Form BSEE-0126 "Well Potential Test Report (Wpt)"

What Is Form BSEE-0126?

This is a legal form that was released by the U.S. Department of the Interior - Bureau of Safety and Environmental Enforcement on January 1, 2019 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2019;
  • The latest available edition released by the U.S. Department of the Interior - Bureau of Safety and Environmental Enforcement;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form BSEE-0126 by clicking the link below or browse more documents and templates provided by the U.S. Department of the Interior - Bureau of Safety and Environmental Enforcement.

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Download Form BSEE-0126 "Well Potential Test Report (Wpt)"

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U.S. Department of the Interior
Submit original plus two copies,
OMB Control Number 1014-0019
OMB Expiration 01/31/2023
Bureau of Safety and Environmental
with one copy marked “Public Information.”
Enforcement (BSEE)
WELL POTENTIAL TEST REPORT (WPT)
1.
11. OPERATOR NAME and ADDRESS
4. LEASE NO.
3. WELL NO.
2. API NO.
(with Completion
ORIGINAL
(Submitting Office)
Code)
CORRECTION
8. FIELD NAME
5. AREA
6. BLOCK NO.
50. RESERVOIR NAME
NAME
88. TYPE OF REQUEST
89. ATTACHMENTS PER
7. OPD NO.
10. BSEE OPERATOR NO. 43. DATE OF FIRST PRODUCTION
§§ 250.1151(a) and 250.1167
INITIAL
RECOMPLETION
LOG SECTION
REWORK
RESERVOIR
9. UNIT NO.
90. RESERVOIR CLASSIFICATION
RECLASSIFICATION
STRUCTURE MAP
SENSITIVE
NONSENSIITIVE
REESTABLISH
OTHER ____________
WELL TEST
92. DATE of TEST
93. PRODUCTION METHOD 94. TYPE OF WELL
95. HOURS TESTED
96. CHOKE SIZE
97. PRETEST TIME
(Test)
OIL
GAS
98. CHOKE SIZE
99. SHUT-IN WELLHEAD PRESSURE
100. FLOWING TUBING PRESSURE
101. STATIC BHP
(Omit on Public Info.Copy)
(Gas wells only)
(Pretest)
102. LINE PRESSURE
103. TOP PERFORATED INTERVAL (md)
104. BOTTOM PERFORATED INTERVAL (md)
(Gas wells only)
TEST PRODUCTION - 24 HOUR RATES
O
O
105. OIL (BOPD)
106. GAS (MCFPD)
107. WATER (BWPD)
109. SP GR GAS @ 14.73 PSI & 60
F
108. API @ 14.73 PSI & 60
F
115. OTHER ACTIVE COMPLETIONS IN RESERVOIR
(Continue in Remarks or attach an additional sheet if necessary.)
LEASE NO.
WELL NAME
API WELL NO.
LEASE NO.
WELL NAME
API WELL NO.
1.
5.
2.
6
3.
7.
4.
8.
91. REQUESTED MAXIMUM PRODUCTION RATE (MPR)
(Required only for Pacific and Alaska OCS Regions.)
26. CONTACT NAME
27. CONTACT TELEPHONE NO.
32. CONTACT E-MAIL ADDRESS
28. AUTHORIZING OFFICIAL
(Type or print name)
29. TITLE
30. AUTHORIZING SIGNATURE
31. DATE
THIS SPACE FOR BSEE USE ONLY
REQUESTED MPR
ACCEPTED
REJECTED
(Pacific and Alaska OCS Regions)
BSEE AUTHORIZING OFFICIAL
EFFECTIVE DATE
BSEE
Page 1 of 2
FORM BSEE-0126
(January/2019 - Replaces all previous editions of this form which may not be used.)
U.S. Department of the Interior
Submit original plus two copies,
OMB Control Number 1014-0019
OMB Expiration 01/31/2023
Bureau of Safety and Environmental
with one copy marked “Public Information.”
Enforcement (BSEE)
WELL POTENTIAL TEST REPORT (WPT)
1.
11. OPERATOR NAME and ADDRESS
4. LEASE NO.
3. WELL NO.
2. API NO.
(with Completion
ORIGINAL
(Submitting Office)
Code)
CORRECTION
8. FIELD NAME
