Emergency Action Plan

• Rig No.

• Start Date

  Date

• Client

• Well & Lease No.

• Location
  Address

• Work Group

  North Dakota

• County

• H2S on location?

  Yes

  No

• Snubbing?

  Yes

  No

• SSE on location? (If yes, put name of SSE in comments.)

  Yes

  No

• Type of Operations

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Directions from nearest town to location

Personnel

• Client Rep. & Phone No.

• Pusher Operator

• Derrick Hand

• Floor Hand

• Floor Hand

• Pump Operator

• Helper