Title Page

  • Site Name

  • API

  • Location

Equipment

Wellhead

  • Lift Type

  • Engine Model

  • Plunger Lift Present?

  • Plunger Controller Make / Model

  • Controller Settings (number of cycles per day)

Connections

  • Oil

  • Gas

  • Water

Flanges

  • Oil

  • Water

  • Gas

Valves

  • Oil

  • Gas

  • Water

Seals

  • Oil

  • Water

  • Gas

  • Separator
  • Burner present?

  • Size (in)

  • Level Controller Height (from bottom of vessel) (in)

  • Separator Temperature (F)

  • Separator Dump Pressure (PSI)

  • Motor Valve Controller present?

  • Motor Valve On Time Setting (Min On)

  • Motor Valve Off Time Setting (Min Off)

Connections

  • Oil

  • Gas

  • Water

Flanges

  • Oil

  • Water

  • Gas

Valves

  • Oil

  • Gas

  • Water

Seals

  • Oil

  • Water

  • Gas

Compressor

  • Compressor Present?

  • Make

  • Model

  • Serial Number

Connections

  • Oil

  • Gas

  • Water

Flanges

  • Oil

  • Water

  • Gas

Valves

  • Oil

  • Gas

  • Water

Seals

  • Oil

  • Water

  • Gas

  • Meter
  • Meter Tube Diameter (in)

  • Meter Length (ft)

  • 7-Day Average MCFPD

  • Pressure (PSI)

Connections

  • Oil

  • Gas

  • Water

Flanges

  • Oil

  • Water

  • Gas

Valves

  • Oil

  • Gas

  • Water

Seals

  • Oil

  • Water

  • Gas

  • Natural Gas Powered Pneumatic Devices
  • Pneumatic Type (Level, Temp, Motor, Dump, etc)

  • Purpose

  • Pressure to Device

  • Size (in)

Signature

  • Signature

  • Date

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