API No.: 42-

11. Purpose of filing

 A. Producers

Initial potential

Retest

Reclass

6. Well Latitude/Longitude (minimum five decimal places required): Latitude/Longitude type: Well record only

 (explain in remarks)

12a. Spud date

 B. Injection/Disposal/

 Recompletion or reclass Multiple completion Storage/Brine Mining

12b. Date of first production after rig released Initial completion

Reclass

Well record only

14. Type(s) of electric or other log(s) run (explain in remarks)

15. Date of test 16. Gas measurement method (check all that apply) 17. Gas production during

 Orifice meter Flange taps Positive choke Pitot tube Other test

 Mass flow meter Pipe taps Orifice vent meter Critical flow prover (explain in remarks) MCF

Temp. Gravity

(Ftf) (Fg

)

1

2

3

4

Was the well preflowed for 48 hours? YES NO

21. Gravity (mixture)

Deg. API CF/Bbl Gmix= °F °F@ (Depth)

Shut-In 3

1 4

2 5

24. Type of completion 25. Permit to Drill, Plug DATE PERMIT NO.

 Back, or Deepen

 New well Deepening Side track Other Rule 37 Exception DATE CASE NO.

 Re-entry Plug back Recompletion (explain in remarks)

26. Number of producing wells on this lease in this field (reservoir) 27. Total number of acres in lease Fluid Injection DATE PERMIT NO.

 including this well Permit F- 

 O&G Waste Disposal DATE PERMIT NO.

28. Date of plug back, Commenced Ended 29. Distance to nearest well in this Permit

 deepening, recompletion, lease & reservoir Other (explain) DATE PERMIT NO.

 or drilling operations

30. Elevation (DF, RKB, RT, GR, etc.) 31. Was directional survey made other than inclination (Form W-12)?

YES NO

34. For new drill or re-entry, surface casing depth determined by:

 TVD MD TVD MD

 GAU Groundwater Protection Depth: 

 Determination Date: 

35. Rotation time within surface casing 36. Is Cementing Affidavit (Form W-15)

 (hours) attached? SWR 13 Exception Depth: 

 YES NO

http://www.rrc.state.tx.us)

Volume

Well No.

RRC Operator No.

Choke Size (in.)

Wellhead Press. 

PW (PSIA)

Wellhead Flow Temp. 

(°F)

18. Gravity (dry gas)

GAS MEASUREMENT DATA

Run 

No. Line Size

Orif. or Choke 

Size (in.)

24 hr. Coeff. Orif. or 

Choke (in.)

Static Pm or 

Choke (in.)

Run 

No.

Time of Run 

(Min.)

19. Gravity (liquid hydrocarbon) 20. Gas-Liquid Hydro Ratio 22.Avg. shut-in temp.

5a. Location (section, block and survey)

Prior Service Type (oil, gas, 

13. If recompletion or reclass, give former field (with reservoir) & Gas ID or Oil Lease No. If multiple 

completion, list all reservoir names (completions in this well) and Gas ID or Oil Lease No.

Field & Reservoir Gas ID or Oil 

Lease No.

Compress

5b. This well is located _____________ miles in a _______________ direction from _______________, which is the nearest town in the county. 

injection/disposal, other)

DATA ON WELL COMPLETION

Diff.

(

h

w)

23. Bottom hole temp.

FIELD DATA AND PRESSURE CALCULATIONS

Run 

No.

Time of Run 

(Min.) Choke Size (in.)

Wellhead Press. 

PW (PSIA)

Wellhead Flow 

Temp. (°F)

Flow Temp.

(°F)

Type or Print Only

(Online filing availabe at 

RAILROAD COMMISSION OF TEXAS

Oil and Gas Division

Form G-1

Rev. 01/2014

(Fpv) (MCF/day)

7. RRC District No.

8. RRC Gas ID No. GAS WELL BACK PRESSURE TEST, COMPLETION OR RECOMPLETION REPORT, AND LOG

3. Operator's Name (exactly as shown on Form P-5, Organization Report)

4. Operator's Address (include street, city, state, zip code)

1. Field Name (as per RRC Records or Wildcat) 2. Lease Name 9. Well No.

10. County

32. Total Depth (ft.) 33. Plug Back Depth (ft.)
API No.: 42-

37.

1

2

3

4

38.

1

2

39. 40.

Does this well currently have tubing set? YES NO

From To

From To

From To

From To

From To

41. Was hydraulic 42. Is well equipped with a downhole 43. Production casing test pressure 44. Actual maximum 45. Has the hydraulic fracturing fluid

fracturing treatment actuation sleeve? YES NO (PSIG) prior to hydraulic fracturing pressure (PSIG) during disclosure been reported to FracFocus

performed? If yes, provide actuation pressure (PSIG) treatment hydraulic fracturing disclosure registry (SWR 29)?

YES NO YES NO

From To

From To

From To

47. Do the producing intervals of this well produce H2S with a 48. Is the completion being down-hole commingled (SWR 10)?

concentration in excess of 100 ppm (SWR 36)? YES NO YES NO

REMARKS:

Form G-1

Slurry Volume 

(cu. ft.) Top of Cement

LINER RECORD

Cement Cement Slurry Volume

ACID, FRACTURE, CEMENT SQUEEZE, CAST IRON BRIDGE PLUG, RETAINER, ETC.

Top of Cement 

Determined By

Type of Operation (indicate acid, fracture, cement squeeze, 

cast iron bridge plug, retainer, etc.)

 PRODUCING/INJECTION/DISPOSAL INTERVAL

Liner Size (in.) Hole Size (in.) Liner Top (ft.) Liner Bottom (ft.) Top of Cement 

Determined by

CASING RECORD

Row

Type of Casing (conductor, surface, 

intermediate, conventional production, 

tapered production or other)

Casing Size (in.) Hole Size (in.) Setting Depth 

(ft.)

Multi-Stage 

Tool Depth (ft.)

Multi-Stage 

Shoe Depth (ft.) Cement Class

Cement 

Amount 

(sacks)

Row Class

Top of

(cu. ft.)

Indicate if formation is a permitted disposal/injection formation, 

productive zone, potential flow zone, and/or a zone with 

TVD MD corrosive formation fluids

Is formation isolated 

in this well? 

(YES/NO) 

(if NO, explain in 

remarks)

TUBING RECORD

Indicate top and bottom measured depths of completion interval(s) or open hole

46. FORMATION RECORD (list depths of principal geological markers and formation tops, including, but not limited to, all permitted disposal/injection formations 

within 1/4-mile of the wellbore, productive zones, potential flow zones, and corrosive formation fluid zones)

Principal Geological Markers and Formation Tops

Depth (ft.)

Amount and Kind of Material Used Depth Interval (ft.)

Size (in.) Depth Set (ft.) Packer Depth/Type

Amount (sacks) Cement

OPERATOR’S CERTIFICATION: I declare under penalties prescribed in Sec. 91.143, Texas Natural Resources Code, that I am authorized to make 

this report, that I prepared or supervised and directed this report, and that data and facts stated therein are true, correct, and complete, to the best of my 

knowledge.

_____________________________________ _________________________________________ Tel:________________________

Signature: Operator’s representative Title Area Code Number

_________________________________________ _______________________________ _____________________________________________

Printed Name Date Email (include email address only if you affirmatively consent to

its public release)