WR-35                                                                                                                                   DATE:

Rev (5-01)                                                                                                                                              API # :

State of West Virginia

Department of Environmental Protection

Office of Oil and Gas

 

Well Operator's Report of Well Work

 

Farm name:________________________________________                      Operator Well No.:__________________________

 

LOCATION:   Elevation: _____________________________                                Quadrangle: _______________________________

 

                 District: __________________________________   County: __________________________________

                 Latitude:____________Feet South of_______Deg. _________Min._________Sec.

                 Longitude___________Feet West  of _______Deg._________Min._________Sec.

 

Company: _________________________________

 

Casing & Tubing

Used in drilling

Left in well

Cement fill up Cu. Ft.

Address:

 

 

 

 

 

 

 

 

 

Agent:

 

 

 

 

Inspector:

 

 

 

 

Date Permit Issued:

 

 

 

 

Date Well Work Commenced:

 

 

 

 

Date Well Work Completed:

 

 

 

 

Verbal Plugging:

 

 

 

 

Date Permission granted on:

 

 

 

 

  Rotary             Cable                     Rig

 

 

 

 

  Total  Depth (feet):

 

 

 

 

  Fresh Water Depth (ft.):

 

 

 

 

 

 

 

 

 

  Salt Water Depth (ft.):

 

 

 

 

 

 

 

 

 

Is coal being mined in area (N/Y)?

 

 

 

 

Coal Depths (ft.):__________________________

 

 

 

 

 

     OPEN FLOW DATA

 

          Producing formation________________________Pay zone depth (ft)________

          Gas: Initial open flow_______MCF/d Oil: Initial open flow________Bbl/d

               Final open flow_________MCF/d      Final open flow _________Bbl/d

               Time of open flow between initial and final tests___________Hours

          Static rock Pressure_________psig (surface pressure) after ______Hours

 

          Second producing formation________________ Pay zone depth (ft)________

          Gas: Initial open flow_______MCF/d Oil: Initial open flow________Bbl/d

               Final open flow_________MCF/d      Final open flow _________Bbl/d

               Time of open flow between initial and final tests___________Hours

          Static rock Pressure_________psig (surface pressure) after ______Hours

 

     NOTE: ON BACK OF  THIS FORM  PUT THE  FOLLOWING: 1).  DETAILS OF PERFORATED

     INTERVALS, FRACTURING  OR STIMULATING,  PHYSICAL CHANGE,  ETC. 2). THE WELL

     LOG WHICH  IS A  SYSTEMATIC DETAILED  GEOLOGICAL RECORD  OF ALL FORMATIONS,

     INCLUDING COAL ENCOUNTERED BY THE WELLBORE.

 

                   Signed:         _________________________________________

                                   By:_________________________________________

                                   Date:_______________________________________

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