1-800-625-3791 1733 W Road, Plainville, Kansas 67663 www.polymergel.com

WELL DATA FOR TREATMENT DESIGN

Date   Email
Company   Phone
Contact Person   Fax
WellName   Legals
Field   County State
Treatments Type: Production Well:   Injection Well: Casing Leak:
Casing
Tubing
Formation   Lithology
Interval   Open Hole Perfs
Other Zones Open
Temp     Permeability     Porosity
API Gravity   WOR
Current Production   BOPD    BWPD OR T.F.
Completion Date   Initial Production
Fluid Levels: Static   Pumping
Type of Pumping System
ProductiveZoneThickness
Date and Amount Last Acid Treatment
 
Treatment Objectives
Post-Treatment Oil Rate   
Post-Treatment Water Rate   
       
Remarks
       
ATTACHMENTS        
PLEASE ATTACH COPIES OF LOGS, STRUCTURE MAPS, PRODUCED WATER ANALYSIS
Please note attachments are limited to 5MB in size.
         
         
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