Sheet 1: Single Page Form 6

	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
BOARD USE ONLY
		
	

		


		
FORM NO. 6 R 10/09
		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
Field
		
	

		


		
ARM 36.22.307
		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
	

		


		
SUBMIT TO:
		
	

		


		
ARM 36.22.1217
		


		
Lease/Unit
		
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
	

		


		
ARM 36.22.1242
		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
Operator
		
	

		


		


		


		


		


		


		


		


		


		
BOARD OF OIL AND GAS CONSERVATION
		
	

		


		


		


		


		


		


		


		


		


		
	

		


		


		


		


		


		


		


		


		


		
2535 ST. JOHNS AVENUE
		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		
BILLINGS, MONTANA  59102
		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
 12. CHECK IF AMENDED
		
	

		


		


		


		


		


		


		


		


		


		
REPORT OF PRODUCTION
		


		
	

		


		


		


		


		


		


		


		


		


		


		


		
   REPORT
		
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
	

		


		


		


		


		


		


		


		


		


		
(TO BE MADE BY PRODUCER)
		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		
Oil or Gas Wells
		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		
1. PRODUCER
		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
13. WELL CLASSIFICATION
		
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
Check One
		
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
OIL WELLS
		
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
NATURAL GAS WELLS
		
	

		


		
2. ADDRESS
		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
 7. FIELD NAME
		


		
	

		


		


		
14. LEASE STATUS
		
	

		


		


		


		


		


		


		


		
 8. LEASE/UNIT NAME
		


		
	

		


		


		


		


		


		


		


		
	

		


		
3. CITY
		


		
 9. COUNTY
		


		
	

		


		
	

		


		
4. STATE
		


		
5. ZIP
		


		
10. CHECK IF ADDRESS CHANGE
		


		


		


		


		
NO. WELLS PRODUCED
		
	

		


		
	

		


		
6. AGENT
		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
NO. WELLS SHUT IN
		
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
	

		


		


		
SIGNATURE
		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
11. MONTH OF
		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		
TELEPHONE NUMBER
		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		
WELL DESCRIPTION
		


		
PRODUCTION INFORMATION
		
	

		
	

		
15. WELL
		
16. API NO
		
17. DAYS
		
18. SEC
		
19. TWP
		
20. RGE
		
FM
		
21. PRODUCING
		
22. BBLS OF
		
23. MCF GAS
		
24. BBLS OF
		
	

		
	

		
NUMBER
		
(LAST 8 DIGITS)
		
PRODUCED
		


		


		


		
CODE
		
FORMATION
		
OIL/COND
		
@14.73 PSIA
		
WATER
		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		


		


		


		


		


		


		


		


		


		


		
	

		
	

		


		
25. INVENTORY SUMMARY
		
BBLS OIL
		
MCF OF
		
BBLS OF
		


		
	

		


		
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
AND COND.
		
GAS
		
WATER
		
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		
	

		


		
On Hand Start of Month
		


		


		


		


		
26. DISPOSITION INFORMATION
		
Bbls or MCF
		
	

		


		
	

		


		
Produced This Month
		


		


		


		


		
BUYER
		


		


		
	

		


		
	

		


		
Sold This Month
		


		


		


		


		
TRANSPORTER
		


		
	

		


		
	

		


		
Spilled This Month
		


		


		


		


		
BUYER
		


		


		
	

		


		
	

		


		
Flared or Vented
		


		


		


		


		
TRANSPORTER
		


		
	

		


		
	

		


		
Used on Lease
		


		


		


		


		
BUYER
		


		


		
	

		


		
	

		


		
Injected
		


		


		


		


		
TRANSPORTER
		


		
	

		


		
	

		


		
Surface Pits
		


		


		


		


		
BUYER
		


		


		
	

		


		
	

		


		


		


		


		


		


		
TRANSPORTER
		


		
	

		


		
	

		


		
NOTE: Separate production reports covering operations in each lease must be filed with the Billings office of the Board of Oil and Gas Conservation by the last day of each calendar month
		
	

		


		
following the month covered by the report.