STATE OF UTAH

DEPARTMENT OF NATURAL RESOURCES

DIVISION OF OIL, GAS AND MINING

AMENDED REPORT FORM 8

 (highlight changes) 5. LEASE DESIGNATION AND SERIAL NUMBER:

WELL COMPLETION OR RECOMPLETION REPORT AND LOG 6. IF INDIAN, ALLOTTEE OR TRIBE NAME

1a. TYPE OF WELL: OIL

WELL GASWELL DRY OTHER 7. UNIT or CA AGREEMENT NAME

 b. TYPE OF WORK: 8. WELL NAME and NUMBER:

NEW

WELL HORIZ.LATS. DEEPEN REENTRY DIFF.RESVR. OTHER 

2. NAME OF OPERATOR: 9. API NUMBER:

3. ADDRESS OF OPERATOR:

 CITY STATE ZIP

 PHONE NUMBER: 10 FIELD AND POOL, OR WILDCAT

4. LOCATION OF WELL (FOOTAGES)

 AT SURFACE: 

11. QTR/QTR, SECTION, TOWNSHIP, RANGE,

 MERIDIAN:

 AT TOP PRODUCING INTERVAL REPORTED BELOW:

 AT TOTAL DEPTH:

12. COUNTY 13. STATE

 UTAH

14. DATE SPUDDED: 15. DATE T.D. REACHED: 16. DATE COMPLETED: 

 ABANDONED READY TO PRODUCE

 

17. ELEVATIONS (DF, RKB, RT, GL):

18. TOTAL DEPTH: MD

TVD

19. PLUG BACK T.D.: MD

TVD

20. IF MULTIPLE COMPLETIONS, HOW MANY? * 21. DEPTH BRIDGE 

 PLUG SET:

MD

TVD

22. TYPE ELECTRIC AND OTHER MECHANICAL LOGS RUN (Submit copy of each) 23.

WAS WELL CORED? NO YES (Submit analysis)

WAS DST RUN? NO YES (Submit report)

DIRECTIONAL SURVEY? NO YES (Submit copy)

24. CASING AND LINER RECORD (Report all strings set in well)

HOLE SIZE SIZE/GRADE WEIGHT (#/ft.) TOP (MD) BOTTOM (MD) STAGE CEMENTER

DEPTH

CEMENT TYPE &

NO. OF SACKS

SLURRY

VOLUME (BBL) CEMENT TOP ** AMOUNT PULLED

25. TUBING RECORD

SIZE DEPTH SET (MD) PACKER SET (MD) SIZE DEPTH SET (MD) PACKER SET (MD) SIZE DEPTH SET (MD) PACKER SET (MD)

26. PRODUCING INTERVALS 27. PERFORATION RECORD

FORMATION NAME TOP (MD) BOTTOM (MD) TOP (TVD) BOTTOM (TVD) INTERVAL (Top/Bot - MD) SIZE NO. HOLES PERFORATION STATUS

(A) Open Squeezed

(B) Open Squeezed

(C) Open Squeezed

(D) Open Squeezed

28. ACID, FRACTURE, TREATMENT, CEMENT SQUEEZE, ETC.

WAS WELL HYDRAULICALLY FRACTURED? YES NO IF YES -- DATE FRACTURED: ____________________________________

DEPTH INTERVAL AMOUNT AND TYPE OF MATERIAL

29. ENCLOSED ATTACHMENTS:

ELECTRICAL/MECHANICAL LOGS GEOLOGIC REPORT DST REPORT DIRECTIONAL SURVEY

SUNDRY NOTICE FOR PLUGGING AND CEMENT VERIFICATION CORE ANALYSIS OTHER: 

30. WELL STATUS:

(5/2013) (CONTINUED ON BACK)
31. INITIAL PRODUCTION INTERVAL A (As shown in item #26)

DATE FIRST PRODUCED: TEST DATE: HOURS TESTED: TEST PRODUCTION

RATES: !

OIL – BBL: GAS – MCF: WATER – BBL: PROD. METHOD:

CHOKE SIZE: TBG. PRESS. CSG. PRESS. API GRAVITY BTU – GAS GAS/OIL RATIO 24 HR PRODUCTION

RATES: !

OIL – BBL: GAS – MCF: WATER – BBL: INTERVAL STATUS:

INTERVAL B (As shown in item #26)

DATE FIRST PRODUCED: TEST DATE: HOURS TESTED: TEST PRODUCTION

RATES: !

OIL – BBL: GAS – MCF: WATER – BBL: PROD. METHOD:

CHOKE SIZE: TBG. PRESS. CSG. PRESS. API GRAVITY BTU – GAS GAS/OIL RATIO 24 HR PRODUCTION

RATES: !

OIL – BBL: GAS – MCF: WATER – BBL: INTERVAL STATUS:

INTERVAL C (As shown in item #26)

DATE FIRST PRODUCED: TEST DATE: HOURS TESTED: TEST PRODUCTION

RATES: !

OIL – BBL: GAS – MCF: WATER – BBL: PROD. METHOD:

CHOKE SIZE: TBG. PRESS. CSG. PRESS. API GRAVITY BTU – GAS GAS/OIL RATIO 24 HR PRODUCTION

RATES: !

OIL – BBL: GAS – MCF: WATER – BBL: INTERVAL STATUS:

INTERVAL D (As shown in item #26)

DATE FIRST PRODUCED: TEST DATE: HOURS TESTED: TEST PRODUCTION

RATES: !

OIL – BBL: GAS – MCF: WATER – BBL: PROD. METHOD:

CHOKE SIZE: TBG. PRESS. CSG. PRESS. API GRAVITY BTU – GAS GAS/OIL RATIO 24 HR PRODUCTION

RATES: !

OIL – BBL: GAS – MCF: WATER – BBL: INTERVAL STATUS:

32. DISPOSITION OF GAS (Sold, Used for Fuel, Vented, Etc.)

33. SUMMARY OF POROUS ZONES (Include Aquifers):

Show all important zones of porosity and contents thereof: Cored intervals and all drill-stem tests, including depth interval tested,

cushion used, time tool open, flowing and shut-in pressures and recoveries.

34. FORMATION (Log) MARKERS:

Formation Top

(MD)

Bottom

(MD) Descriptions, Contents, etc. Name Top(Measured Depth)

35. ADDITIONAL REMARKS (Include plugging procedure)

36. I hereby certify that the foregoing and attached information is complete and correct as determined from all available records.

 NAME (PLEASE PRINT) TITLE 

 SIGNATURE DATE 

This report must be submitted within 30 days of 

! completing or plugging a new well ! reentering a previously plugged and abandoned well

! drilling horizontal laterals from an existing well bore ! significantly deepening an existing well bore below the previous bottom-hole depth

! recompleting to a different producing formation ! drilling hydrocarbon exploratory holes, such as core samples and stratigraphic tests

* ITEM 20: Show the number of completions if production is measured separately from two or more formations.

** ITEM 24: Cement Top – Show how reported top(s) of cement were determined (circulated (CIR), calculated (CAL), cement bond log (CBL), temperature survey (TS)).

Send to: Utah Division of Oil, Gas and Mining Phone: 801-538-5340

1594 West North Temple, Suite 1210

Box 145801 Fax: 801-359-3940

Salt Lake City, Utah 84114-5801

(5/2013)