Oil and Gas Forms

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​ Geothermal forms can be found on the Geoth​ermal Forms page.​


The Geologic Energy Management Division (CalGEM) requires oil and gas operators in California to submit data about well production, injection, stimulation, testing, maintenance, and more. Operators are urged to check this Oil and Gas Forms webpage regularly for required, new and updated forms, and reference data information for those operations.​

CalGEM engineers inspecting wellhead in a natural gas storage field

CalGEM Associate Oil and Gas Engineer Kris Gustafson​ (standing) and Engineering Geologist Kevin Herman check a wellhead at one of California’s 12 natural gas storage fields.

​​​If you have questions about reference data or forms, contact your district office​​​.

Forms Available in WellSTAR (Well Statewide Tracking and Reporting system)​

​Electronic Data Delivery (EDD), Business to Government (B2G) Reference Data and Forms now available electronically​ ​

Paper Forms


WellSTAR Online Forms List​

The forms below are now available in WellSTAR.

NumberForm Name Form Description
1.
110BQ Quarterly Water Injection
Report water injection data on a quarterly basis.
2. 110FQ Quarterly Other Water Allocation Report quarterly water allocation data.
3.
110Q Quarterly Water Production Allows Operators to report water production data on a quarterly basis.
4. 72-Hour Notification Form Create or maintain pre-stimulation treatment data.
5. Analytical Sample Data Submission Submit analytical sample data for a Well, Facility, UIC Project, or WST Permit.
6.
Application for Injection Approval Online form used to create of update a UIC Project.
7. Application for Well Stimulation Permit Create or maintain a well stimulation permit.
8. Bond Information Create or maintain bond information.
9. Bond Release Request Request a bond release.
10. Complaint Complaint information form.
11. Compliance Information Create or maintain compliance information.
12. Confidentiality Request Request confidentiality.
13. Construction Site Well Review (CSWR) Create or maintain CSWR.
14. Document Upload Upload new or existing WellSTAR documents to associate to Wells, Facilities, and/or Projects.
15. Facility Information Create or modify Facility information.
16. Notice of Intention (NOI) Apply for a Permit to drill/rework or abandon a well.
17. OG110 Monthly Production Report monthly production data.
18. OG110B Monthly Injection Report monthly injection data.
19. OG110D Monthly Disposition Report monthly disposition data.
20. Operator Incident Report Create and maintain Incidents.
21. Organizational Questionnaire Create and maintain Entity information.
22. Plan Submission Submission of a Plan and the association of the applicable wells, facilities, lease, or project.
23. Reconcile Production Reconcile annual and monthly reported volumes.
24. Schedule Test Schedule test for facilities, components, and wells.
25. Upload Test Results Upload results of schedule and on scheduled tests.
26. Well Name Change Change a well name or number.
27. Well Stimulation Disclosure Create or maintain well stimulation disclosure data.
28. Well Summary Update well information.

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EDD and B2G Reference Data

Access the Reference Data spreadsheet (updated 10-29-19)​ to locate specific data values accepted in Electronic Data Delivery (EDD) and Business to Government (B2G) file submissions as well as accepted FAP Combinations and Chemical Constituents. Please check the spreadsheet posted here regularly to ensure you are referencing current information.

​To locate reference data in the spreadsheet:

  1. Select the tab associated to the form you are submitting.
  2. Go to the Reference Data column.
  3. If there is a "yes", select the reference data tab and find the Reference Data Code Type associated to that field/s.
  4. If there is a "no", associated information is in the Valid Values/Notes on the Form tab.
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​Electronic Data Delivery (EDD) Forms

Electronic Data Delivery (EDD) Forms are electronic files that are uploaded to populate data on an on-line form. EDD forms will allow you to bulk-​load data into WellSTAR via online forms.

Form​ Title / Description
Well Stimulation Permit
(XML​)
(Updated  04-30-20) ​ ​Well Stimulation Permit
File prior to commencement of Well Stimulation operations.
Access the Well Stimulation Permit form instructions.
Access the Well Stimulation Permit form template​.
Well Stimulation Disclosure
(XML​​)
(Updated​ 10-04-19) ​ Well Stimulation Disclosure
Disclosure of well stimulation treatment is required within 60 days following the cessation of a well stimulation.
Access the Well Stimulation Disclosure form instructions​.
Access the Well Stimulation Disclosure form template.
Notice of Intention
(XML)
(Updated 07-23-20)​  Notice of Intention
File prior to commencement of drilling operations, along with a general plan showing the proposed location and the total depth. Submit with proper bond (if needed).
Access the Notice of Intention form instructions​.​
Access the Notice of Intention form template.
Well Summary
(XML​​​)
(Updated 07-​23-20​)​​  Well Summary
File within 60 days after completion of drilling, suspension, or abandonment.
Access the Well Summary form instructions​.
Access the Well Summary form template​​.
Neighbor Notification
(Excel)
(Updated 08-26-19) ​Neighbor Notification
This EDD is used to automatically upload data.
Aggregate Well Maintenance Information
(Excel)
(Updated 09-17-19)​​  Aggregate Well Maintenance Information
This EDD is used to automatically upload data.
Fluid Level Results  (Excel)
(Updated 09-17-19)  Fluid Level Results
This EDD is used to automatically upload data.
Single Well Maintenance Information
(Excel)
(Updated 05-26-20)​  Single Well Maintenance Information
This EDD is used to automatically upload data.
Step Rate Test
(Excel)
(Updated 09-17-19)​  Step Rate Test
This EDD is used to automatically upload data.
Directional Survey
(Excel)
(Updated​ 04-30-20)​​  Directional Survey
This EDD is uploaded from the Document Upload step from either the Notice of Intention or the Well Summary. Access the Directional Survey form Instructions
Analytical Data​
(Excel)
(Updated 09-17-19)​  Analytical Data Submission​
This EDD is used to automatically upload data.


