Email Address: Date:
Company: Phone:
Contact Person: Fax:
Well Name: Legals:
Field: County: State:
Production Well Injection Well Casing Leak
Casing:
Tubing:
Formation: Lithology:
Interval: Open Hole: Perfs:
Other Zones Open:
Temp: Permeability: Porosity:
API Gravity: WOR:
Current Production (BOPD): BWPD:
Completion Date: Initial Production:
Fluid Levels: Static Pumping:
Type of Pumping System:
Productive Zone Thickness:
Date and Amount Last Acid Treatment:
Treatment Objectives:
Post-Treatment Oil Rate:
Post-Treatment Water Rate:
Remarks: