| Engineer | Form: (04 )
403061062
5/31/2022 | 1) Report work completed with a Form 4 Sundry REPORT OF WORK DONE - Repair Well noting final pressure test results and include any operational or job summaries. If the wellbore geometry changes submit an updated WBD.
2) If wellbore geometry changes or cement work is executed, submit information on a Form 5
3) Complete a Form 21 MIT to verify repairs for injection wells
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