HomeMy WebLinkAboutMILLER 1 - Flowline Abandonment Notice - Extraction - 7/9/2019State of Colorado
Oil and Gas Conservation Commission
1120 Lincoln Street, Suite 801, Denver, Colorado 80203
Phone: (303) 894-2100 Fax: (303) 894-2109
FIELD OPERATIONS NOTICE
FORM
42
Rev
03/15
Document Number:
OGCC RECEPTION
Receive Date:
07/09/2019
402099655
JAMIE KEMPEMA
Signature:Title:
Print Name:Email:
Date:
JKEMPEMA@EXTRACTIONOG.COM
I hereby certify all statements made in this form are, to the best of my knowledge, true, correct and complete.
07/09/2019OPERATIONS TECH
OGCC Operator Number:
City:
Company Name:
Address:
10459
EXTRACTION OIL & GAS INC
370 17TH STREET SUITE 5300
DENVER Zip:State:80202
Contact Person:JAMIE KEMPEMA
Phone:
( )
(970) 576-3447
CO Email:
Fax:
JKEMPEMA@EXTRACTIONOG.COM
Entity Information
05 - 123 - 07272 - 00
Sec:Twp:Range:QtrQtr:17 Lat:Long:2N 67W NENE 40.142918 -104.908310
API #:Facility ID:Location ID:
Facility Name:MILLER 1
FLOWLINES ABANDONED - per RULE 1105
Date completed:06/13/2019
Submit By Other Operator
Update of a previous Form 42 Notice NO
The Form 42 shall be submitted as required by Rule, Notice to Operators, Policy, or Condition of Approval.
A Form 42 Update shall be submitted to revise the scheduled date or time on a previous Form 42 - Advance Notice of Field Operations.
A Form 42 Update must be for the same well, location, or facility and for the same Field Operation as a previous Form 42.
NOTE: Operator's Contact for Advance Notices of Field Operations should be available 24 hours a day, 7 days a week and should have
the most current scheduling information for the operation. Operator's Contact for other notices should be able to respond to questions
regarding the reported information.
Date Run: 7/9/2019 Doc [#402099655] Well Name: MILLER 1