Form IDLOGD 001.01 Application for Permit to Drill, Deepen, or Plug Back - Idaho

Form IDLOGD001.01 or the "Application For Permit To Drill, Deepen, Or Plug Back" is a form issued by the Idaho Department of Lands.

Download a PDF version of the Form IDLOGD001.01 down below or find it on the Idaho Department of Lands Forms website.

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IDAHO OIL AND GAS CONSERVATION COMMISSION
Application For Permit to Drill, Deepen, or Plug Back
APPLICATION TO:
Drill ($2,000)
Deepen ($500)
Plug Back ($500)
NAME OF OPERATOR:
Date:
Address:
City:
State:
Zip Code:
Telephone:
Contact Name:
Email Address:
Emergency Contact Name/Phone:
DESCRIPTION OF WELL AND LEASE
Name of Lease:
Well Number:
Elevation (ground):
Well Location: Section:
Township:
Range:
(or block and survey)
(Give footage from Section lines):
Latitude/Longitude (Dec Degrees NAD83 minimum requirement):
/
Datum:
WGS84
NAD83
NAD27
Other:
Field and Reservoir (if wildcat, so state):
County:
Distance, in miles, and direction from nearest town or post office:
Nearest distance from proposed location to property or lease line:
feet
Nearest producing well:
feet
Type of Test/Unit:
Gas / 640 acre unit
Gas / 160 acre unit
Oil / 40 acre unit
Other/Docket No.
Is Operator requesting a well location exception?
Yes
No
Confidential Well Status Request?
Yes
No
Distance from proposed location to nearest drilling, completed or applied for on the same lease:
feet
Proposed depth:
Approx. date work will start:
Number of acres in lease(s):
Number of wells on lease, including this well, completed in or drilling to this reservoir:
If lease purchased with one or more wells drilled, complete the following information:
Purchased from (Name):
Address of above:
Bond Type and Number:
Surface Rights Owner
: Name
Phone:
(At proposed surface location)
1
Does the drilling unit contain state leases?
If yes, check all that apply:
IDL
IDFG
IDT
Public Trust
Other:
Does this application include the following actions? If yes, check all that apply:
Well Treatment
Pit construction
Directional or Horizontal Drilling
Applications that include well treatments, pit construction, and directional drilling must provide attachments with the information required
from the respective sections of IDAPA 20.07.02 and Idaho Code § 47-3. If these activities are not included in this application, then a
separate application and approval will be required prior to commencement of any of these activities.
Remarks: (If this is an application to deepen or plug back, briefly describe work to be done, giving present producing zone
and expected new producing zone)
Page 1 of 3
IDLOGD001.01 (06/17)
IDAHO OIL AND GAS CONSERVATION COMMISSION
Application For Permit to Drill, Deepen, or Plug Back
APPLICATION TO:
Drill ($2,000)
Deepen ($500)
Plug Back ($500)
NAME OF OPERATOR:
Date:
Address:
City:
State:
Zip Code:
Telephone:
Contact Name:
Email Address:
Emergency Contact Name/Phone:
DESCRIPTION OF WELL AND LEASE
Name of Lease:
Well Number:
Elevation (ground):
Well Location: Section:
Township:
Range:
(or block and survey)
(Give footage from Section lines):
Latitude/Longitude (Dec Degrees NAD83 minimum requirement):
/
Datum:
WGS84
NAD83
NAD27
Other:
Field and Reservoir (if wildcat, so state):
County:
Distance, in miles, and direction from nearest town or post office:
Nearest distance from proposed location to property or lease line:
feet
Nearest producing well:
feet
Type of Test/Unit:
Gas / 640 acre unit
Gas / 160 acre unit
Oil / 40 acre unit
Other/Docket No.
Is Operator requesting a well location exception?
Yes
No
Confidential Well Status Request?
Yes
No
Distance from proposed location to nearest drilling, completed or applied for on the same lease:
feet
Proposed depth:
Approx. date work will start:
Number of acres in lease(s):
Number of wells on lease, including this well, completed in or drilling to this reservoir:
If lease purchased with one or more wells drilled, complete the following information:
Purchased from (Name):
Address of above:
Bond Type and Number:
Surface Rights Owner
: Name
Phone:
(At proposed surface location)
1
Does the drilling unit contain state leases?
If yes, check all that apply:
IDL
IDFG
IDT
Public Trust
Other:
Does this application include the following actions? If yes, check all that apply:
Well Treatment
Pit construction
Directional or Horizontal Drilling
Applications that include well treatments, pit construction, and directional drilling must provide attachments with the information required
from the respective sections of IDAPA 20.07.02 and Idaho Code § 47-3. If these activities are not included in this application, then a
separate application and approval will be required prior to commencement of any of these activities.
Remarks: (If this is an application to deepen or plug back, briefly describe work to be done, giving present producing zone
and expected new producing zone)
Page 1 of 3
IDLOGD001.01 (06/17)
IDAHO OIL AND GAS CONSERVATION COMMISSION
Application For Permit to Drill, Deepen, or Plug Back
Applicant(s) should be familiar with and adhere to IDAPA 20.07.02, Rules Governing Conservation
of Oil and Natural Gas in the State of Idaho, and Idaho Code § 47-3, Oil and Gas Wells--Geologic
Information and Prevention of Waste.
Please check the boxes below to indicate that you have supplied the required information.
