123 Application for Permit to Drill (APD)

U.S. Department of the Interior						OMB Control No. 1010-0141
Minerals Management Service						OMB Approval Expires 8/31/2008
	Supplemental APD Information Sheet (Casing Design)
1) Operator Name:				2) Well Name (Proposed):			ST:	BP:
3) Bottom Hole Lease:				4) Surface Lease:
5) API Number:				6)Type of Well:		Exploratory	Development
7) H2S:		Absent		8) H2S Activation Plan Depth (TVD) (ft):
9) Rig Name:				10) SubSea BOP:			No
11) Water Depth (ft):			12) RKB Height (ft):			13) Mineral Code:
14) Drive Pipe Size (in):			15) Drive Pipe Depth (ft):			16)Anchors	Yes	No
17) Well Design Information
Interval Number:			Type:			Name:
Section Number	Casing Size (in)	Casing Weight (#/ft)	Casing Grade	Burst Rating (psi)		Collapse Rating (psi)	Depth (ft) MD TVD	Pore Pressure (psi)
GENERAL INFORMATION			PREVENTER INFORMATION			TEST INFORMATION
Hole Size (in)			Type			Annular Test (psi)
Mud Weight (ppg)			Size (in)			BOP/Diverter Test (psi)
Mud Type Code			Wellhead Rating (psi)			Mud Test Weight (ppg)
Frac Gradient (ppg)			Annular Rating (psi)			Casing/Liner Test (psi)
Liner Top Depth (ft)			BOP/Diverter Rating (psi)			Formation Test (ppg)
Cement Volume (ft3)
Interval Number:			Type:			Name:
Section Number	Casing Size (in)	Casing Weight (#/ft)	Casing Grade	Burst Rating (psi)		Collapse Rating (psi)	Depth (ft) MD TVD	Pore Pressure (psi)
GENERAL INFORMATION			PREVENTER INFORMATION			TEST INFORMATION
Hole Size (in)			Type			Annular Test (psi)
Mud Weight (ppg)			Size (in)			BOP/Diverter Test (psi)
Mud Type Code			Wellhead Rating (psi)			Mud Test Weight (ppg)
Frac Gradient (ppg)			Annular Rating (psi)			Casing/Liner Test (psi)
Liner Top Depth (ft)			BOP/Diverter Rating (psi)			Formation Test (ppg)
Cement Volume (ft3)
Interval Number:			Type:			Name:
Section Number	Casing Size (in)	Casing Weight (#/ft)	Casing Grade	Burst Rating (psi)		Collapse Rating (psi)	Depth (ft) MD TVD	Pore Pressure (psi)
GENERAL INFORMATION			PREVENTER INFORMATION			TEST INFORMATION
Hole Size (in)			Type			Annular Test (psi)
Mud Weight (ppg)			Size (in)			BOP/Diverter Test (psi)
Mud Type Code			Wellhead Rating (psi)			Mud Test Weight (ppg)
Frac Gradient (ppg)			Annular Rating (psi)			Casing/Liner Test (psi)
Liner Top Depth (ft)			BOP/Diverter Rating (psi)			Formation Test (ppg)
Cement Volume (ft3)
* NOTE*	For additional casing/liner intervals, please submit an additional Form MMS-123S.
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 operation. Responses are mandatory (43 U.S.C. 1334). Proprietary data are covered under 30 CFR 250.196. 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 this form, MMS-123S, is estimated to average between 1-3 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-123S (Oct 2005 - Supersedes all previous versions of form MMS-123S which may not be used.) Page 1 of 1