Qualify Your Well

Please fill out the form below as completely as possible.

Name First Last
Email
Phone - (###) - ### ####
Do you have oil wells? Yes No
Are you the land owner? Yes No
Are you the mineral rights owner? Yes No
Are your wells currently producing? Yes No
How many barrels are your wells producing per day?
Do you have completion reports? Yes No
Do you have a problem with water? Yes No
Are your wells currently utilizing injection? Yes No
If you are utilizing injection, how many barrels of water are you injecting per day?
Do you have any wells that are currently NOT producing? Yes No
Are your non-producing wells open, capped, or plugged? Open Capped Plugged
What is the depth of your wells? 0 - 400 feet 400 - 800 feet 800 - 1,200 feet Greater then 1,200 feet
Approximate year wells were drilled:
Are your holding tanks accessible by large tanker trucks? Yes No
Approximately how many feet away from your well is power located?
What is the quality of the access roads to your well? Poor Mediocre Excellent
Do you know the type of well formations? Yes No
Do you know the API numbers for each well? Yes No
Do you have the legal description of each well? Yes No
Please list the counties and states where your wells are located:
Please list any other information about your wells: