0123S Supplemental APD Information Sheet

U.S. Department of the Interior						OMB Control No. 1010-0141
Bureau of Ocean Energy Manangement,						OMB Approval Expires XX/XX/XXXX
Regulation and Enforcement (BOEMRE)
	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 (ppg)
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 (ppg)
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 (ppg)
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 0123S.
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. BOEMRE 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 250.197. 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 BOEMRE Forms 0123 and 0123S is estimated to average 100 hours per response. 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 5438, Bureau of Ocean Energy Management, Regulation and Enforcement, 1849 C Street, NW, Washington, DC 20240.
BOEMRE Form 0123S (Mo/Yr-Supersedes all previous versions of this form which may not be used.) Page 1 of 1