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## Florida

Department of

Environmental Protection Oil &Gas Form 9

Form Title: WELL COMPLETION REPORT

(FIRST PRODUCTION OR RETEST REPORT)

Date Revised: March, 1998

Incorporated by Reference in: Section 62C

- 26.00 8 , F.A.C.



### File this report with the Florida Department of Environmental Protection, Oil and Gas Program, 2600 Blair Stone Road, MS 3588,

Tallahassee, Florida 32399-2400 (phone 850/245-8848), within 30 days after testing.

Type of Report:

Permit Number:

A. P. I. Number: __________________________________________

Field: ________________________________________________

Operator: _____________________________________________

Well Name & Number: __________________________________

Type of Well (Oil or Gas): ________________________________

County: ______________________________________________

Location (Section Calls, Section, T, R) ______________________

Date Completed: _______________________________________

Flowing or Pumping: ____________________________________

Production Horizon: _____________________________________

Producing From: __________________ To: _________________

Perforated From: __________________ To: ________________

Oil String Size: _________________ Seat:: _________________

Tubing Size: ___________________ Bottom: _______________

Total Depth: ___________________________________________

Elevation: DF ___________ KB ____________ GL ___________

Type of Subsurface Safety Device: _________________________

Depth Set: ____________________ DF Ht.: _________________ (First Production or Retest?)

Time Gauged or Metered: ________________________________

Opening Tank Gauge: _________________ Ft. ___________ In.

Closing Tank Gauge: __________________ Ft. ___________ In.

Difference: ___________________________Ft. ___________ In.

Volume Metered: _______________________________________

Tank Co-Eff. (Bbls./In.) _________________________________

Oil ________________________ Bbls. per _______________ Hrs.

Gas ________________________ M.C.F. per ____________ Hrs.

Salt Water ___________________ Bbls. per _____________ Hrs.

Oil ______________________________ Estimated Bbls. per Day

Salt Water ________________________ Estimated Bbls. per Day

Gas ___________________________ Estimated M.C.F. per Day

Choke Size: ______________________ Type: _______________

If pumping, Strokes/Min.: _________________________________

Gas Oil Ratio: _________________________________________

Tubing Pressure: _______________________________________

Casing Pressure: _______________________________________

Volume or Percent B. S. & W.: ____________________________

Corrected Gravity: ______________ A.P. I. __________________

Amount of Oil Produced Prior to Test: ______________________

BHSI Pressure: ________________________________________

Gauged By: ______________________________________________________________________________________________________

(Name) (Title)

Witnessed By: ____________________________________________________________________________________________________

(Name) (Title)



### [Type here]===========================================================================================================================================

OPERATOR’S STATEMENT

State: _________________________________

County: ________________________________

I, _____________________________________________________, am the ___________________________________________________

(Name) (Title)

of ________________________________________________________ and attest that all information contained herein is true and correct.

(Name of Company)

Date: ___________________________________________________

Signature: ________________________________________________

DEP No. 51-005(16)