GENERAL: This form is designed for submitting a complete and accurate geothermal well completion report, and must be accompanied
by a detailed chronological history of well operations as well as the final copies of the results of any logs, surveys or tests performed on
the well that have not previously been submitted. The report must be submitted within 30 days after the date of completion of continuous
well activities as determined by the BLM. The completion date usually is the day that the well became producible; generally the date of
initial production test. The BLM may postpone the required report submittal date if adequate justification is presented by the lessee.
Item 18: Show the surface location coordinates from the nearest section corner or tract line. Show production zone and total depth
coordinates from the surface location if the well is directionally drilled.
Item 34: If the well is immediately placed into operation without testing, this section should reflect the first month's production data.
Items 35 & 36: Indicate the depth(s) of subsurface pressure, temperature measurement, and include the reference datum.
The Privacy Act of 1974 and 43 CFR 2.48(d) require that you be furnished the following information:
AUTHORITY: 30 U.S.C. 1001-1028; 43 CFR Part 3200.
PRINCIPAL PURPOSE: The BLM uses this information to evaluate the technical, safety, and environmental factors involved with
geothermal resources on Federal geothermal leases.
ROUTINE USES: (1) The adjudication of this form. (2) Documentation for public information in support of notations made on land
status, records for the management, disposal, and use of public lands and resources. (3) Transfer to appropriate Federal agencies when
concurrence is required prior to granting a right in public lands or resources. (4) Information from the record and/or the record will be
transferred to appropriate Federal, State, local or foreign agencies, when relevant to civil, criminal or regulatory investigations or
EFFECT OF NOT PROVIDING INFORMATION: Disclosure of t
e information is required to seek approval of geothermal drilling
operations. If all the information is not provided, geothermal drilling operations might not be approved.
The Paperwork Reduction Act of 1995 requires us to inform you that:
The BLM collects this information to evaluate the technical, safety, and environmental factors involved with geothermal resources on
Federal geothermal leases.
The BLM will use this information to analyze operations and to compare equipment and procedures actually used with proposals that
you applied for.
Response to this request is required to obtain or maintain a benefit.
The BLM would like you to know that you do not have to respond to this or any other Federal agency-sponsored information collection
unless it displays a currently valid OMB control number.
BURDEN HOURS STATEMENT: Public reporting burden for this form is estimated to average 10 hours per response, including
the time for reviewing instructions, gathering and maintaining data and completing and reviewing the form. Direct comments regarding
the burden estimate or any other aspect of this form to U.S. Department of the Interior, Bureau of Land Management (1004-0132),
Bureau Information Collection Clearance Officer (WO-630), 1849 C Street, N.W., Washington, D.C. 20240.
(Form 3260-4, page 3)