BSEE-0144 Rig Movement Notification Report

U. S. Department of the Interior BSEE

OMB Control Number 1014-0028 OMB Approval Expires: 07/31/2019

RIG MOVEMENT NOTIFICATION REPORT

Use this form to report the movement (including skids, stacking, and moving in or out of the OCS) of all rig units include MODUs, platform rigs, snubbing units, wire-line units used for non-routine operations, and coiled tubing 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 https://ewell.BSEE.gov; or you have the option to e-mail or telefax (see page 2 for contact information) to the appropriate BSEE Office(s) at least 72 hours before you move the rig.

GENERAL INFORMATION

Report Date

Lease Operator

Rig Name

Rig Type: Barge ___ Coiled Tubing Unit ___ Drill Ship ___ Jackup ___Platform ___ Snubbing Unit ___ Semisubmersible ___ Submersible ___ Wire-Line Unit ___

Rig Representative

Rig Telephone Number

RIG ARRIVAL INFORMATION

Rig Arrival Date

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

Is rig new to OCS? Yes ___ No ___

Location where rig came from: ____________________________________________

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)

FORM BSEE-0144 (07/2019 – Supersedes all previous versions of this form which may not be used). Page 1 of 2

RIG STACKING INFORMATION
Rig Arrival Date				Rig Departure Date
Manned (warm)		Un-manned (cold)		Location:
Any modifications, repairs, or construction: Yes ___ No ___	Date of Modifications, repairs, or construction		Area Name	Block No.	Latitude(Optional)	Longitude(Optional)
Area Clearance Information (Optional)	Is Area Clear of Obstructions? Yes___ No ___			If No, Explain
Remarks (Explain any modifications, repairs, or construction.)

CERTIFICATION: I certify that the information submitted above is complete and accurate to the best of my knowledge. I understand that making a false statement may subject me to criminal penalties under 18 U.S.C. 1001.

Name and Title: ________________________________ Date: ___________________

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]
Alaska OCS Region	(907) 334-5300	(907) 334-5202	[email protected]
Pacific OCS Region	(805) 389-7745	(805) 389-7784	[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 42 minutes per response.  This form has been assigned OMB Control Number 1014-0028. However, this form is also used for activities regulated under 30 CFR 250, subparts D, E, F, P, and Q. 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, 45600 Woodland Road, Sterling, VA 20166.

FORM BSEE-0144 (07/2019 – Supersedes all previous versions of this form which may not be used). Page 2 of 2