terminate and be of no further force and

effect unless a well is drilling, or has been drilled, below surface casing on the first

anniversary of the date of issuance or renewal.

11. The original and one copy of this report shall be filed with the Industrial Commission of

North Dakota, Oil and Gas Division, 600 East Boulevard, Dept. 405, Bismarck, ND 58505-

0840.
Other

Production Well

BEFORE TEST

Tubing Pressure

Well Type

Disposal Well

Enhanced Recovery Well

 

Workover

PSIG FTP or

Tubing Type

TAO MIT

Reason for Test

Company Representative Witnessing Test Title

TA

Type of Test

Initial MIT

Qtr-Qtr Section Township Range

WELL INTEGRITY REPORT - FORM 19

INDUSTRIAL COMMISSION OF NORTH DAKOTA

OIL AND GAS DIVISION

600 EAST BOULEVARD DEPT 405

Well Name and Number Field

Operator Telephone Number

Address City State Zip Code

SITP

Annulus or Casing Pressure

PSIG

START OF TEST

Starting Tubing Pressure

PSIG FTP or SITP

Starting Annulus or Casing Pressure

PSIG

END OF TEST

Ending Tubing Pressure

PSIG FTP or SITP

Ending Annulus or Casing Pressure

PSIG

TEST DATA

Annular or Casing Fluid Fluid Used to Test Amount of Fluid Needed to Fill Annulus or Casing

Bbls

Yes No - Pressure Left PSIG

Commission Field Inspector Witnessing Test

Location of Well County

Tubing Size

This report is true and complete to the best of my knowledge.

Inches

N W

Feet

Length of Test

Minutes

Tool Type Packer

5 Year MIT

Was Annulus or Casing Bled Off to Zero After Test?

CICR

Well File No.

SFN 5767 (10-2001)

BISMARCK, ND 58505-0840

PLEASE READ INSTRUCTIONS BEFORE FILLING OUT FORM.

PLEASE SUBMIT THE ORIGINAL.

Date of Test Name of Contractor Performing Pressure Test

Annual MIT

COMMENTS

Depth

Feet

Packer Model

CIBP

UIC No.

UIC MIT

WELL DATA

Formation Perforations
1. A Well Integrity Report - Form 19 (SFN 5767) shall be filed with the Commission

subsequent to any workover conducted on a UIC well, any periodic pressure test conducted

on a UIC well, or any pressure test conducted for temporary abandonment purposes. This

report will be filed by the Commission field inspector if they witness the mechanical integrity

test.

2. The well file number, UIC number, operator, well name and number, field, well location, and

any other pertinent information shall coincide with the official records on file with the

Commission. If it does not, an explanation shall be given.

3. The "Before Test" section of the report shall report the condition(s) of the well prior to

connecting to the well for the mechanical integrity test.

4. The "Start of Test" section of the report shall report the condition(s) of the well after

pressuring up the well to start the mechanical integrity test.

5. The "End of Test" section of the report shall report the condition(s) of the well at the end of

the test interval prior to relieving the pressure on the well.

6. The original of this report shall be filed with the Industrial Commission of North Dakota, Oil

and Gas Division, 600 East Boulevard, Dept. 405, Bismarck, ND 58505-0840.

WELL INTEGRITY REPORT - FORM 19

SFN 5767
Address City

 Approximate Start Date

Well Name and Number

Qtr-Qtr Oil

Company Telephone Number

After

F N W Bbls

Section

MCF

Temporarily Abandon

Other

Before

Reclamation

Redrilling or Repair Shooting

24-HOUR PRODUCTION RATE

DETAILS OF WORK

Water

County Gas

L

SUNDRY NOTICES AND REPORTS ON WELLS - FORM 4

INDUSTRIAL COMMISSION OF NORTH DAKOTA

SFN 5749 (09-2006)

Footages

Drilling Prognosis

Date

Township Range

State

OIL AND GAS DIVISION Well File No.

Oil Bbls

Supplemental History

600 EAST BOULEVARD DEPT 405

BISMARCK, ND 58505-0840

Change Production Method

Bbls

Bbls

MCF

Name of Contractor(s)

F

Notice of Intent Approximate Start Date

Report of Work Done Date Work Completed

Field

Casing or Liner

Plug Well

PLEASE READ INSTRUCTIONS BEFORE FILLING OUT FORM.

Received

Spill Report

Acidizing

Fracture Treatment

Approved

PLEASE SUBMIT THE ORIGINAL AND ONE COPY.

FOR STATE USE ONLY

Notice of Intent to Begin a Workover Project that may Qualify

for a Tax Exemption Pursuant to NDCC Section 57-51.1-03.

