Form MMS-133 Well Activity Report

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Overview

MMS-133 pg 1
MMS-133 pg 2
MMS-133 pg 3

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Sheet 1: MMS-133 pg 1

U.S. Department of the Interior

OMB control Number 1010-0141

Minerals Management Service

Submit ORIGINAL

OMB Approval Expires xx/xx/xxxx

WELL ACTIVITY REPORT

BEGINNING DATE:

ENDING DATE:

REPORT IS NOT TO EXCEED 7 DAYS (1 WEEK) IN DURATION

CORRECTION

CHECK IF THIS IS THE LAST WELL ACTIVITY REPORT

GENERAL INFORMATION

1. API WELL NO. (10 digits)

2. OPERATOR NAME

3. WELL NAME

4. SIDETRACK NO.

5. BYPASS NO.

6. CONTACT NAME / CONTACT TELEPHONE NUMBER / CONTACT E-MAIL ADDRESS

7. RIG NAME OR PRIMARY UNIT (e.g., wireline unit, coil tubing unit, etc.)

8. WATER DEPTH (surveyed) (ft)

9. ELEVATION AT KB (Surveyed) (ft)

10. CURRENT WELLBORE INFORMATION

SURFACE

BOTTOM

LEASE NO.

AREA NAME

BLOCK NO.

LEASE NO.

BLOCK NO.

WELLBORE

START DATE

TD DATE

STATUS

END DATE

KOP (MD)

MD

TVD

MW PPG

LAST BOP TEST DATE

LAST BOP TEST PRESSURE

LOW

HIGH

11. WELLBORE HISTORICAL INFORMATION

WELLBORE

BOTTOM LEASE

START DATE

TD DATE

PA DATE

FINAL MD

FINAL TVD

MMS Form MMS-133 (August 2008 - Supersedes all previous versions of form MMS-133 which may not be used.) Page 1 of 3

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Sheet 2: MMS-133 pg 2

WELL ACTIVITY REPORT

12. CASING / LINER / TUBING RECORD

TUBULAR TYPE

HOLE SIZE (IN)

SIZE (IN)

WEIGHT (#/ft)

GRADE

TEST PRESSURE (psi)

SHOE TEST (EMW)

SETTING DEPTH (MD)

CEMENT QUANTITY (cubic ft.)

TOP

BOTTOM

13. WELL ACTIVITY SUMMARY

Provide a daily summary of well activities.

14. Open Hole Log Data

Minerals Management Service's Technical Data Management Section requires an Open Hole Well Report (Form MMS-133S) to accompany this Well Activity Report if any of the below conditions have occurred for this wellbore during this period:

None of the following have occurred:

Any of the above have occurred; if checked then submit Form MMS-133S.

15. Significant Well Events

Please check as many events from the list below:

Kick Occurrence

Well Control Equipment Failure

Shallow Water Flow

H2S Encounter

Weather and Oceanographic Conditions

New Technology Failure

General Rig Equipment Failure

Stuck Pipe

Lost Returns

Wellbore Integrity Failure

Station Keeping Failure

Other

MMS Form MMS-133 (August 2008 - Supersedes all previous versions of form MMS-133 which may not be used.) Page 2 of 3

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Sheet 3: MMS-133 pg 3

WELL ACTIVITY REPORT

Please provide narrative information with regards to any significant events. Provide attachments, if necessary.

MMS:

PAPERWORK REDUCTION ACT OF 1995 (PRA) STATEMENT: The PRA (44 U.S.C. 3501 et seq.) requires us to inform you that we collect this information to obtain knowledge of equipment and procedures to be used in drilling operations. MMS uses the information to evaluate and approve or disapprove the adequacy of the equipment and/or procedures to safely perform the proposed drilling operations. Responses are mandatory (43 U.S.C. 1334). Proprietary data are covered under 30 CFR 250.197. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB Control Number. Public reporting burden for forms MMS-133 and MMS-133S is estimated to average between 0.5 - 3 hours per response, depending on whether it is a paper submittal or electronic submittal. This includes the time for reviewing instructions, gathering and maintaining data, and completing and reviewing the form. Direct comments regarding the burden estimate or any other aspect of this form to the Information Collection Clearance Officer, Mail Stop 4230, Minerals Management Service, 1849 C Street, NW, Washington, DC 20240.

MMS Form MMS-133 (August 2008 - Supersedes all previous versions of form MMS-133 which may not be used.) Page 3 of 3