"Osage Lease Status Report (Unplugged Wells Only)"

Osage Lease Status Report (Unplugged Wells Only) is a 4-page legal document that was released by the U.S. Department of the Interior - Indian Affairs, Osage Agency on June 1, 2015 and used nation-wide.

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REVISED 06-2015
LEASE STATUS REPORT
Reporting Year
_ _ _ _ _
__
(Unplugged Wells Only)
Osage
Agency
PLAT OF _ _ QTRSEC_T_R_
.
LESSEE:_
__ _ _ _ _
__
__ _ _
Pawhuska, Oklahoma 74056
SPOT WELLS AND WELL NUMBERS
ACCURATELY ON PLAT. USE SCALE ANO
SYMBOLS SHOWN BELOW. PLUGGED
WELLS NEED NOT BE SHOWN.
160 ACRES
jH
I
I
l
1
.
I
0 330
1000
2640
1
11
=1000
1
WELL SYMB<l.S TO BE USED O"l PLAT
ABOVE AND IN STATUS CClUMN.
al.
..
...
.
.
...
.....
..
.
..
.
GAS············•·······
i •
~TICN OIL AND GAS
·
• •
·
LOCATOi CR ORLLING • · • •
• •
· •
t&
SWD
· .
...
......•.......
.
TEMP. ABO, CR
SHUT-~·
·
· ·
· ·
· ·
"' •
WA.TERSUPPLY
• • ·
·
·
·
·
· ·
"'Q
WATER I\IJECTlOO·
• ·
·
· •
@
GAS
VQUMN:
I
THcx.JSAr,D_ _
!
M
t
MlLU~
_ _ l MM
0
z
...J
...J
w
s
0
z
a::
<{
WELL
STATUS
USE
SYMBO
L
BARRELS DAILY
NAMES OF
FORMATION
s
PRODUCING
DATE T.A.
OR SHUT-IN
*SEE
BELOW
GAS INCLUDING
CASINGHEAD ESTIMATE IF
NECESSARY
LONGITUDE/LATITU
DE
PRESENT
OIL
PRODUC
T
PRESENT
WATER
PRODUC
T
DAILY
FLOW
DISPOSITIO
N SOLD,
LEASE FUEL,
INJECTED,
FLARED
(Enter salt water disposal
&
injection
on reverse)
*Future plans for T.A. and Shut-in wells on reverse.
I CERTIFY THAT THE FOREGOING REPORT IS TRUE AND CORRECT
SIGNATURE
TITLE
DATE
REVISED 06-2015
LEASE STATUS REPORT
Reporting Year
_ _ _ _ _
__
(Unplugged Wells Only)
Osage
Agency
PLAT OF _ _ QTRSEC_T_R_
.
LESSEE:_
__ _ _ _ _
__
__ _ _
Pawhuska, Oklahoma 74056
SPOT WELLS AND WELL NUMBERS
ACCURATELY ON PLAT. USE SCALE ANO
SYMBOLS SHOWN BELOW. PLUGGED
WELLS NEED NOT BE SHOWN.
160 ACRES
jH
I
I
l
1
.
I
0 330
1000
2640
1
11
=1000
1
WELL SYMB<l.S TO BE USED O"l PLAT
ABOVE AND IN STATUS CClUMN.
al.
..
...
.
.
...
.....
..
.
..
.
GAS············•·······
i •
~TICN OIL AND GAS
·
• •
·
LOCATOi CR ORLLING • · • •
• •
· •
t&
SWD
· .
...
......•.......
.
TEMP. ABO, CR
SHUT-~·
·
· ·
· ·
· ·
"' •
WA.TERSUPPLY
• • ·
·
·
·
·
· ·
"'Q
WATER I\IJECTlOO·
• ·
·
· •
@
GAS
VQUMN:
I
THcx.JSAr,D_ _
!
M
t
MlLU~
_ _ l MM
0
z
...J
...J
w
s
0
z
a::
<{
WELL
STATUS
USE
SYMBO
L
BARRELS DAILY
NAMES OF
FORMATION
s
PRODUCING
DATE T.A.
OR SHUT-IN
*SEE
BELOW
GAS INCLUDING
CASINGHEAD ESTIMATE IF
NECESSARY
LONGITUDE/LATITU
DE
PRESENT
OIL
PRODUC
T
PRESENT
WATER
PRODUC
T
DAILY
FLOW
DISPOSITIO
N SOLD,
LEASE FUEL,
INJECTED,
FLARED
(Enter salt water disposal
&
injection
on reverse)
*Future plans for T.A. and Shut-in wells on reverse.
I CERTIFY THAT THE FOREGOING REPORT IS TRUE AND CORRECT
SIGNATURE
TITLE
DATE
DISPOSAL OR INJECTION WELL INFORMATION
WELL
API
BARRELS DAILY
INJECTION
NAMES OF ZONE (S)
DATET.A.
TUBING
DEPTH
NO.
NO.
WATER INJECTION
PRESSURE
WATER INJECTED
OR SHUT-IN
&PACKER
PACKER
INTO
YES OR NO
SET
REMARKS
GAS WELL INFORMATION
WELL
NO.
API
NO.
CAOF
SITP
FTP
CHOKE
SIZE
PRODUCTION
RATE
PURCHASER
REMARKS
CAOF
............
CALCULATED ABSOLUTE OPEN FLOW
SITP •••••••••..... SHUT-IN TUBING PRESSURE
FTP ••••.........•• FLOWING TUBING PRESSURE
SHUT-IN AND TEMPORARILY ABANDONED WELLS-FUTURE PLANS
WELL
API
WELL
DATET.A.
NO.
NO.
STATUS
REMARKS
DISPOSAL OR INJECTION WELL INFORMATION
WELL
API
BARRELS DAILY
INJECTION
NAMES OF ZONE {SJ
DATET.A.
TUBING
DEPTH
NO.
NO.
WATER INJECTION
PRESSURE
WATER INJECTED
OR SHUT-IN
&
PACKER
PACKER
INTO
YES OR NO
SET
REMARKS
GAS WELL INFORMATION
WELL
API
CAOF
SITP
FTP
CHOKE
PRODUCTION
PURCHASER
NO.
NO.
SIZE
RATE
REMARKS
CAOF ............ CALCULATED ABSOLUTE OPEN FLOW
SITP .............. SHUT-IN TUBING PRESSURE
FTP ............... FLOWING TUBING PRESSURE
SHUT-IN AND TEMPORARIL V ABANDONED WELLS-FUTURE PLANS
WELL
API
WELL
DATET.A.
NO.
NO.
STATUS
REMARKS
DISPOSAL OR INJECTION WELL INFORMATION
EE
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