WR-35 Page ___ of ___

Rev. 8/23/13

State of West Virginia

Department of Environmental Protection - Office of Oil and Gas

Well Operator’s Report of Well Work

API 47 - ________- __________ County _________________________ District ___________________________

Quad ____________________________ Pad Name ________________________ Field/Pool Name __________________

Farm name Well Number __________________________ 

Operator (as registered with the OOG) _________________________________________________________

Address _________________________________ City _________________________ State _____________ Zip _____________

As Drilled location NAD 83/UTM Attach an as-drilled plat, profile view, and deviation survey 

 Top hole Northing _____________________ Easting ________________________________

Landing Point of Curve Northing _____________________ Easting ________________________________

 Bottom Hole Northing ______________________ Easting ________________________________

Elevation (ft) _____________ GL Type of Well □New □ Existing Type of Report □Interim □Final 

Permit Type □ Deviated □ Horizontal □ Horizontal 6A □ Vertical Depth Type □ Deep □ Shallow

Type of Operation □ Convert □ Deepen □ Drill □ Plug Back □ Redrilling □ Rework □ Stimulate 

Well Type □ Brine Disposal □ CBM □ Gas □ Oil □ Secondary Recovery □ Solution Mining □ Storage □ Other __________

Type of Completion □ Single □ Multiple Fluids Produced □ Brine □Gas □ NGL □ Oil □ Other __________ 

Drilled with □ Cable □ Rotary 

Drilling Media Surface hole □ Air □ Mud □Fresh Water Intermediate hole □ Air □ Mud □ Fresh Water □ Brine

Production hole □ Air □ Mud □ Fresh Water □ Brine

Mud Type(s) and Additive(s)

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

Date permit issued ________________ Date drilling commenced Date drilling ceased 

Date completion activities began _______________________ Date completion activities ceased ______________________

Verbal plugging (Y/N) __________ Date permission granted ___________________ Granted by________________________

Please note: Operator is required to submit a plugging application within 5 days of verbal permission to plug

Freshwater depth(s) ft ____________________________ Open mine(s) (Y/N) depths _________________________________

Salt water depth(s) ft ______________________________ Void(s) encountered (Y/N) depths ____________________________

Coal depth(s) ft _________________________________ Cavern(s) encountered (Y/N) depths ___________________________

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

Reviewed by:
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API 47- ____ - _______________ Farm name Well number

CASING Hole Casing New or Grade Basket Did cement circulate (Y/ N)

STRINGS Size Size Depth Used wt/ft Depth(s) * Provide details below* 

Conductor

Surface

Coal

Intermediate 1

Intermediate 2

Intermediate 3

Production

Tubing

Packer type and depth set

Comment Details _____________________________________________________________________________________________________________________

_______________________________________________________________________________________________________________________________________

CEMENT Class/Type Number Slurry Yield Volume Cement WOC

DATA of Cement of Sacks wt (ppg) ( ft 3/sks) (ft 3 ) Top (MD) (hrs)

Conductor

Surface

Coal

Intermediate 1

Intermediate 2

Intermediate 3

Production

Tubing

Drillers TD (ft) ____________________________________ Loggers TD (ft) ___________________________________________

Deepest formation penetrated _________________________ Plug back to (ft) ___________________________________________

Plug back procedure __________________________________________________________________________________________

____________________________________________________________________________________________________________

Kick off depth (ft)_______________________________________

Check all wireline logs run □ caliper □ density □ deviated/directional □ induction 

□ neutron □ resistivity □ gamma ray □ temperature □sonic 

Well cored □ Yes □ No □ Conventional □ Sidewall Were cuttings collected □ Yes □ No 

DESCRIBE THE CENTRALIZER PLACEMENT USED FOR EACH CASING STRING __________________________________________

_______________________________________________________________________________________________________________________________________

_______________________________________________________________________________________________________________________________________

_______________________________________________________________________________________________________________________________________

_______________________________________________________________________________________________________________________________________

WAS WELL COMPLETED AS SHOT HOLE □ Yes □ No DETAILS _________________________________________

____________________________________________________________________________________________________________

WAS WELL COMPLETED OPEN HOLE? □ Yes □ No DETAILS ___________________________________________

____________________________________________________________________________________________________________

WERE TRACERS USED □ Yes □ No TYPE OF TRACER(S) USED ______________________________________________________

_____________________________________________________________________________________________________________________________________
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API 47- ____ - _______________ Farm name Well number

PERFORATION RECORD

Stage Perforated from Perforated to Number of

No. Perforation date MD ft. MD ft. Perforations Formation(s)

Please insert additional pages as applicable.

STIMULATION INFORMATION PER STAGE

Complete a separate record for each stimulation stage. 

Stage Stimulations Ave Pump Ave Treatment Max Breakdown Amount of Amount of Amount of

No. Date Rate (BPM) Pressure (PSI) Pressure (PSI) ISIP (PSI) Proppant (lbs) Water (bbls) Nitrogen/other (units)

Please insert additional pages as applicable.
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API 47- ____ - _______________ Farm name Well number

PRODUCING FORMATION(S) DEPTHS

_____________________________ ______________ TVD _______________ MD

_____________________________ _______________ _______________

_____________________________ _______________ _______________

_____________________________ _______________ _______________

Please insert additional pages as applicable.

GAS TEST □ Build up □ Drawdown □ Open Flow OIL TEST □ Flow □ Pump

SHUT-IN PRESSURE Surface __________psi Bottom Hole__________psi DURATION OF TEST ________ hrs 

OPEN FLOW Gas Oil NGL Water GAS MEASURED BY

mcfpd bpd bpd bpd □ Estimated □ Orifice □ Pilot 

LITHOLOGY/ TOP BOTTOM TOP BOTTOM

FORMATION DEPTH IN FT DEPTH IN FT DEPTH IN FT DEPTH IN FT DESCRIBE ROCK TYPE AND RECORD QUANTITYAND

NAME TVD TVD MD MD TYPE OF FLUID (FRESHWATER, BRINE, OIL, GAS, H2S, ETC)

0 0

Please insert additional pages as applicable.

Drilling Contractor _______________________________________

Address ____________________________________ City ______________________ State _______ Zip _________________

Logging Company _______________________________________

Address ____________________________________ City ______________________ State _______ Zip _________________

Cementing Company _______________________________________

Address ____________________________________ City ______________________ State _______ Zip _________________

Stimulating Company _______________________________________

Address ____________________________________ City ______________________ State _______ Zip _________________

Please insert additional pages as applicable.

Completed by _____________________________________________ Telephone ________________________________

Signature _________________________________ Title _____________________________ Date _______________

Submittal of Hydraulic Fracturing Chemical Disclosure Information Attach copy of FRACFOCUS Registry