Well Health Questionnaire

Stage 1 — Quick Well Screening (5 minutes)

Operator & Contact Information

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Operator / Company

Your Name

Phone

Well Identification

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Well Name

API Number

County / Field

Primary Producing Formation

Basin

Year Drilled

Current Well Status

Lift Mechanism

Current & Historical Production

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Current Production (BOPD)

Peak/Historical Production (BOPD)

Current Water Cut (%)

Decline Start (Year)

What is the primary problem?

What conditions apply to this well? Check all that apply

Paraffin / Wax Buildup Asphaltene Deposits Inorganic Scale (calcium carbonate, barium sulfate, etc.) Corrosion Sand / Fines Production Emulsion Problems Bacteria / Souring Not Sure

Ready to submit for evaluation?

After initial screening, NOOW will reach out with an evaluation and may request technical details or fluid samples.

Evaluate Your Well for Production Restoration

Stage 1 — Quick Well Screening (5 minutes)

Operator & Contact Information

Well Identification

Current & Historical Production

Ready to submit for evaluation?

Stage 2 — Detailed Technical Evaluation

Wellbore Geometry

Tubing Information

Casing Information

Perforated Interval & Reservoir

Produced Fluid Properties

H₂S / Sour Gas Assessment

Prior Treatment History

Chemical Treatment History & Goals