1. FORM 1003/1003C – PLUGGING RECORD

2. FORM 1003/1003C – PLUGGING RECORD
This presentation will assist you in the completion of the Form 1003/1003C. The plugging record.
Date of Last Revision: 2011
Rule Requirement: OAC 165:
Explanation of Form: Operator will file Form 1003, in duplicate, within 30 days after plugging operations are completed. Both copies are to be mailed to the appropriate Conservation Division District Office. Form 1003 shall be completed and signed by employees of both the operator and the cementer. If a depleted producer, list OTC assigned county and lease number. [Reference 165: and 165: ]
Question concerning this Form: Contact your Local District Office

3. FORM 1003/1003C – PLUGGING RECORD
API NUMBER OF THE WELL

4. FORM 1003/1003C – PLUGGING RECORD
OTC (OKLAHOMA TAX COMMISSION) PRODUCTION UNIT NUMBER

5. FORM 1003/1003C – PLUGGING RECORD
PLUGGING DATE

6. FORM 1003/1003C – PLUGGING RECORD
PLOT THE WELL LOCATION ON THE GRID

7. FORM 1003/1003C – PLUGGING RECORD
WELL NAME AND NUMBER

8. FORM 1003/1003C – PLUGGING RECORD
LEGAL LOCATION

9. FORM 1003/1003C – PLUGGING RECORD
FOOTAGES FROM THE SOUTH OF THE ¼ SECTION AND THE FOOTAGES FROM THE WEST OF ¼ SECTION

10. FORM 1003/1003C – PLUGGING RECORD
COUNTY IN WHICH THE WELL EXISTS

11. FORM 1003/1003C – PLUGGING RECORD
TOTAL DEPTH OF THE WELL

12. FORM 1003/1003C – PLUGGING RECORD
BASE OF TREATABLE WATER (IN FEET)

13. FORM 1003/1003C – PLUGGING RECORD
WELL CLASSIFICATION (GAS, OIL, DRY, INJECTION OR SALTWATER DISPOSAL)

14. FORM 1003/1003C – PLUGGING RECORD
OPERATOR OF THE WELL’S NAME AND OPERATOR’S NUMBER

15. FORM 1003/1003C – PLUGGING RECORD
PIPE INFORAMTION – Size of the Pipe, the Footage of Pipe in the Hole, and the Amount of Pipe Pulled (all amounts should be reported in feet)

16. FORM 1003/1003C – PLUGGING RECORD
PERFORATION DEPTHS

17. FORM 1003/1003C – PLUGGING RECORD
TYPE OF PLUG

18. FORM 1003/1003C – PLUGGING RECORD
HOLE SIZE OR PIPE SIZE

19. FORM 1003/1003C – PLUGGING RECORD
DEPTH

20. FORM 1003/1003C – PLUGGING RECORD
NUMBER OF SACKS OF CEMENT

21. FORM 1003/1003C – PLUGGING RECORD
SLURRY VOLUME

22. FORM 1003/1003C – PLUGGING RECORD
CALCULATED TOP OF CEMENT

23. FORM 1003/1003C – PLUGGING RECORD
MEASURED TOP OF PLUG IF TAGGED

24. FORM 1003/1003C – PLUGGING RECORD
REMARKS CONCERNING THE PLUGGING OF THE WELL AND PROVIDE A REASON WHY THE WELL WAS PLUGGED

25. FORM 1003/1003C – PLUGGING RECORD
CEMENTING COMPANY’S NAME, ADDRESS AND PERMIT NUMBER

26. FORM 1003/1003C – PLUGGING RECORD
OPERATOR’S NAME AND SIGNATURE

27. FORM 1003/1003C – PLUGGING RECORD
OCC USE ONLY – Do not write in this space

28. FORM 1003/1003C – PLUGGING RECORD
INSTRUCTIONS TO COMPLETE THE FORM 1003/1003C

29. FORM 1003/1003C – PLUGGING RECORD
ADDRESSES OF THE FOUR LOCAL DISTRICT OFFICES

30. FORM 1003/1003C – PLUGGING RECORD
OCC USE ONLY – Do not write in this space