(a) An applicant or permittee shall use the following forms, as provided by the Department:
- (1) Form 1 – Financial Responsibility Ownership;
- (2) Form 2 – Oil or Gas Well Permit Application;
- (3) Form 3 – Well Construction Design;
- (4) Form 4 – Water Management Plan;
- (5) Form 5 – Waste Management Plan;
- (6) Form 6 – Well Site Reclamation Plan;
- (7) Form 7 – Irrevocable Letter of Standby Credit;
- (8) Form 8 – Surety Bond;
- (9) Form 9 – Assignment of Savings;
- (10) Form 10 – Cash Deposit;
- (11) Form 11 – Required Notifications to the Department;
- (12) Form 12 – Well Drilling Report;
- (13) Form 14 – Plugging and Abandonment;
- (14) Form 15 – Oil or Gas Well Status;
- (15) Form 16 – Mechanical Integrity Test Results;
- (16) Form 17 – Notification of Return of Oil or Gas Well to Active Status;
- (17) Form 18 – Well Stimulation Report;
- (18) Form 19 – Chemical Disclosure Report;
- (19) Form 20 – Confidential Information Claim;
- (20) Form 21 – Water Supply Investigation Request;
- (21) Form 22 – Water Supply Testing Report;
- (22) Form 23 – Annual Water Use Report;
- (23) Form 24 – Annual E & P Waste Management Report;
- (24) Form 25 – Pit Closure Report;
- (25) Form 26 – Spill and Release Report;
- (26) Form 27 – Site Investigation and Remediation Work Plan;
- (27) Form 28 – Monthly Production Report; and
- (28) Form 29 – Well Site Inspection Report.
- (b) The use of any forms other than those provided by the Department is prohibited. These forms are available on the Division's Oil and Gas Program webpage at the following address: http://portal.ncdenr.org/web/lr/oilgas.
- (c) All notice and forms required by the rules in this Subchapter to be submitted to the Department shall be made to: Oil & Gas Program, Division of Energy, Mineral, and Land Resources, 1612 Mail Service Center, Raleigh, NC 27699-1612 and a copy in .pdf form submitted to Oil&Gas@ncdenr.gov. The phone number for the Division is 919-707-9220 and the fax number is 919-715-8801.
History Note: Authority G.S. 113-391;
Eff. March 17, 2015.