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U.S. Department of the Interior | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9 | Unnamed: 10 | Unnamed: 11 | Unnamed: 12 | Unnamed: 13 | Unnamed: 14 | Unnamed: 15 | Submit original plus THREE copies, | Unnamed: 17 | Unnamed: 18 | Unnamed: 19 | Unnamed: 20 | Unnamed: 21 | Unnamed: 22 | Unnamed: 23 | Unnamed: 24 | Unnamed: 25 | Unnamed: 26 | Unnamed: 27 | Unnamed: 28 | Unnamed: 29 | OMB Control No. 1010-0141
Bureau of Ocean Energy Management, |  |  |  |  |  |  |  |  |  |  |  |  |  |  | with ONE copy marked "Public Information." |  |  |  |  |  |  |  |  |  |  |  |  |  |  | OMB Approval Expires XX/XX/XXXX
Regulation and Enforcement (BOEMRE)
END OF OPERATIONS REPORT (EOR)
1. |  |  | COMPLETION |  |  |  |  |  |  | ABANDONMENT |  |  |  |  |  |  | 2.  BOEMRE OPERATOR NO. |  |  |  |  |  |  |  |  | 3.  OPERATOR NAME and ADDRESS
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | (Submitting office)
 |  |  | [NAME]
4. WELL [NAME] (CURRENT) |  |  |  |  |  |  |  | 5.  SIDETRACK NO. (CURRENT) |  |  |  |  |  |  |  |  | 6.  BYPASS NO. (CURRENT)
7. API WELL NO. (CURRENT SIDETRACK / BYPASS) (12 DIGITS) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 8.  PRODUCING INTERVAL CODE
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | WELL AT TOTAL DEPTH
9. LEASE NO. |  |  |  |  | 10. AREA NAME |  |  |  |  |  | 11. BLOCK NO. |  |  |  |  | 12. LATITUDE |  |  |  |  |  |  |  |  |  |  | 13. LONGITUDE
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | NAD 27 (GOM & Pacific) |  |  |  |  |  |  |  |  |  |  | NAD 27 (GOM & Pacific)
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | NAD 83 (Alaska) |  |  |  |  |  |  |  |  |  |  | NAD 83 (Alaska)
WELL STATUS INFORMATION
14. Well Status |  |  |  |  | 15. Type Code |  |  |  |  |  | 16. Well Status Date |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 17 
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | MD ________  TVD ________ Total Depth ________
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | WELL AT PRODUCING ZONE
18. LEASE NO. |  |  |  |  | 19. AREA NAME |  |  |  |  |  | 20. BLOCK NO. |  |  |  |  | 21. LATITUDE |  |  |  |  |  |  |  |  |  |  | 22 LONGITUDE
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | NAD 27 (GOM & Pacific) |  |  |  |  |  |  |  |  |  |  | NAD 27 (GOM & Pacific)
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | NAD 83 (Alaska) |  |  |  |  |  |  |  |  |  |  | NAD 83 (Alaska)
23.COMPLETION DATE:                              24.DATE OF FIRST PRODUCTION:                                    25. ISOLATED DATE:
PERFORATED INTERVAL(S) THIS COMPLETION
26.TOP (MD): |  |  |  |  |  |  |  |  |  | 27. BOTTOM (MD) |  |  |  |  |  |  |  |  | 28. TOP (TVD) |  |  |  |  |  |  |  |  | 29. BOTTOM (TVD):
30. [NAME]): |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 31. NAME(S) OF PRODUCING FORMATION(S) THIS COMPLETION
HYDROCARBON BEARING INTERVALS
32. INTERVAL NAME: |  |  |  |  |  |  |  |  |  |  |  |  |  | 33. TOP (MD) |  |  |  |  | 34. BOTTOM (MD) |  |  |  |  | 35. TYPE OF HYDROCARBON
SIGNIFICANT MARKERS Penetrated (account for all markers identified on APD)
36. INTERVAL NAME: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 37. TOP (MD) |  |  |  |  | 38. REASON IF MARKER NOT PENETRATED
SUBSEA COMPLETION
39. SUBSEA COMPLETION? |  |  |  |  |  |  |  |  | 40.  IF YES:  PROTECTION PROVIDED? |  |  |  |  |  |  |  |  |  |  |  | 41.  BUOY INSTALLED? |  |  |  |  |  |  |  |  | 42.  TREE HEIGHT ABOVE ML(ft):
Yes/No |  |  |  |  |  |  |  |  | Yes/No |  |  |  |  |  |  |  |  |  |  |  | Yes/No
BOEMRE  Form 0125 (Mo/Year - Supersedes all previous versions of this form which may not be used.)                  Page 1 of 3