NATURAL LIFT SYSTEMS DATA FORM
DATE:
March 09, 2010
COMPANY:
ADDRESS:
PHONE:
LEASE:
COMPLETION DATE:
TYPE OF FORMATION:
TD:
CASING:
WEIGHT:
TYPE OF WELLHEAD:
PRESENT PRODUCTION:
BOPD:
GRAVITY:
BOWD:
GRAVITY:
GAS:
LINE PRESSURE:
WELL CONDITIONS:
SAND?
H2S?
CO2?
PARAFFIN?
ANY CASING OBSTRUCTIONS?
SEPARATIONS?
ANY & ALL PERFORATION DEPTHS?
EXPLAIN:
CHEMICAL TREATMENTS:
SHUT IN
3HRS.
6HRS.
12HRS.
24HRS.
B.H.P.?
HAS WELL GOT A SEPARATOR?
CURRENT
PUMPING CYCLE:
LAST 3 MONTH PRODUCTION RECORDS (please attach):
VERIFICATION
OF DATA BY:
COMPANY REP:
TITLE:
E-MAIL:
PHONE:
wade@naturalliftsystems.com
