Form IDLOGD 0021.01 Well Completion or Recompletion Report and Well Report - Idaho

Form IDLOGD0021.01 is a Idaho Department of Lands form also known as the "Well Completion Or Recompletion Report And Well Report". The latest edition of the form was released in December 1, 2017 and is available for digital filing.

Download a PDF version of the Form IDLOGD0021.01 down below or find it on Idaho Department of Lands Forms website.

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IDAHO OIL AND GAS CONSERVATION COMMISSION
WELL COMPLETION OR RECOMPLETION REPORT AND WELL REPORT
DESIGNATE TYPE OF COMPLETION:
New Well
Work-Over
Deepen
Plug Back
Same Reservoir
Different Reservoir
Oil
Gas
Dry
Well Name/Number:
US Well Number:
Operator:
Contact Person:
Address:
Field & Reservoir:
County:
:
Location
Date Permit Issued:
(Sec.-TWP-Range or Block & Survey):
Date spudded
Date total depth reached
Date completed, ready to produce
Elevation (DF, RKB, RT, or GR)
Elevation of casing hd. Flange
1
Total depth
Single, dual, or triple completion
If this is a dual or triple completion, furnish separate report for each
P.B.T.D.
completion. Enter NA or Multiple; see separate report:
Producing interval(s) for this completion
Rotary Tools used (interval)
Cable tools used (interval)
Was this well directionally drilled?
Was a directional survey made?
Was a copy of directional survey
Date filed
Yes
No
Yes
No
NA
filed? Yes
No
NA
Type of electrical or other logs run (check logs filed with the commission)
Date filed
1
Plug Back Total Depth
CASING RECORD
Casing (report all strings set in well—conductor, surface, intermediate, producing, etc.)
Purpose
Size Hole Drilled
Size Casing set
Weight (lb./ft.)
Depth set
Sacks Cement
Amount. Pulled
TUBING RECORD
LINER RECORD
Size: (ft)
Tubing Weight:
Depth: (ft)
Packer set at: (ft)
Size: (ft)
Top: (ft)
Bottom: (ft)
Sacks Cement:
Screen: (ft)
PERFORATION RECORD
ACID, SHOT, FRACTURE, CEMENT SQUEEZE RECORD
Number per ft.
Size & Type
Depth Interval
Amount & Kind of Material Used
Depth Interval
Date of First Production:
NOTE: Please attach copies of ALL pressure tests performed including:
multi-point tests, build-up tests, bottom-hole pressure tests, and RFT’s.
Date of Test
Hrs. Tested
Choke Size
Oil Prod. During Test (bbls.)
Gas Prod. During Test (MCF)
Water Prod. During Test (bbls.)
Tubing Pressure (PSI)
Casing Pressure (PSI)
BHP (PSI)
Oil Gravity *API (Corr)
Producing method (indicate if flowing, gas
lift or pumping—if pumping, show size &
type of pump):
Cal’ted Rate per 24 hrs
Oil (bbls.)
Gas (MCF)
Water (bbls.)
Gas—oil ratio
Disposition of gas (state whether vented, used for fuel or sold):
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IDLOGD0021.01 (12/17)
IDAHO OIL AND GAS CONSERVATION COMMISSION
WELL COMPLETION OR RECOMPLETION REPORT AND WELL REPORT
DESIGNATE TYPE OF COMPLETION:
New Well
Work-Over
Deepen
Plug Back
Same Reservoir
Different Reservoir
Oil
Gas
Dry
Well Name/Number:
US Well Number:
Operator:
Contact Person:
Address:
Field & Reservoir:
County:
:
Location
Date Permit Issued:
(Sec.-TWP-Range or Block & Survey):
Date spudded
Date total depth reached
Date completed, ready to produce
Elevation (DF, RKB, RT, or GR)
Elevation of casing hd. Flange
1
Total depth
Single, dual, or triple completion
If this is a dual or triple completion, furnish separate report for each
P.B.T.D.
completion. Enter NA or Multiple; see separate report:
Producing interval(s) for this completion
Rotary Tools used (interval)
Cable tools used (interval)
Was this well directionally drilled?
Was a directional survey made?
Was a copy of directional survey
Date filed
Yes
No
Yes
No
NA
filed? Yes
No
NA
Type of electrical or other logs run (check logs filed with the commission)
Date filed
1
Plug Back Total Depth
CASING RECORD
Casing (report all strings set in well—conductor, surface, intermediate, producing, etc.)
Purpose
Size Hole Drilled
Size Casing set
Weight (lb./ft.)
Depth set
Sacks Cement
Amount. Pulled
TUBING RECORD
LINER RECORD
Size: (ft)
Tubing Weight:
Depth: (ft)
Packer set at: (ft)
Size: (ft)
Top: (ft)
Bottom: (ft)
Sacks Cement:
Screen: (ft)
PERFORATION RECORD
ACID, SHOT, FRACTURE, CEMENT SQUEEZE RECORD
Number per ft.
Size & Type
Depth Interval
Amount & Kind of Material Used
Depth Interval
Date of First Production:
NOTE: Please attach copies of ALL pressure tests performed including:
multi-point tests, build-up tests, bottom-hole pressure tests, and RFT’s.
Date of Test
Hrs. Tested
Choke Size
Oil Prod. During Test (bbls.)
Gas Prod. During Test (MCF)
Water Prod. During Test (bbls.)
Tubing Pressure (PSI)
Casing Pressure (PSI)
BHP (PSI)
Oil Gravity *API (Corr)
Producing method (indicate if flowing, gas
lift or pumping—if pumping, show size &
type of pump):
Cal’ted Rate per 24 hrs
Oil (bbls.)
Gas (MCF)
Water (bbls.)
Gas—oil ratio
Disposition of gas (state whether vented, used for fuel or sold):
Page 1 of 2
IDLOGD0021.01 (12/17)
IDAHO OIL AND GAS CONSERVATION COMMISSION
WELL COMPLETION OR RECOMPLETION REPORT AND WELL REPORT
Well Name/Number:
US Well Number:
Operator:
DETAIL OF FORMATIONS PENETRATED
Formation
Top
Bottom
Description*
*In accordance with IDAPA 20.07.02.10.58, describe the strata, water, oil, or gas encountered. Provide additional information as to give volumes,
pressures, rate of fill-up, water depths, caving strata, etc, as is usually recorded in normal procedure of drilling. Show all important zones of porosity,
lithologic description of all cores, and all drill-stem tests, including depth interval tested, cushion used, time tool open, flowing and shut-in pressures and
recoveries.
INSTRUCTIONS: IF NEEDED, PLEASE ATTACH A SEPARATE DOCUMENT FOR FORMATION DETAIL, IF PAGE TWO DOES NOT PROVIDE
ENOUGH ROOM TO DO SO.
CERTIFICATE: I, the undersigned, state that I am the
of the
(company) and that I am authorized by said company to make this report and that this report 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
This Well Completion or Recompletion Report and Well Report shall be filed with the:
Idaho Department of Lands
Oil and Gas Division
th
300 N. 6
Street, Suite 103
Boise, Idaho, 83702
not later than thirty (30) days after project completion as per Rule 20.07.02.340 and Idaho Code § 47-3.
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IDLOGD0021.01 (12/17)
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