Title Date

Signature Printed Name

Title

By

Water

Gas

City

Zip Code

L

Pool

Address

State Zip Code

Email Address
1. Approval shall be obtained prior to perforating or recompleting a well in a reservoir other than the

reservoir in which the well is currently completed, prior to plug back of a well, prior to temporary

abandonment of a well, prior to abandonment of a well, prior to reclamation of a well site, prior to

reclamation of a reserve pit, and prior to beginning a workover project, which may qualify for a tax

exemption pursuant to NDCC Section 57-51.1-03. Please refer to Section 43-02-03-16 of the

North Dakota Administrative Code (NDAC) regarding recompleting a well in a reservoir other than

the reservoir in which the well is currently completed or plugging back of a well, to Section 43-02-

03-55 NDAC regarding temporary abandonment of a well, to Section 43-02-03-33 or Section 43-

02-05-08 NDAC regarding abandonment of wells, to Section 43-02-03-19 NDAC regarding

reclamation, and to Section 43-02-09-03 NDAC regarding workover projects.

2. Upon the completion of any remedial work, or attempted remedial work such as plugging back,

drilling deeper, acidizing, shooting, formation fracturing, squeezing operations, setting liner, fishing

operations, repair work, perforating, reperforating, or other similar operations not specifically

covered herein, a report on the operation shall be filed on a Sundry Notice - Form 4 (SFN 5749)

with the Director. The report shall present a detailed account of all work done and the date of

such work; the daily production of oil, gas, and water both prior to and after the operation; the

shots per foot, size, and depth of perforations; the quantity of sand, crude, chemical, or other

materials employed in the operation; and any other pertinent information or operations which

affect the original status of the well and are not specifically covered herein. Please refer to

Section 43-02-03-31 NDAC.

3. Upon the completion of a workover project, which may qualify for a tax exemption pursuant to

NDCC Section 57-51.1-03, a report on the operation shall be filed on a Sundry Notice - Form 4

(SFN 5749) detailing the work done. Include the dates during which the workover rig was in

service actually performing work on the workover project and the date the workover was

completed, a detailed list identifying all labor, services, and materials used and equipment

replaced during the workover project, the cost of each item, and whether the replacement

equipment was new or used. The value of all equipment removed from service must be listed.

The average daily oil production from the well during the first two months after completion of the

project must be included if the costs of the project did not exceed sixty-five thousand dollars. All

gauge tickets of oil produced in incomplete months during the first two months after completion of

the workover and the volume of oil stored on the well premises immediately prior to

commencement of the workover project must also be included. Please refer to Section 43-02-09-

04 NDAC.

4. Upon the initial installation of pumping equipment, or change in type or depth of pumping

equipment designed to increase productivity in a well, the operator shall file a Sundry Notice -

Form 4 (SFN 5749) of such installation. The notice shall include all pertinent information on the

pump and the operation thereof including the date of such installation, and the daily production of

the well prior to and after the pump has been installed. Please refer to Section 43-02-03-31

NDAC.

5. The well file number, well name and number, well location, field, pool, and county shall coincide

with the official records on file with the Commission.

6. The original and one copy of this report shall be filed with the Industrial Commission of North

Dakota, Oil and Gas Division, 600 East Boulevard, Dept. 405, Bismarck, ND 58505-0840.

SUNDRY NOTICES AND REPORTS ON WELLS - FORM 4

SFN 5749
Perforations Holes Per Foot

L

Qtr-Qtr

Date Well Plugged

Weight of Fluid Between Plugs (Lbs/Gal)

Bottom Hole Location Section Township Range

County

W

Range

F

Type of Plug Interval/Depth Formation Isolated Sacks of Cement/Class

ATTEMPTED COMPLETION DATA (If not previously reported)

Hole Size (Inches) Weight (Lbs/Ft)

CASING RECORD (Report all strings set in well)

Measured Depth Set (Feet)

List Intervals:

No

(See Back)

Yes

No

Name of Field Inspector Present During Plugging

TD (Feet) No. of DSTs

Was Well Cored?

TVD Yes

Spud Date Date TD Reached KB Elevation Directional Survey Run?

N

N W

County

MD

L

Type of Electric and Other Logs Run (See Instructions)

F L

LOCATION

F L F

At Surface Qtr-Qtr Section Township

City State Zip Code Deepest Pool Penetrated

Address Field

INDUSTRIAL COMMISSION OF NORTH DAKOTA

OIL AND GAS DIVISION

600 EAST BOULEVARD DEPT 405

CARBON DIOXIDE STORAGE INJECTION WELL PLUGGING REPORT - FORM 25A

BISMARCK, ND 58505-0840

SFN _____ (06-2013)

Well File No.

PLUGGING RECORD

Amount and Kind of Material Used

Drilling Contractor and Rig Number Plugging Contractor(s)

Sacks Cement Top of Cement

Well Name and Number

PLEASE READ INSTRUCTIONS BEFORE FILLING OUT FORM.

PLEASE SUBMIT THE ORIGINAL AND ONE COPY.

Operator Telephone Number

Swab/Prod. Potential (Oil/Water) Acid, Frac, Sqz, Etc.

