Form BSEE-0144 Rig Movement Nofication Report

U. S. Department of the Interior Bureau of Safety and Environmental Enforcement (BSEE)

OMB Control Number 1014-0018 OMB Approval Expires: 10/31/2014

RIG MOVEMENT NOTIFICATION REPORT

Use this form to report the movement (including skids, stacking, and moving in or out of the Gulf of Mexico OCS) of all drilling rigs, workover rigs, and coiled tubing and snubbing units. If the rig is moving from one location to another, you may show this by completing the information for both rig departure and rig arrival on the same form. It is preferred by BSEE that the report information be submitted utilizing the BSEE eWell web based system at http://ewell.gomr.BSEE.gov; or you have the option to e-mail or telefax (see page 2 for contact information) to the appropriate BSEE District Office(s) at least 24 hours before you move the rig.

GENERAL INFORMATION

Report Date

Lease Operator

Rig Name

Rig Type: BR ___ CT ___ DS ___ JU ___ PF ___ SN ___ SS ___ SU ___

Rig Representative

Rig Telephone Number

RIG ARRIVAL INFORMATION

Rig Arrival Date

Work Scheduled: Drilling ___ Workover ___ Completion ___ TA ___ PA ___ Other (specify) _________________________________________

Well API Number (10 digits)

Well Name

Expected Duration of Well Operations

Well Surface Location Information

Lease No.

Area Name

Block No.

Latitude (Optional)

Longitude(Optional)

Structure Location Information(Optional)

Is Well Adjacent to Structure? Yes ___ No ___

If Yes, Identify Structure

Distance from Structure

Remarks (Include size and extent of the mooring system and number of lighted and unlighted buoys deployed.) (Optional)

RIG DEPARTURE INFORMATION

Rig Departure Date

Well Status: Completed ___ DSI ___ TA ___ PA ___

Well API Number (10 digits)

Well Name

Is Rig Being Skidded on the Platform? Yes ___ No ___

Well Surface Location Information

Lease No.

Area Name

Block No.

Latitude(Optional)

Longitude(Optional)

Area Clearance Information(Optional)

Is Area Clear of Obstructions? Yes___ No ___

If No, Explain

Remarks (Include any significant en route movements.) (Optional)

BSEE FORM BSEE-0144 (March 2012 – Supersedes all previous versions of this form which may not be used). Page 1 of 2

BSEE OCS CONTACT INFORMATION
District/Subdistrict	Telephone	Telefax	E-mail Address
New Orleans District	(504) 734-6740	(504) 734-6741	[email protected]
Houma District	(985) 853-5884	(985) 879-2738	[email protected]
Lafayette District	(337) 289-5100	(337) 354-0008	[email protected]
Lake Charles District	(337) 480-4600	(337) 562-2955	[email protected]
Lake Jackson District	(979) 238-8121	(979) 238-8122	[email protected]

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, sidetracking, completing, reworking, recompleting, and abandoning wells. BSEE uses the information to schedule inspections and verify that equipment and/or procedures are adequate to perform the proposed operations safely. 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 reviewing the instructions, completing and filling out this form is estimated to average 12 minutes per response. Direct comments regarding the burden estimate or any other aspect of this form to the Information Collection Clearance Officer, Bureau of Safety and Environmental Enforcement, 381 Elden Street, Herndon, VA 20170.

BSEE FORM BSEE-0144 (March 2012 – Supersedes all previous versions of this form which may not be used). Page 2 of 2