Injection Well Operating Report - Michigan



MICHIGAN DEPARTMENT OF ENVIRONMENT, GREAT LAKES, AND ENERGY – OIL, GAS, AND MINERALS DIVISION

Annual Secondary AND ENHANCED Recovery PROJECT Report

This report is required by Rule 612 (R 324.612) of the rules promulgated under Part 615 Supervisor of Wells, Natural Resources and Environmental Protection Act, 1994 PA 451, as amended or by Supervisor of Wells Order. The deadline for filing the report is March 1 of each year for reporting the data from the previous calendar year. A separate report is required for each project.

Note: Additional information is required on the reverse side of this form.

The instructions for filling out this form are on the reverse side.

|Project or unit name |Annual report for calendar year |

|      |      |

|Operator name |Page of |

|      |            |

|Prepared by |Date |

|      |      |

|Tract name and number |Well name and number |Well Permit number|Status at end |Comments |

| | | |of year | |

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Annual Secondary AND ENHANCED Recovery PROJECT Report

|Project or unit name |Annual report for calendar year |

|      |      |

Record the summary of unit injection and production volumes below.

|Summary of Unit Injection |

|Injection fluid |Annual volume injected |Cumulative volume injected |

| | | |

|Fresh water |      Bbl |      Bbl |

| | | |

|Brine |      Bbl |      Bbl |

| | | |

|Natural Gas |      Mcf |      Mcf |

| | | |

|Carbon Dioxide |      Mcf |      Mcf |

|Other (specify) | | |

|      |      |      |

|Other (specify) | | |

| |

|Summary of Unit Production |

|Fluid |Annual volume produced |Cumulative volume produced |

| | | |

|Oil |      Bbl |      Bbl |

| | | |

|Condensate |      Bbl |      Bbl |

| | | |

|Gas |      Mcf |      Mcf |

| | | |

|Water |      Bbl |      Bbl |

|Other (specify) | | |

|      |      |      |

|REMARKS |

|      |

|      |

On side 1, list all wells that are 1: within the unitized or project area; 2: completed in the unitized formation; and 3: were used in unit operations during any part of the year. Group the wells by tract number, then by well name and number. Record comments as needed. Use additional sheets if necessary to list all wells. Record the status for each well as of the end of the calendar year, using the status codes below.

Code Status Code Status

PR producing SI shut in

WIW water injection well GIW gas injection well

BDW brine disposal well into unitized formation TA temporary abandoned well approved by DEQ

PLC plugged to surface during the year Obs observation well

WSW water source well Other Other - specify in comments

Mail original to: Oil, Gas, and Minerals Division, Michigan Department of Environment, Great Lakes, and Energy, P.O. Box 30256, Lansing, MI 48909-7756.

Or submit via email to egle-geologicalrecords@.

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