REQUIRED DATA FORM – SURFACE Contact Name : Contact Company : Contact Phone: Contact Email : Name of Project: Project Location: Gas Flow Rate: Gas Specific Gravity: Water Flow Rate: Water Specific Gravity: Oil Flow Rate: Oil API: psig Pressure at Tool: Downstream Pressure: psig Dist to Downstream Pressure: ft Temperature at Tool : iF Pipe Size: ID or nom Pipe Length: ft - to first flow upset* Elevation Changes*: ft Paraffin Problems? If yes, freq. of chemical/hot oil treatments/week