43 CFR Part 3170 - PART 3170—ONSHORE OIL AND GAS PRODUCTION

Authority:
25 U.S.C. 396d and 2107; 30 U.S.C. 189, 306, 359, and 1751; and 43 U.S.C. 1732(b), 1733, and 1740.
Source:
81 FR 81421, Nov. 17, 2016, unless otherwise noted.
(Not to be used in place of Application for Permit to Drill or Reenter Form 3160–3)
1. Oil Well
Gas Well
Other (Specify)
2. Name, Address, and Telephone of Operator
3. Name and Telephone of Specific Contact Person
4. Surface Location of Well
Attach:
(a) Sketch showing road entry onto pad, pad dimensions, and reserve pit
(b) Topographical or other acceptable map (e.g., a USGS 7– 1/2″ Quadrangle) showing location, access road, and lease boundaries
5. Lease Number
6. If Indian, Allottee or Tribe Name
7. Unit Agreement Name
8. Well Name and Number
9. American Petroleum Institute (API) Well Number (if available)
10. Field Name or Wildcat
11. Section, Township, Range, Meridian; or Block and Survey; or Area
12. County, Parish, or Borough
13. State
14. Name and Depth of Formation Objective(s)
15. Estimated Well Depth
16. For directional or horizontal wells, anticipated bottom-hole location.
17. Additional Information (as appropriate; include surface owner's name, address and, if known, telephone).
18. Signed
Title
Date

Note: When the Bureau of Land Management or the Forest Service, as appropriate, receives this Notice, the agency will schedule the date of the onsite inspection. You must stake the location and flag the access road before the onsite inspection. Operators should consider the following before the onsite inspection and incorporate these considerations into the Notice of Staking Option, as appropriate:

(a) H2S Potential;
(b) Cultural Resources (Archeology); and
(c) Federal Right-of-Way or Special Use Permit.