# STATE OIL AND GAS BOARD OF ALABAMA Well Record and Completion or Recompletion Report

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# 01 - - - - Permit Number API Number 

## New Drill/Reentry Deep en Recompletion Conversion Sidetrack Plu g Back Name of Operator ____________________________________________________________________________________________________ Address ____________________________________________ City _______________________ State ____________ Zip _____________ 1. Well name and number 2. County (give footage from nearest section or offshore tract lines) Section-Township-Range or Tract 3. 

# Well Location (actual surface) Latitude Longitude (NAD27) ▪ (NAD27) ▪ (give footage from nearest section or offshore tract lines) Section-Township-Range or Tract 4. 

# Well Location (actual bottom hole) Latitude Longitude (NAD27) ▪ (NAD27) ▪ 5. Field (If wildcat, so state) 6. P ool(s) 7. Closest di stance from borehole within pool to nearest unit line feet 8. Drilling contractor 9. Date spudded 10. Date drilling reached total depth 11. Surveyed elevations (feet): KB DF GL 12. Total Depth: driller logger plug back 13. Total Depth in sidetracked hole: driller logger plug back 14. Kickoff point: direction @ depth of 15. Depths measured from: KB DF GL 16. Workover: Contractor Date operati ons commenced Date operations completed CASING AND LINER RECORD Depth set below KB GL Purpose Size Weight/ft. Name & Type Other _______________

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_____________________ _____________________ _____________________ _____________________ _____________________ CEMENT RECORD FOR CASING AND LINER Size of hole Interval cemented Date No. sacks of cement Yield (ft 3 /sk) Type cement Test pressure Service company

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__________ _________to_________ ___________ _________ _________ _________ _________ _____________

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__________ _________to_________ ___________ _________ _________ _________ _________ _____________ SQUEEZE CEMENT RECORD Interval squeezed Date No. sacks of cement Yield (ft 3 /sk) Type cement Service company __________to__________ ___________ _____________ _____________ _________________ _______________________ __________to__________ ___________ _____________ _____________ _________________ _______________________ __________to__________ ___________ _____________ _____________ _________________ _______________________ __________to__________ ___________ _____________ _____________ _________________ _______________________ PERFORATION RECORD Interval perforated Date Holes/ft. Size & Type Service company ___________to___________ _________________ _________________ _________________ _________________________ ___________to___________ _________________ _________________ _________________ _________________________ ___________to___________ _________________ _________________ _________________ _________________________ ___________to___________ _________________ _________________ _________________ _________________________ ___________to___________ _________________ _________________ _________________ _________________________ ___________to___________ _________________ _________________ _________________ _________________________ ___________to___________ _________________ _________________ _________________ _________________________ Form OGB-7 , Rev. 0 7 /1 3 (File in triplicate)

## Form OGB-7 ________________________ (Page 2) Permit Number TUBING RECORD Size Weight/ft. Name & Type Depth set

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___________________ _________________ ____________________________________ ______________________________________ PACKER RECORD Size (O.D.) Size (I.D.) Name & Type Depth set Date Test pressure

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______________ _____________ ___________________________ _______________ _______________ _________________ MECHANICAL PLUG Size Weight range Name & Type Depth set Date Test pressure

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______________ _____________ ___________________________ _______________ _______________ _________________ WELL STIMULATION AND TREATMENT RECORD* Process Interval Date Material & Quantity Pressure Service company

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____________ ___________to___________ _________ _______________________ _________ _________________________ * Full details should be given on Form OGB-6, Report of Well Treatment. DRILL STEM TEST RECORD** Test date Interval Type and volume of fluids recovered (oil, gas, water, etc.)

______________ ____________to____________ _____________________________________________ ; Rw = _____________________

______________ ____________to____________ _____________________________________________ ; Rw = _____________________

______________ ____________to____________ _____________________________________________ ; Rw = _____________________

______________ ____________to____________ _____________________________________________ ; Rw = _____________________ ** Submit two copies of drill stem test results with this form. ARTIFICIAL LIFT Date installed: _________________________________ Type: ______________________________ Depth: __________________________ Phone number Fax number Person to contact regarding this form E-mail Address Remarks:

Executed this the _______ day of __________

__________ , 20 __ ________ ___________________________________________________ Signature Before me, the undersigned authority, on this day personally appeared

________________________________________ known to me to be the person whose name is subscribed to the above instrument, who being by me duly sworn on oath states that he/she is duly authorized to m ake the above report and that he/she has knowledge of the facts stat ed therein, and that said report is true and correct. Subscribed and sworn to before me this _______ day of ____________________ , 20 _________ SEAL My commission expires ____________________ _____________________________________ Notary Public in and for _____________________ County, ________________________________