Form P&A "Plug and Abandon Report" - Louisiana

What Is Form P&A?

This is a legal form that was released by the Louisiana Department of Natural Resources - a government authority operating within Louisiana. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2013;
  • The latest edition provided by the Louisiana Department of Natural Resources;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form P&A by clicking the link below or browse more documents and templates provided by the Louisiana Department of Natural Resources.

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Download Form P&A "Plug and Abandon Report" - Louisiana

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STATE OF LOUISIANA
OFFICE OF CONSERVATION
PLUG AND ABANDON REPORT
WORK PERMIT No.:
WELL SERIAL NUMBER:
TOTAL DEPTH:
PBTD:
DATE WORK FINISHED:
(Prior to P&A)
DISTRICT
(Submit Original and Two (2) Copies to District Office.)
Field:
FIELD CODE:
Parish:
PARISH CODE:
Operator:
OPER CODE:
Well Name:
WELL No.:
Sec.
Twp.
Rge.
29: DRY HOLE
30: FORMERLY PRODUCTIVE
18: TEMPORARILY ABANDONED
Check Appropriate Box:
(ALL BUT TOP PLUG SET)
Depth Casing Cut Below Mud Line or Land Surface:
Mud Weight Left in Well After Abandonment:
feet
ppg
Setting Depths of Bridge Plugs And/Or Cement Retainers:
Type
Depth
Size
Type
Depth
Size
Was this well a multiple completion?
If so, List Other Well Serial Numbers.
SN's:
CEMENT PLUGS *
Casing
Casing
Pulled
Size
Top of
Bottom of
Slurry
Number of
Casing Size
(feet)
(in. O.D.)
PLACEMENT METHOD
Plug
Plug
Weight
Sacks
(in. O.D.)
(ft.)
(ft.)
(ppg)
* List Casing Size And Plug Depths in Descending Order
STEEL PLATE WAS WELDED ON TOP
Remarks:
This work was done according to the rules and regulations of the Office of Conservation.
Witness
Operator
Representative
FORM P&A
(REV 10/13)
STATE OF LOUISIANA
OFFICE OF CONSERVATION
PLUG AND ABANDON REPORT
WORK PERMIT No.:
WELL SERIAL NUMBER:
TOTAL DEPTH:
PBTD:
DATE WORK FINISHED:
(Prior to P&A)
DISTRICT
(Submit Original and Two (2) Copies to District Office.)
Field:
FIELD CODE:
Parish:
PARISH CODE:
Operator:
OPER CODE:
Well Name:
WELL No.:
Sec.
Twp.
Rge.
29: DRY HOLE
30: FORMERLY PRODUCTIVE
18: TEMPORARILY ABANDONED
Check Appropriate Box:
(ALL BUT TOP PLUG SET)
Depth Casing Cut Below Mud Line or Land Surface:
Mud Weight Left in Well After Abandonment:
feet
ppg
Setting Depths of Bridge Plugs And/Or Cement Retainers:
Type
Depth
Size
Type
Depth
Size
Was this well a multiple completion?
If so, List Other Well Serial Numbers.
SN's:
CEMENT PLUGS *
Casing
Casing
Pulled
Size
Top of
Bottom of
Slurry
Number of
Casing Size
(feet)
(in. O.D.)
PLACEMENT METHOD
Plug
Plug
Weight
Sacks
(in. O.D.)
(ft.)
(ft.)
(ppg)
* List Casing Size And Plug Depths in Descending Order
STEEL PLATE WAS WELDED ON TOP
Remarks:
This work was done according to the rules and regulations of the Office of Conservation.
Witness
Operator
Representative
FORM P&A
(REV 10/13)