| Engineer | Form: (04 )
402698847
6/3/2021 | 1) Report work completed with a Form 4 Sundry REPORT OF WORK DONE - Repair Well noting final pressure test results.
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.
4) If a casing leak is identified, contact area engineer with repair plans.
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