OHIO DEPARTMENT OF NATURAL RESOURCES



### DIVISION OF OIL & GAS RESOURCES MANAGEMENT

2045 MORSE RD. , F

- 2, C OLUMBUS, OH 43229- 6693



## W ELL COMPLETION RECORD (Form 8 )

Required by ORC Section 1509.10 Page 1 of 2 DOGRM 5607 (REV 102012)

DOGRM 5607 (REV 102012) 

### This	report	is	due	in	duplicate	60	days	after	completion	of	the	well.	If	the	permit	has	expired	and	the	well	was	not	drilled,

check	the	box	below,	sign	on	reverse	side	(Back),	and	return	to	our	office	within	30	days	after	expiration.

1. Owner #: 3. API #:

2. Owner name, address and telephone numbers:

Telephone No.: 4. Type of Permit:

5. County:

6. Civil Township:

7. Footage:

8. Type of Well:

9. X: Y: 21. Da te drilling commenced:

10. Quad: 22. Date drilling completed:

11. Section: 12. Lot: 23. Date put into production:

13. Fract ion: 14. Qtr. Twp: 24. Date plugged, if dry:

15. Tract: 25. Producing formation:

16. Allot: 26. Deepest formation:

17. Well #: 27. Driller’s total depth:

18. Lease Name: 28. Logger’s total depth:

19. PTD: 20. Drilling unit: 29. Lost hole at feet.

30. Type of tools: 31. Type of completion: 32: Elevation:

Cable Air Rotary Open Hole Ground Level

Flu id Rotary Service Rig Through Casing Derrick Floor

Slotted Liner Kelly Bushing

33. Perforated intervals and number of shots:

34. Name of Frac Company:

35. Method of shot, acid, or fracture treatments, production tests, pressures, etc.:

SHOT: ACID: FRAC FLUIDS: SAND: PRESSURES (psi):

Lbs. Gals. Water (gals) Lbs. Breakdown

Qts. Type Water (bbl) Sks. ATP

Type Percent CO2 (tons) ISIP

N2 (mscf) 5 min. SIP

Avg. Rate

METHOD OF FLUID CONTAINMENT

FLUIDS: PIT FRAC TANK DATE TREATED:

Swab Well Stimulation Additives Report (Form 8B) Attached

Flowback Stimulati on Information Reported to FracFocus.

36. Amount of initial production per day: (MCF) (Bbls) (Bbls)

Natural: Gas Oil Brine

After Treatment: Gas Oil Brine

SERC Data: Number of Tanks: Maximum Storage Capacity of all Tanks (bbls.)

37. Casing and tubing record:

Type Wellbore

Diameter Casing Size Feet Insta lled Amount of

Cement (Sacks) Feet Left in

Well Number of

Centralizers

Conductor/Drive Pipe:

Surface:

Attach Form 8A (Surface Hole Additives Report)

Intermediate:

Production:

Tubi ng:

Other:

38. Name of drilling contractor:

39. Type of electrical and/o r wireline logs run:

(all logs must be submitted)

40. Name of logging company:

DIVISION USE ONLY

Log Submitted: Yes/No FRAC DATA SUBMITTED: Well Class:

Confidenti al: Yes/No Pressure/Rate Graph

Record

InvoiceOHIO DEPARTMENT OF NATURAL RESOURCES



### DIVISION OF OIL & GAS RESOURCES MANAGEMENT

2045 MORSE RD. , F

- 2, C OLUMBUS, OH 43229- 6693



## W ELL COMPLETION RECORD (Form 8 )

Required by ORC Section 1509.10 Page 2 of 2 DOGRM 5607 (REV 102012)

DOGRM 5607 (REV 102012) FORMATION TOP BASE Shows of oil, gas, fresh water, or brine;

indicate depth or interval REMARKS

Fresh water Strata

Glacial Deposits

Coal Seams

1st Cow Run

Buell Run

2nd Cow Run

Salt Sand

Maxton Sand

Keener Sand

Big Injun Sand

Squaw Sand

Mississippian Shale

Weir Sand

Berea Sand

Bedford Shale

2

nd Berea

Ohio Shale

Gantz

Thirty Foot

Gordon

Cinnamon

Rhinestreet

Marcellus

Big Lime

Sylvania

Oriskany

Bass Island

Salina

Salt Section

Newburg

Lockport

Little Lime

Packer Shell

Stray Clinton

Red Clinton

White Clinton

Medina

Queenston

Utica

Point Pleasant

Trenton

Black River

Gull River

Glenwood Shal e

Knox Unconformity

Beekmantown

Rose Run

Trempealeau/Copper Ridge

“B” Zone

Krysik

Kerbel

Conasauga

Rome

Mt. Simon

Granite Wash

Middle Run

Granite

I certify that the above information is true and correct, to the best of my knowledge:

(SIGNATURE) (DATE)

(NAME TYPED OR PRINTED) (TITLE)

(REPRESENTING)