Form Ogb - 3d - Bond For Underground Storage Facility For A Solution-Mined Cavity And Storage Well

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STATE OIL AND GAS BOARD OF ALABAMA
Form OGB - 3D
Surety Bond No.
420 Hackberry Lane
5 / 00
P.O. Box 869999
Tuscaloosa, Alabama 35486-6999
To be filled in by Board
Fax (205)349-2861
(205) 349-2852
Permit number
Bond For Underground Storage Facility For
-
01-
A Solution-mined Cavity and Storage Well
API number
Know All Men By These Presents, That l/we
,
as
principal(s), and
, as surety, are held hereby and firmly bound unto the State of Alabama in the penal
sum of
Thousand Dollars ($
) lawful
money of the United States, for the faithful payment of which we hereby bind ourselves, our heirs, executors, administrators,
successors, and assigns, jointly and severally.
The conditions of this obligation are whereas the above bounden principal(s) proposes(s) to commence operation of an
underground storage facility for a solution-mined cavity and storage well in order to store gas to be known
as the
Underground Storage Facility.
.
Now, therefore, if said underground storage facility for a solution-mined cavity and storage well is operated in compliance with
state law, the rules, regulations and orders of the State Oil and Gas Board; if the above bounden principal(s) shall prevent the
escape of gas out of one stratum to another at such facility, prevent the intrusion of water into any oil or gas stratum from a separate
stratum at such facility, prevent the pollution of all surface and ground water; and if the above bounden principals shall make all
reports required by the Supervisor or Board, including drilling records and all logs of such well and solution-mined cavity, if taken;
conditioned also that such principal(s) shall operate such facility, plug and abandon such well and abandon such cavity and
underground storage facility in compliance with all lawful rules, regulations, and orders of the Board now existing or hereafter
promulgated and with the laws of the State of Alabama now existing or hereafter enacted; then this obligation is void; otherwise the
same shall be and remain in full force and effect.
In Testimony Whereof, Witness Our Hands, this
day of
20
,
Signature
Print or Type Name
Position or Officer
Name and Address of Principal(s)
,
In Testimony Whereof, Witness Our Hands, this
day of
20
Surety Signature
Name and Address of Surety
Signature of Duly Authorized Agent of Said Surety
COUNTERSIGNED:
Name and Address of Agent
Signature of Duly Authorized Resident Alabama Agent
Agent #
Name and Address of Resident Alabama Agent

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