Coordinates of Wellhead: Latitude: Longitude: Zone: Datum: Fracturing Commencement Date: (dd/mm/yy) Fracturing Completion Date: (dd/mm/yy) Well Name: Eastings: Northings: Latitude: Longitude: Coordinates of Wellhead: Zone: Datum: Fracturing Commencement Date: (dd/mm/yy) Fracturing Completion Date: (dd/mm/yy) Note: Attach separate sheets for additional wells Part F - Fracture Stimulation Completion Report Note: A title holder must submit a completed Fracture Stimulation Completion Report to the Department, which contains the information specified in Section 14.2 Code of Practice for Coal Seam Gas Fracture Stimulation Activities for the well operation within 30 days of cessation of the fracture – stimulation activity. The Fracture Stimulation Completion Report should also contain an assessment of the fracture stimulation, as per Section 14.2(b)(v) Code of Practice for Coal Seam Gas Fracture Stimulation – Activities. Note: One Fracture Stimulation Completion Report can be submitted for multiple wells. Included? Minimum Contents of Fracture Stimulation Completion Report Y N CHECKLIST Well Name(s): Eastings/Northings:
Coordinates of Wellhead: Latitude: Longitude: Zone: Datum: Fracturing Commencement Date: (dd/mm/yy) Fracturing Completion Date: (dd/mm/yy) Well Name: Coordinates of Wellhead: Eastings: Northings: Latitude: Longitude: Zone: Datum: Fracturing Commencement Date: (dd/mm/yy) Fracturing Completion Date: (dd/mm/yy) Note: Attach separate sheets for additional wells Part F - Fracture Stimulation Completion Report Note: A title holder must submit a completed Fracture Stimulation Completion Report to the Department, which contains the information specified in Section 14.2 Code of Practice for Coal Seam Gas – Fracture Stimulation Activities for the well operation within 30 days of cessation of the fracture stimulation activity. The Fracture Stimulation Completion Report should also contain an assessment of the fracture stimulation, as per Section 14.2(b)(v) Code of Practice for Coal Seam Gas – Fracture Stimulation Activities. Note: One Fracture Stimulation Completion Report can be submitted for multiple wells. Minimum Contents of Fracture Stimulation Completion Report CHECKLIST Included? Y N Well Name(s): Eastings/Northings:
OCSG-F04-Fracture-Stimulation-Completion-Report-Form-Version-2.docx