Oil, Gas, and Minerals Division - Mineral Well Forms Page
Contact: Oil, Gas, and Minerals Division 517-284-6826Download all Mineral Well Forms in zipped file (approximately 1,004 Kb).
Forms on this page are in Microsoft Word format.
(Adobe format forms are available upon request)
Items on this page:
Forms used for Permits and Bonding (PBU)
Forms used for Drilling and Completion (PMGU)
Forms used for Production and Operating (PMGU)
Forms Used by District Office (District and Area Geologists Map)
Forms Used for Permits and Bonding
Permit Applications may be submitted by mail to:
Michigan Department of Environment, Great Lakes, and Energy
Oil, Gas, and Minerals Division
P.O. Box 30256 Lansing, Michigan 48909-7756
or by email to: EGLE-OGMDpermitapplications@michigan.gov
Contact: 517-284-6826
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FORM NAME |
FORM NUMBER |
ORIGINATOR |
WHEN TO FILE |
WHERE TO FILE |
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*Application for Permit to Drill/Deepen/Convert, and Operate a Well Forms marked w/ * are attached as part of a complete application to drill |
EQP 7200-1 |
Permit Applicant |
Application |
PBU |
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*Survey Record of Well Location |
Permit Applicant |
w/ Application for Permit to Drill |
PBU |
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*Wellhead Blowout Control System |
Permit Applicant |
w/ Application for Permit to Drill |
PBU |
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*Injection Well Data & Attachments |
Permit Applicant |
w/ Application for Permit to Drill Injection Well or ACOWS |
PBU |
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*Soil Erosion & Sedimentation Control Plan & attachments |
Permit Applicant |
w/ Application for Permit to Drill |
PBU |
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*Environmental Impact Assessment for Mineral Wells and Surface Facilities |
Permit Applicant |
w/ Application for Permit to Drill |
PBU |
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Bond for Conformance |
Permit Applicant |
If for a single well: w/Application for Permit to Drill or Request for Transfer Blanket bond docs already on file at OGMD do not need to be copied for new applications |
PBU |
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CD |
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check |
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IRS form W-9 Request for Taxpayer Identification Number and Certification |
Form W-9 |
Permit Applicant |
w/CD bond |
Budget Unit |
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Acceptance of CD as Performance Bond |
EQP 7200-15MW (single) EQP 7200-16 MW (blanket) |
Permit Applicant |
w/CD bond |
PBU |
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Well Permittee Organization Report |
Permit Applicant |
As requested by PB Unit: usually w/App or Request for Transfer |
PBU |
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Request for Transfer of Permit |
Permittee |
At change of owner or operator |
PBU |
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COMPLETION AND DRILLING FORMS |
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FORM NAME |
FORM NUMBER |
ORIGINATOR |
WHEN TO FILE |
WHERE TO FILE |
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Record of Well Drilling or Deepening |
Permittee |
Within 60 days of drilling completion |
PMGU |
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Well Elevations |
No form. |
Permittee |
Within 60 days of drilling completion |
PMGU |
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Electric or Radiation Logs |
No form. |
Permittee |
30 days after running log(s) |
PMGU |
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Survey of Directionally Drilled Well |
No form. |
Permittee |
30 days after drilling completion Note: a well may not be produced until survey is filed |
PMGU |
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Water Well Record for Oil, Gas, or Mineral Well Operations |
Permittee |
30 days after water well completion |
PMGU |
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Certification of Casing and Sealing of Surface Hole |
Permittee |
30 days after drilling completion |
PMGU |
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Mud Pit Plot |
Permittee |
60 days after drilling completion |
DO |
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Record of Well Completion |
Permittee |
Within 60 days of drilling completion |
PMGU |
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Core descriptions |
No form. |
Permittee |
Within 60 days of drilling completion |
PMGU |
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Application to Change Well Status and/or Plug and Abandon |
Permittee |
Before start of operation |
DO |
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Record of Well Plugging or Change of Well Status |
Permittee |
30 days after Change/Plugging |
DO |
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Water Well Plugging Record for Oil, Gas, or Mineral Well Operations |
EQP 7200-20 | Permittee | 30 days after water well plugging | PMGU | ||||
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Annual Certification for Blowout Preventers, Accumulators, Pumps and Secondary Systems |
Drilling Contractor |
Annually or when BOP is modified |
PBU |
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PRODUCTION AND OPERATING FORMS |
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FORM NAME |
FORM NUMBER |
ORIGINATOR |
WHEN TO FILE |
WHERE TO FILE |
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Bottom Hole Pressure Test |
Permittee |
After completion and as requested |
PMGU |
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Monthly Operating Report - Deep Well Injection |
Permittee |
Monthly |
PMGU |
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Annual Mineral Well Regulatory Fee Assessment Report |
Permittee |
Annually |
PMGU |
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Liquid and Gas Analysis |
--- |
Permittee |
After completion and as requested |
PMGU |
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Annular Pressure Test |
Permittee |
per R299.2391 and R299.2393 |
PMGU |
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