Name

Company

Busniness Phone

Business Cell Phone

Business E-mail

Well Name

Field Name

Formation Name

Well Location

Well API Number

Production Casting

Production Tubing

Flowing Tubing Pressure (psi)

Flowing Casing Pressure (psi)

Shut in Bottom Hole Pressure (psi)

Bottom Hole Temp. at lowest mid Perf (OF)

Well Depth

Liner

Packers

Perforations -Total Interval

If More than one zone, what top and bottom for each

Current Production Method (all that apply);

Specific Gravity:

Daily Average Produced Volumes:

Operating Problems;