5. AREA
6. BLOCK NO.
50. RESERVOIR NAME
NAME
88. TYPE OF REQUEST
89. ATTACHMENTS PER
7. OPD NO.
10. BSEE OPERATOR NO. 43. DATE OF FIRST PRODUCTION
§§ 250.1151(a) and 250.1167
INITIAL
RECOMPLETION
LOG SECTION
REWORK
RESERVOIR
9. UNIT NO.
90. RESERVOIR CLASSIFICATION
RECLASSIFICATION
STRUCTURE MAP
SENSITIVE
NONSENSIITIVE
REESTABLISH
OTHER ____________
WELL TEST
92. DATE of TEST
93. PRODUCTION METHOD 94. TYPE OF WELL
95. HOURS TESTED
96. CHOKE SIZE
97. PRETEST TIME
(Test)
OIL
GAS
98. CHOKE SIZE
99. SHUT-IN WELLHEAD PRESSURE
100. FLOWING TUBING PRESSURE
101. STATIC BHP
(Omit on Public Info.Copy)
(Gas wells only)
(Pretest)
102. LINE PRESSURE
103. TOP PERFORATED INTERVAL (md)
104. BOTTOM PERFORATED INTERVAL (md)
(Gas wells only)
TEST PRODUCTION - 24 HOUR RATES
O
O
105. OIL (BOPD)
106. GAS (MCFPD)
107. WATER (BWPD)
109. SP GR GAS @ 14.73 PSI & 60
F
108. API @ 14.73 PSI & 60
F
115. OTHER ACTIVE COMPLETIONS IN RESERVOIR
(Continue in Remarks or attach an additional sheet if necessary.)
LEASE NO.
WELL NAME
API WELL NO.
LEASE NO.
WELL NAME
API WELL NO.
1.
5.
2.
6
3.
7.
4.
8.
91. REQUESTED MAXIMUM PRODUCTION RATE (MPR)
(Required only for Pacific and Alaska OCS Regions.)
26. CONTACT NAME
27. CONTACT TELEPHONE NO.
32. CONTACT E-MAIL ADDRESS
28. AUTHORIZING OFFICIAL
(Type or print name)
29. TITLE
30. AUTHORIZING SIGNATURE
31. DATE
THIS SPACE FOR BSEE USE ONLY
REQUESTED MPR
ACCEPTED
REJECTED
(Pacific and Alaska OCS Regions)
BSEE AUTHORIZING OFFICIAL
EFFECTIVE DATE
BSEE
Page 1 of 2
FORM BSEE-0126
(January/2019 - Replaces all previous editions of this form which may not be used.)
WELL POTENTIAL TEST REPORT (WPT)
116. REMARKS
CERTIFICATION: I certify that the information submitted is complete and accurate to the best of my knowledge. I understand that making a
false statement may subject me to the criminal penalties of 18 U.S.C. 1001.
Name and Title: ________________________________________ Date: ________________________
PAPERWORK REDUCTION ACT STATEMENT: The Paperwork Reduction Act of 1995 (44. U.S.C. 3501 et seq.) requires us to inform you that
this information is collected to implement the various environmental provisions of the OCS Lands Act. We use the information to determine well,
lease, and field producing capability and serves as the basis for approving maximum production rates for certain oil and gas completions.
Responses are mandatory (43 U.S.C. 1334). Proprietary data are covered under 30 CFR 250.197. An agency may not conduct or sponsor, and a
person is not required to respond to, a collection of information unless it displays a currently valid OMB Control Number. Public reporting burden of
this form is estimated to average 3 hours per response, including the time the geologists need to prepare the map, time for reviewing instructions,
gathering and maintaining data, and completing and reviewing the form. Direct comments regarding the burden estimate or any other aspect of the
this form to the Information Collection Clearance Officer, Bureau of Safety and Environmental Enforcement, 381 Elden Street, Herndon, VA 20170.
BSEE
Page 2 of 2
FORM BSEE-0126
(January/2019 - Replaces all previous editions of this form which may not be used.)
Page of 2