Well Data Form
All fields are required
Subject:
Company Name:
Primary Contact:
Address:
City
Prov./State
Postal/Zip
Country
Phone No.
Mobile No.
Email:
Do you have an immediate application
for QuickSilverUSA ?
Brief description of inquiry:
1. Well #./Name:
2. Field Name:
3. Formation Type & Name:
4. Age of Well:
5. Estimated depth of Paraffin / Asphaltene:
6. Paraffin / Asphaltene in the flow line: Yes
7. Do you pig the flow line: Yes
8. Do you suspect formation plugging or damage due to Paraffin / Asphaltene: Yes
QuickSilverUSA///TM.
WE ARE ALL ABOUT GREEN!!!
9. API gravity of oil:
10. Bottom hole temperature:
11. Bottom hole pressure:
12. Daily oil production bbl/m3:
13. Daily water production bbl/m3:
14. Daily gas production MCF/decs.:
15. Number of perforation zones:
16. Perforation depth from ft/m to ft/m:
17. Well T.D. ft/m:
18. Tubing T.D. ft/m:
19. Casing size = mm/inches:
20. Tubing size = mm/inches:
21. Packer in well: Yes
22. Pumping or flowing well: Pumping Flowing
23. Type of pump used:
24. Oil & water produced up: Casing Tubing
25. Open hole or casing: Open Casing
26. Previous 6 month production history:
27. Drive mechanism:
28. Previous treatments used:
29. Frequency of previous treatments:
30. Relative success of previous treatments:
31. Appx. Cost of previous treatments:
32. Is the well's hydrostatic pressure easily offset to inject treating fluid into the formation: Yes
