Instructions for Form Completion

This is document is a Microsoft Word Form.

All parts of this form are locked except for those areas (fields) available for data entry.

Open this form as a “copy” in order to preserve the original for future use.

Place your curser at the beginning of the field you wish to complete.

Type in the relevant information. All fields are large enough to accommodate the data required. Fields on the form where large amounts of information are to be entered are self-expanding. If you find there is not enough room in a field to put in the information, check that the information you are entering is in the correct format.

Note that some fields have drop down lists to assist in data entry and clarity as to the type of information required. For these fields, double click on the appropriate value from the drop down list to enter that value on the form.

Once you have completed all required fields on the form, print the required number of copies, then have each copy signed and dated in blue ink by a responsible officer of the company.

The printed copies of the forms, along with the appropriate supporting technical documentation, are to be submitted to:

Chief Conservation Officer

National Energy Board

444 Seventh Avenue S.W.

Calgary AB T2P 0X8

The National Energy Board is implementing a process for submission of electronic application documents. However, until further notice, all application forms and supporting technical documentation must continue to be supplied as paper documents.

Approval to Alter condition of a well
This application is to be submitted to the Chief Conservation Officer at least 45 days before commencement of operations.
Well Name:
Operator:	Well ID:
Operating License No.:	Depth:	m
Contractor:	Drilling Rig or Unit:
Area:	Grid:	- - -
Coordinates:

(NAD 27)	Surface Lat.:	° ’ ”	Long.:	° ’ ”
Bottom Hole Lat:	° ’ ”	Long.:	° ’ ”
Date ADW issued:	Date of last Operation:
Elevation-KB/RT:	m	GL / Seafloor:	m
Approx. Spud Date:	Est. Days on Location:
type of operation
Summary of Proposed operations
Signed:
Date:
Responsible Officer
Name:	Operator:
Title:	Phone:	( ) -
neb use only
An approved copy of this notice is to be posted at each drillsite. This operation is authorized under Section 5.(1)(b) of the Canada Oil and Gas Operations Act (O-7) and is subject to the terms and conditions attached to this authorization.
Well Status Before Operation:	Date:
Signed:
Suspended	File:
Chief Conservation Officer
Completed	WID:
Abandoned	UWI:

Approval to Alter Condition of a Well

Approval to Alter Condition of a Well

Approval to Alter Condition of a Well

National Energy Board - NEB

2005-12-12

National Energy Board - NEB