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

411 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.

Exploratory
Delineation
Development
Other:
Service
Approval To Drill a Well
This application is submitted under Section 82.(1) of the Canada Oil and Gas Drilling Regulations (SOR/79-82). When approved under Section 83 of the Regulations it is the requisite approval for the commencement of drilling operations.
Well Name:
Operator:
Operating License No.:	Drilling Program No.:
Contractor:	Interest Identifier:
Drilling Rig or Unit:	Estimated Well Cost:	$
Land Use Permit No.:	Water Licence No.:
Location:	Unit:	Section:	Grid:	- - -
Coordinates:

(NAD 27)	Surface:	Lat.:	° ’ ”	Long.:	° ’ ”
Bottom Hole:	Lat.:	° ’ ”	Long.:	° ’ ”
Region:	Field / Pool:
Elevation KB/RT:	m	GL / Seafloor:	m
Approximate Spud Date:	Est. Days on Location:
Anticipated Total Depth:	m	Target Formation:
Evaluation Program
Interval (m KB)	Comments
Ten-metre samples:	-
Five-metre samples:	-
Canned sample intervals:	-
Conventional cores at:	-
Logs and Tests:	-
CASING AND CEMENTING PROGRAM
O.D. (mm)	Weight (kg/m)	Grade	Setting Depth (m KB)	Cementing (m³)
B.O.P. Equipment:
Other Information:
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.
Date:
Signed:
File:
Chief Conservation Officer
WID:
UWI:

Approval to Drill A Well

Approval to Drill A Well

Approval to Drill A Well

National Energy Board - NEB

2005-12-12

National Energy Board - NEB