"Application for a Well Authorization" - New Brunswick, Canada

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APPLICATION FOR A WELL AUTHORIZATION
Form to be submitted in duplicate at least 14 days prior to the desired spud date and accompanied by the required fee, deposit, agreement with
the owner of the surface rights, and survey plan, to the Director, Minerals and Petroleum Development Branch, Department of Natural
Resources, P.O. Box 6000, Fredericton, New Brunswick, E3B 5H1, or delivered to 1350 Regent St., Fredericton, New Brunswick, E3C 2G6.
The undersigned operator in compliance with the regulations under the Oil and Natural Gas Act applies for a well authorization to drill:
1.
Well name
2.
Location: Unit
Section
Grid Index No.
Elevation: Gr.
K.B.
Grid Latitude
Grid Longitude
Well Latitude
Well Longitude
3.
Applicant’s Name
Address
4.
Expected completion:
in
Oil
Gas
(Formation)
(Depth m)
5.
Expected total depth
Formation at total depth
6.
Title
Title Holder
(Licence / Lease ID)
(Licensee / Lessee)
7.
Surface Rights Owner
Address
8.
Right of Entry
Obtained
Under Negotiation
Pending
9.
Proposed starting date
Proposed spud date
1 / 2
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APPLICATION FOR A WELL AUTHORIZATION
Form to be submitted in duplicate at least 14 days prior to the desired spud date and accompanied by the required fee, deposit, agreement with
the owner of the surface rights, and survey plan, to the Director, Minerals and Petroleum Development Branch, Department of Natural
Resources, P.O. Box 6000, Fredericton, New Brunswick, E3B 5H1, or delivered to 1350 Regent St., Fredericton, New Brunswick, E3C 2G6.
The undersigned operator in compliance with the regulations under the Oil and Natural Gas Act applies for a well authorization to drill:
1.
Well name
2.
Location: Unit
Section
Grid Index No.
Elevation: Gr.
K.B.
Grid Latitude
Grid Longitude
Well Latitude
Well Longitude
3.
Applicant’s Name
Address
4.
Expected completion:
in
Oil
Gas
(Formation)
(Depth m)
5.
Expected total depth
Formation at total depth
6.
Title
Title Holder
(Licence / Lease ID)
(Licensee / Lessee)
7.
Surface Rights Owner
Address
8.
Right of Entry
Obtained
Under Negotiation
Pending
9.
Proposed starting date
Proposed spud date
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10. Proposed casing and cementing program.
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Bit Size
Casing,
Weight
Make
New or Used
Setting Depth
Cement
Program
3
outside diameter
(kg/m)
(m)
(m
)
11.
Control Equipment and Expected Oil, Gas and Water Zones
12.
Drilling Fluid
Sump Construction
(Earth Pit, Tank, Lined Pit, etc.)
13.
Type of Security:
Cash
Bearer Bonds
Term Certificates
Bond
Promissory Note
14.
Drilling Contractor
Address
15.
Rig Name
Rig Licence No.
Rig Size
16.
Remarks
17. Responsible Agent of Applicant:
At well site
At local office
Address
Address
Telephone
Telephone
Dated at
this
day
20
Signed by
Position
Approved subject to conditions specified on the well licence
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