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SU0000087 SSC RPT
Environmental Health - Public
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SU0000087 SSC RPT
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Last modified
11/21/2019 10:20:56 AM
Creation date
11/21/2019 9:48:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSC RPT
RECORD_ID
SU0000087
PE
2622
FACILITY_NAME
MS-99-09
STREET_NUMBER
1120
Direction
W
STREET_NAME
FOREST LAKE
City
ACAMPO
ENTERED_DATE
8/8/2001 12:00:00 AM
SITE_LOCATION
1120 W FOREST LAKE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\gmartinez
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EHD - Public
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SUBMIT IN DUPLICrATE �i rw l N Or OIL ANO GAS <br /> RESOURCES AGENCY OF CALIFORNIA ti Ci I V F' 0 <br /> DEPARTMENT OF CONSERVATION <br /> DIVISION OF OIL AND GAS NOV 1 71986 <br /> History of Oil or Gas Well WOOC'LAND• <br /> Operator....4UINTANA. PETROLEUM .CORPORAT.IQJ......... . Field or County ........San..Joaq.uia..C.o.unt.y............. <br /> Weil .........BROVELLI 1..8..... ........................ ........... ............ . Sec.. .$...., T ..4N...., R ..G .... ,. ..D.B. & M. <br /> A.P.I. No..P77-.20487.......,....... . Name...... M.-...WzIIiams.................. Title .P.r.odu.c.t.ion..T.e.ch... <br /> Date ...... .NQV�mF ?r..1.3....... 10.6... (Person suomnung repos) (President.Secretary or Agent) <br /> Signature ..... <br /> 10,50.......17th. S,tree.t.a...S.....t.e...4..0.0.,..D.env.er.,...C.o.lo.ra..d.o.....8.0.2.65.... ........ ......(303.)628-92.1.1. ..... <br /> (Address) (Trlepnunc Numner) <br /> History must be complete in all detail. Use this form to report all operations dining drilling and testing of the well or durin.q redrilling <br /> or altering the casing,plugging,or abandonment with the dates thereof. Include such items as hole size,formation test details, :)mounts <br /> of cement used, top and bottom of plugs, perforation details, sidetracked junk, bailing tests and initial production data. <br /> Dace <br /> Please see attached detail sheets <br /> t, <br />
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