Form 3260-4 Geothermal Well Completion Report

UNITED STATES
DEPARTMENT OF THE INTERIOR
BUREAU OF LAND MANAGEMENT

Form 3260-4
(April 2004)

FORM APPROVED
OMB No. 1004-0132
Expires: March 31, 2007

GEOTHERMAL WELL COMPLETION REPORT

4. Lease Serial No.

The Bureau of Land Management (BLM) requires this form or other BLM-approved forms to be prepared and filed in
duplicate with requisite attachments with the authorized officer within 30 days after completion of permitted operations.

5. Surface Manager:
Other

1a. Well Type:

Production
Injection
Cold
Heat Exchange

6. Unit Agreement Name

1b. Completion:

New
Recompleted

Disposal
Other

Water Supply

Workover
Deepened
Drilled & Abandoned
Other

Observation

Plugback

7. Well No.

Redrill

8. Permit No.

10. Sec., T., R., B. & M.

3. Address of Lessee/Operator

11. County

18. Location of Well
At Surface:
At Top of Production Zone:
At Total Depth:
19. Total Depth
Measured:
20. Plugback Total Depth
Measured:

22. Drilling Media:
Air
List Characteristics:

FS

9. Field or Area

2. Name of Lessee/Operator

21. Elevation:
Estimated
Reference Datum: GR

BLM

12. State

13. Spud Date

Date T.D. Reached

14. Completion Date (Ready to produce)
True Vertical:
15. Directionally Drilled Intervals
True Vertical:
Final
MAT
Water

16. Surveyed Intervals
KB

DF
Mud

RT

Foam

Casinghead Flange

Other

Other

17. Core Size and Intervals

23. Log Type & Intervals

Weight

Size

Size

Weight

Size

26. TUBING RECORD
Weight
Grade
Depth Set

Type

Total No.

Grade

24. CASING RECORD
Collars & Threads

Grade

Depths Set
Top
SHoe

25. LINER RECORD
Top
Bottom

Collars & Threads

Cementing Record
(slurry volume)

Perforated Intervals

Cementing Record
(slurry volume)

27. Cement Squeeze, Acid, Fracture, etc. (detail type, amount, intervals)
Packer Depth
28. PERFORATION RECORD
Size

Density (No./ft)

Hole Size

Intervals

29. Attachments & Previous Submittals: List all reports, surveys, tests and logs, not listed in item 23, which have resulted from drilling and completion operations.
List relevant previously furnished data with date of submittal referenced.

30. Well Status:

Producing

Shut-In

31. Do you consider the well to be commercial?

Suspended

Yes

Injection
No

Disposal

Heat Exchange

Abandoned

Water Supply

Explain:

32. I hereby certify the information on this report and the attached information is complete and accurate according to the best of my knowledge.

Signed:
(Continued on page 2)

Title

Date

Other

Test Date

Production Method:

Flowing
Other

Hours Tested
Total Liquids (lb)

Surface Pressure (psig)

Depth

Surface Pressure
Wellhead:
Separator:

33. WELL TEST
Pumping – include size type, intake depth, etc.

34. PRODUCTION
Production During Test
Steam (lb)
35. STATIC TEST DATE
Subsurface Pressure (psig)

Enthalpy (Btu/lb)
Water (lb)

Subsurface Temperature (ºF)

36. FLOWING TEST DATA
Subsurface Pressure Surface Temperature Subsurface Temperature
at top of perfs.
at
feet

37. SUMMARY OF POROUS ZONES. Show all important porous zones and contents of each; cored
intervals with recoveries, drill stem or formation tests with depth of interval tested, time open, cushion
used, and flowing and shut-in pressures, temperatures and recoveries.

Formation

Top

Bottom

Description of Details

Water Analysis
Total Dissolved Solids

pH

Avg. Total Mass Flow Rate Per Hour
Total (lb/hr)
Steam (lb/hr)
Water (lb/hr)

38.

GEOLOGIC MARKERS (TOP)
Name

Measured Depth

True Vertical
Depth

Title 18 U.S.C. Section 1001, makes it a crime for any person knowingly and willfully to make to any department or agency of the United States any false, fictitious or
fraudulent statements or representations as to any matter within its jurisdiction.
(Continued on page 3)

(Form 3260-4, page 2)

GENERAL INSTRUCTIONS
GENERAL: This form is designed for submitting a complete and accurate geothermal well completion report, and should be accompanied by a detailed chronological history
of well operations and final copies of the results of any logs, surveys or tests performed on the well, which have not previously been submitted. The report shall be submitted
within 30 days after the date of completion of continuous well activities, as determined by the authorized officer. The completion date usually is the day the well became
producible, and generally is the date of initialproduction test. The authorized officer may postpone the required report submittal date if adequate justification is presented by the lessee.

SPECIFIC INSTRUCTIONS
Item 18: Show the surface location coordinates from the nearest section corner or tract line. Show production zone and total depth coordinates from the surface location
if the well is directionally drilled.
Item 34: If the well is immediately placed into operation without testing, this section should reflect the first month’s production data.
Items 35 & 36: Indicate the depth(s) of subsurface pressure and temperature measurement, and include the reference datum.

NOTICE
The Paperwork Reduction Act of 1995 requires us to inform you that:
We are collecting this information to evaluate the technical, safety, and environmental
factors involved with geothermal resources on Federal geothermal leases.
We will use this information to analyze operations and to compare equipment and
procedures actually used with proposals that you applied for.
Response to this request is mandatory once you drill a geothermal well.
BLM would like you to know that you do not have to respond to this or any other Federal
agency-sponsored information collection unless it displays a currently valid OMB
control number.

BURDEN HOURS STATEMENT
Public reporting burden for this form is estimated to average 2 to 6 hours per response,
including 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 U.S. Department of the Interior, Bureau of Land
Management, Information (1004-0132), Bureau Information Collection Clearance Officer,
(WO-630), 1849 C Street, Mail Stop 401 LS, N.W., Washington, D.C. 20240.

(Form 3260-4, page 3)