Maps Required
Attach a survey plat or map, preferably on a scale of one (1) inch equals one thousand (1,000) feet, prepared
by a licensed surveyor or engineer.
The plat must show:
Distance of the proposed surface location to the nearest occupied structure and the nearest highway.
The proposed well location. For directional wells, both surface and bottom hole locations should be marked.
The location of the well with reference to the nearest lines of an established public survey.
All leased tracts held by the applicant within the drilling unit. Distances of the proposed well from the two
nearest unit boundary lines, if applicable, and from the nearest oil or gas wells on the same unit. completed
in or being drilled to the same reservoir. If the well location requested is not in conformance with the
applicable well-spacing rules, show all off-setting wells to the proposed well, and the names and addresses
of all adjoining lease or property owners.
The location of the nearest structure with a water supply, or the nearest water well as shown on the IDWR
registry of water rights or well log database. The location of the nearest canal, ditch, or ordinary high-water
mark of surface waters (§47-319(1)).
Other Required Information
Estimated depth to the top of the important geologic markers.
Estimated depth to the top of the target formations.
Information on the type of tools to be used.
Proposed logging program.
Proposed casing program, including size and weight of casing and the depth at which each casing type is to
be set.
Type and amount of cement to be used, and the intervals cemented.
Information on the drilling plan (drill pad and rig set up, etc).
Schematic diagram of the BOP and well head assemblies, including the minimum size and pressure rating of
all components of the BOP and well head assemblies.
Best management practices to be used for erosion and sediment control.
Plan for interim reclamation of the drill site after the well is completed, and a plan for final reclamation of the
drill site following plugging and abandonment of the well. These plans must contain the information needed
to implement reclamation as described in IDAPA 20.07.02 subsection 310.16 and section 510.
CERTIFICATION: I,
the undersigned, state that I am the
of
(company) and that I am authorized by said company to make this
application, and that this application was prepared under my supervision and direction, and that the facts stated herein are
true, correct and complete to the best of my knowledge.
Date:
Signature:
NOTICE: Before submitting this form, be sure that you have given all information requested.
IDL Office Use Only:
Approval Date:
Approved by:
Signature and Title
Operator Number (if known):
US Well Number:
Page 2 of 3
IDLOGD001.01 (06/17)
IDAHO OIL AND GAS CONSERVATION COMMISSION
Application For Permit to Drill, Deepen, or Plug Back
ADDITIONAL INFORMATION
1
State Land Ownership Explanation
IDL
Idaho Department of Lands
IDFG
Idaho Department of Fish and Game
IDT
Idaho Department of Transportation
Public Trust
State owned beds and banks of navigable rivers and lakes
Other
Other state agencies not named above. Includes, but is not limited to; Idaho Department of Parks and
Recreation, Idaho Military Division, etc.
Fees: IDAPA 20.07.02.200.02
An application fee must accompany each application for permit to drill, deepen, or plug back. No service fee is required
for a permit to deepen or plug back in a well for which the fee has been paid for permit to drill unless the drilling permit
has expired.
Permit Denial: IDAPA 20.07.02.200.05
Applications may be denied for the following reasons:
a. Application fee was not submitted.
b. Application is incomplete.
c. Failure to post required bonds.
d. Proposed well will result in a waste of oil or gas, a violation of correlative rights, or the pollution of fresh water
supplies.
Well Completion/Recompletion Report: IDAPA 20.07.02.340
Within thirty (30) days after the completion of a well drilled for oil or gas, or the recompletion of a well into a different
source of supply, or where the producing interval is changed, a completion report shall be filed with the Department, on a
form prescribed by the department.
Log Submittals: IDAPA 20.07.02.341
All wells shall have:
1. A lithologic log from the bottom of the hole to the top, to the extent practicable.
2. A bottomhole location survey log.
3. A cement bond log.
4. If other logs were run, including, but not limited to, resistivity, gamma-neutron log, sonic log, etc., then the
owner or operator shall retain a copy regardless of results.
5. All logs shall be submitted to the Department in paper and digital formats within thirty (30) days of the log being
run. If logs were run in color, then the submitted copies shall also be in color. Digital formats must be Tiff and
LAS 2.0 or higher. Logs submitted to the department must have a scale of one (1) inch for correlation logs and
five (5) inches for detail logs.
Please submit Application to Drill, Deepen, or Plug Back to:
Idaho Department of Lands
Oil and Gas Division
th
300 N. 6
Street, Suite 103
PO Box 83720
Boise, Idaho 83702-0050
Page 3 of 3
IDLOGD001.01 (06/17)

Download Form IDLOGD 001.01 Application for Permit to Drill, Deepen, or Plug Back - Idaho

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