​Business to Government (B2G) Forms

Business to Government (B2G) Forms will allow your system to deliver a file for bulk generation of online forms. If you are interested in using one of the B2G forms​, please contact the ​CalGEM​ Service Desk at servicedeskmail@conservation.ca.gov with the following information: Organization Name, Technical Contact Name, Technical Contact email, and Phone Number.

Form​ Title / Description
Well Summary
(XML)
(Updated 0​7-23​-20) ​​ Well Summary
File within 60 days after completion of drilling, suspension, or abandonment.
Access the Well Summary form instructions.
Access the Well Summary form template​.
Notice of Intention
(XML​)
(Updated 07-23​-20) ​​ ​Notice of Intention
File prior to commencement of drilling operations, along with a general plan showing the proposed location and the total depth. Submit with proper bond (if needed).
Access the Notice of Intention form instructions​.
Access the Notice of Intention form template​.


Oil and Gas Paper Forms

Publication Number Title / Description
Form 122
Report of Oil and Gas Production
For calendar year 2019. Operators will access Form 122 to report Annual Production in WellSTAR under Online Forms.
OG100  (PDF)
Well Summary
File within 60 days after completion of drilling, suspension, or abandonment.
OG103  (PDF)
History of Oil or Gas Well
File within 60 days after drilling, completion, suspension, or abandonment.
OG106  (PDF) Notice of Intention
File prior to commencement of drilling operations, along with a general plan showing the proposed location and the total depth. Submit with the proper bond (if needed). This new form takes the place of the OG 105, 107, 108 and 123.
PDF Form-fill format is now available.
OG110  (Excel)
Monthly Production
File to submit or amend monthly production reports.
OG110B  (Excel)
Monthly Injection
File to submit or amend monthly injection reports.
OG110D  (Excel)
Monthly Disposition
File to report or amend oil and gas used during production operations or gas blown, flared, or otherwise released into the atmosphere during production or testing operations.
OG110Q  (Excel)
Quarterly Water Production
File to submit or amend quarterly water production reports.
OG110BQ  (Excel)
Quarterly Water Injection
File to submit or amend quarterly water injection reports.
OG110FQ  (Excel)
Quarterly Other Water Allocation
File to report or amend quarterly other water allocation.
OG30A  (PDF)
Notification of Well and/or Facility Disposition/Transfer
This form is used to notify the California Geologic Energy Management Division (CalGEM) ​that a change has occurred. Operators who sell, transfer, or otherwise exchange the right to operate a well, and the land (owned or leased) where the well is located, must notify CalGEM no later than the date the sale, transfer, conveyance, exchange, or other disposition, becomes final.

Notification is also required from persons acquiring ownership or operation of any well – whether by purchase, transfer, or another method - no later than the date the sale, transfer, conveyance, exchange, or other disposition, becomes final.

OG120  (PDF)
Application for Injection Approval
File prior to commencement of underground injection or to modify an existing previously approved injection project.
OG16  (PDF)
Request for Change of Well Designation
Form to change a lease name or well number for an existing well.
OGD7  (PDF)
Contact Questionnaire
Form to supply names and contact information and type of business entity.
OG140  (PDF)

Oil and Gas Facility Information (new form, there is no replacement)
Please use this form to create a new facility or modify and existing facility.
OG150  (PDF)
Oil and Gas Agent Designation and Organization Information Change (this form replaces OGD42D, OG134A, OG134B)
File this form when designating an agent. The Agent shall serve as the contact person for all CalGEM​ communications. The Agent must reside within the state and have a street address. This form can also be used by operators to make updates and changes to addresses and contact information.
OG160  (Word)
Oil and Gas Bond (Updated June ​03, 2020​)

This form replaces all previous bond forms including the blanket or individual bond, onshore/offshore bond, indemnity or cash, etc.

§ 3204. (a) An operator who, on or after January 1, 2018, engages in the drilling, redrilling, deepening, or in any operation permanently altering the casing, of a well, or who acquires a well, shall file with the supervisor an individual indemnity bond for each well so drilled, redrilled, deepened, or permanently altered, or acquired in the following amount:

Onshore:

  • $25,000 - less than 10,000 total feet depth
  • $40,000 - 10,000 or more total feet depth

§ 3205. (a) An operator who engages in the drilling, redrilling, deepening, or in any operation permanently altering the casing, of 20 or more wells at any time, may file with the supervisor one blanket indemnity bond to cover all the operations in any of its wells in the state in lieu of an individual indemnity bond for each operation as required by Section 3204. The bond shall be executed by the operator, as principal, and by an authorized surety company, as surety, and shall be in substantially the same language and upon the same conditions as provided in Section 3204, except as to the difference in the amount. The bond shall be provided in one of the following amounts, as applicable:

  • $200,000 - 50 or fewer onshore wells
  • $400,000 - 51 to 500 onshore wells
  • $2,000,000 - 501 to 10,000 onshore wells
  • $3,000,000 - 10,001 or more onshore wells

Offshore:

  • $1,000,000 - 1 or more offshore wells

Transfers:

  • An indemnity bond for each well as required under Section 3204 or 3205

Deposit in Lieu of Bond:

  • In lieu of a surety bond, a certificate of deposit, share account, note, savings account, share certificate, or investment certificate may be given.

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