Casing Size (Inches) Amount Pulled
 Page 2

SFN _____ (06-2013) 

Signature Printed Name

Above Signature Witnessed By

Witness Signature Witness Printed Name Witness Title

Title

DRILL STEM TEST DATA (IF NOT PREVIOUSLY REPORTED), ADDITIONAL INFORMATION, AND/OR LIST OF ATTACHMENTS

Date

I hereby swear or affirm that the information provided is true, complete and correct as determined from all available records.
1. This report shall be filed by the operator with the Commission within sixty (60) days after the

plugging of any well. Please refer to Section 43-05-01-11.5 of the North Dakota Administrative Code.

2. The well file number, operator, well name and number, field, pool, well location(s), and any other

pertinent data shall coincide with the official records on file with the Commission. If it does not,

an explanation shall be given.

3. If a parasite string was used in the drilling of a well, the size, depth set, cement volume used to

plug, and the date plugged shall be included. This information may be included in the "Additional

Information" portion of the report or included as an attachment.

4. On horizontal or directional wells, the following information shall be included if applicable: pilot

hole total depth, kick-off point, original lateral total depth, and all sidetracked interval starting and

ending footages. This information may be included in the "Additional Information" portion of the

report or included as an attachment.

Dakota, Oil and Gas Division, 600 East Boulevard, Dept. 405, Bismarck, ND 58505-0840.

7. The original and one copy of this report shall be filed with the Industrial Commission of North

CARBON DIOXIDE STORAGE INJECTION WELL PLUGGING REPORT - FORM 25A

SFN _____

survey contractor.

6. Two copies of any directional surveys run shall be filed directly with the Commission by the

5. The operator shall file with the Commission two copies of all logs run. Logs shall be

submitted as one paper copy and one digital LAS (log ASCII) formatted copy, or a 

format approved by the Director. In addition, operators shall file two copies of the

following: drill stem test reports and charts, core analyses, formation water analyses and

noninterpretive lithologic logs or sample descriptions if compiled.
Page 1 of 3

GEOLOGIC STORAGE OF CO2 INSPECTION REPORT

Industrial Commission of North Dakota 

Oil and Gas Division – Class VI Underground Injection Well

I. General Information

Facility Name: 

Facility Location Address: City: State: ND Zip: 

Facility Mailing Address: City: State: ND Zip: 

Telephone Well Name & No.: State Permit No.: 

Geographic Location: Quarter: Section: Township: Range: County: 

Latitude and Longitude (degrees, minutes and seconds):

Well Type: Inspection Date: Time: 

Inspection Type: Routine MIT Complaint Compliance Permit Other:

Name(s) of person(s) UIC inspector met with during inspection:

 Name: Title: Phone No.:

II. CO2 Injection Well Information

Shut In Pressure: (Psig) Annulus Pressure: (Psig) Injection Rate: 

Average Daily injection Volume: Injection CO2 Temperature: (°F)

 

1. Is there documentation of gauge calibration? Yes No Date of calibration:

 

2. Is injection rate and volume: Measured orEstimated?

3. Does the type of injection fluid fluctuate? Yes No

4. Type and specific gravity of the annulus fluid: / SG = 

5. Specific gravity of the injection fluid: 

6. Location of perforations and/or open hole: 

7. Type and model of packer: tension/compression/neutral/other (please specify below):

Packer type: Model: 

8. What is the setting depth of the packer: feet

9. How is injection pressure recorded? Manual Automatic  Computer
Page 2 of 3

10. How is annulus pressure recorded? Manual Automatic Computer

11. Is fluid temperature recorded?  Yes No

12. Is annulus fluid volume recorded? Yes No

Well information comment section:

III. Annulus Pressure Maintenance System

1. Is annulus pressure continuously maintained in accordance with permit? Yes  No

2. Is annulus pressure required to be greater than injection pressure? Yes No**

3. Is annulus pressure continuously greater than injection pressure?  Yes No

4. How is annulus pressurized? Positive displacement pump Bottled Air Other: 

5. Is annulus fluid volume continuously monitored/recorded by operator?  Yes  No

6. Has operator received training on well operation? Yes No

Maintenance system comment section:

IV. Alarm System

1. Is injection well alarm system operable? Yes No

2. What type of alarm system is utilized? Manual system Automatic system

3. Has alarm system been tested by a UIC inspector? Yes No

4. On what frequency is alarm system tested? 

5. Is alarm triggered by:

 High pressure? Yes 

 No Low pressure differential? Yes No

 Low pressure? Yes No

 Other? Yes No

6. Is there a time delay before alarm sounds to account for start-ups? Yes No
Page 3 of 3

7. Is operator on site 24 hours per day to respond to failure? Yes No

Alarm system comment section:

V. Testing

1. Was a mechanical integrity test conducted at this inspection? Yes No

2. Was a start-up test conducted at this inspection? Yes No

Testing comment section:

VI. Overall Inspection Comments

Print inspector’s name: Signature of Inspector:

Attachment: Copy of test report:  Yes No