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    Forms

    New and revised forms for application for permits to drill and operate oil and gas wells have been posted to the DEP eLibrary. There are now separate forms for application of oil and gas well permits for conventional, unconventional and wells to be drilled in coal areas. There is an added form to describe ownership and control of companies seeking oil and gas well permits.In addition, new bonding forms that meet the requirements of the Oil and Gas Act 13 of 2012 are posted and available for use.

    8000-PM-OOGM0001Checklist for Completing an Application for a Permit to Drill, Operate or Alter an Oil or Gas Well
    8000-FM-OOGM0099Operator's General Information Form
    8000-FM-OOGM0118Oil and Gas Operator Ownership and Control Information
    8000-FM-OOGM0153Oil and Gas Operator Email Registration
    8000-PM-OOGM0001aPermit Application to Drill and Operate a Conventional Well
    8000-FM-OOGM0109aAffidavit Request for Conventional Well Permit Renewal
    8000-PM-OOGM0001bUPermit Application to Drill and Operate an Unconventional Well
    8000-PM-OOGM0109bAffidavit Request for Unconventional Well Permit Renewal
    8000-PM-OOGM0001cPermit Application to Drill and Operate a Well Coal Module
    8000-PM-OOGM0024Proposed Alternate Method or Material for Casing, Plugging, Venting or Equipping a Well
    8000-PM-OOGM0058Request for Variance from Distance Restriction from Existing Building or Water Supply
    8000-PM-OOGM0017Proposed Subsurface Operations Procedure
    8000-PM-OOGM0002Well Location Plat
    8000-FM-OOGM0004aWell Record
    8000-FM-OOGM0004aUWell Record (Unconventional Operations Only)
    8000-FM-OOGM0004bCompletion Report
    8000-FM-OOGM0004bUCompletion Report (Unconventional Operations Only)
    8000-FM-OOGM0132Registration of Trade Secret/Confidential Proprietary Stimulation Fluid Chemical Information Form
    8000-PM-OOGM0076Coordination of a Well Location with Public Resources
    8000-PM-OOGM0076UCoordination of a Well Location with Public Resources (Unconventional Operations Only)
    8000-FM-OOGM0056Application for Inactive Well Status
    8000-FM-OOGM0123Notification of Return of Well(s) to Active Status
    5500-PM-OG0010Application for Transfer of Well Permit or Registration
    8000-FM-OOGM0023Operators List of Well(s) Permitted but Never Drilled
    8000-FM-OOGM0047Contractual Consent of Landowner
    8000-FM-OOGM0052Notification of Surface Landowner-Water Purveyor of Well Drilling Operation or Alteration
    8000-FM-OOGM0053Landowner Notification of Well Drilling or Alterations
    8000-FM-OOGM0144ULandowner Consent for Storing Drilling Supplies and Equipment (Unconventional Operations Only)
    8000-FM-OOGM0101aAffidavit of Non-Delivery of Certified Mail for Conventional Well
    8000-FM-OOGM0101bAffidavit of Non-Delivery of Certified Mail for Unconventional Well

    8000-FM-OOGM0008Request for approval of impoundment embankment alternative design standards (UC only) application.docx
    8000-FM-OOGM0008Request for approval of impoundment embankment alternative design standards (UC only) application.pdf
    8000-FM-OOGM0008Request for approval of impoundment embankment alternative design standards (UC only) instructions.pdf
    5500-PM-OG0073Request for the Use of Alternative Pit Liner
    8000-FM-OOGM0137UMonthly Tank Maintenance Inspection Checklist (Unconventional Operations Only)
    8000-FM-OOGM0138UOil and Gas Operations Well Development Impoundment Registration (Unconventional Operations Only)
    8000-FM-OOGM0139UOil and Gas Operations Well Development Impoundment Transfer Form (Unconventional Operations Only)
    8000-FM-OOGM0140ULandowner Request to Waive Well Development Impoundment Restoration Requirements (Unconventional Operations Only)
    8000-FM-OOGM0141UBorrow Pit Registration Form (Unconventional Operations Only)
    8000-FM-OOGM0142URequest for Approval of Mine Influenced Water Storage in a Well Development Impoundment (Unconventional Operations Only)
    8000-FM-OOGM0143UOil and Gas Operations Underground or Partially Buried Storage Tank Registration Form (Unconventional Operations Only)
    8000-FM-OOGM0156UWell Development Impoundment Restoration Extension Request (Unconventional Operations Only)
    8000-FM-OOGM0157UBorrow Pit Restoration Extension Request (Unconventional Operations Only)
    8000-PM-OOGM0072Request for Approval of a Pit for Control, Handling or Storage of Production Fluids