The inventory form is designed to collect basic information for all systems/wells to determine which are used for underground disposal of waste fluids.

• If your business has more than one location within our primacy enforcement authority, please complete this form for each facility.
• If this is your residence, and your commercial facility is located elsewhere, provide the information for your commercial facility. However, if you work out of your home, please complete and submit this form.
• If you lease or rent the space for your business, as the operator of the business, you are responsible for submitting the inventory information form.

If you have any questions regarding this forms, please contact:

Omar Sierra-Lopez  (303) 312-7045

please complete and submit this form to: sierra-lopez.omar@epa.gov

• Well Inventory Form (for EPA Region 8 only) (PDF)(2 pp, 113 K)