Form Wrfo-Mw - Historic Well Pad Component Form

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WRFO-MW
Historic Well Pad Component Form
Rev. 1/10/2013
This form should be completed for each historic well pad. Call OAHP staff (303-866-5216) prior to assigning a resource
number.
I. Resource Identification
1. Resource Number:
2. Temporary Resource Number:
3. Resource Property Name:
II. Geographic Location
4. Location
PM
Township
Range
Section
¼
¼
¼
¼
If section is irregular, explain alignment method:
5. USGS Quad:
6. County
7. UTM Coordinates
Datum Used
NAD 27
NAD 83
WGS 84
Other:
Zone
__
mE
mN
8. UTM Source
Corrected GPS/rectified survey (<5m error)
Uncorrected GPS
Map template
9. Well pad elevation (feet):
III. Resource Description
10. Well Name/ Number:
Abandoned/ capped oil well (“Monument” spire)
11. Well Type:
Modernized historic oil well (New well head)
Shut-in oil well (Large shut-off valve at well head but active)
Oil well converted to water injection (Abandoned)
Oil well converted to water injection (Shut-in)
Reclaimed (No bore hole evident)
Other (Describe below)
Description:
12. Current Operator:
13. Federal or State Lease:
14. Spud Date:
15. Well Bore Completion Date:
16. Component Description:
17. Modifications (describe and include dates):
18. Associated Artifacts:
19. Associated Features or Resources:
IV. Research Information
20. Date of Construction / Date Range:
Source(s) of Information:
21. Original Operator (if different from #7 above):
Source(s) of Information:

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