Patch Job Evaluation Form

•  
  * mandatory field
•  
  Company *
•  
  Address
•  
  Country *

  Select your countryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, The Democratic Republic of TheCook IslandsCosta RicaCote D\'ivoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEaster IslandEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-bissauGuyanaHaitiHeard Island and Mcdonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States ofMoldova, Republic ofMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre and MiquelonSaint Vincent and The GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and The South Sandwich IslandsSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzania, United Republic ofThailandTimor-lesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.SWallis and FutunaWestern SaharaYemenZambiaZimbabwe
•  
  Title
•  
  Miss
•  
  Mr.
•  
  Ms.
•  
  Firstname *
•  
  Surname *
•  
  Date job required
  select date
•  
  Phone
•  
  Fax
•  
  Email *
•  
  Well
•  
  Well name/number
•  
  Location
•  
  Well Type

  SelectOil ProducerWater InjectionGas ProducerDisposal WellSteam InjectionOther
•  
  Zone to be treated
•  
  Application type

  SelectWater Shut-OffGas Shut-OffCasing RepairTubing RepairOpen Hole IsolationPerforation Shut OffOther
•  
  Job Objective
•  
  Indicate what is the objective and specification of the job in addition of the data listed
•  
  Fluid to Shut Off

  SelectWaterGazOilNot Applicable
•  
  Casing or Open Hole *

  SelectCasingOpen Hole
•  
  Casing Integrity

  SelectNewCorrodedVery corrodedDamagedNot known
•  
  Bore Hole ID *
•  
  inmm
•  
  Casing size and weight *
•  
  inmm
•  
  Casing size and weight
•  
  Open Hole ID
•  
  Zone to be treated Depth
•  
  ftm
•  
  Measure Depth
•  
  Restriction to go through
•  
  inmm
•  
  Minimum restriction to go through
•  
  Temperature *
•  
  °C°F
•  
  Estimated Temperature at setting depth
•  
  Perforation or hole size
•  
  inmm
•  
  If known
•  
  Deviation at depth
•  
  Fluid/chemical
•  
  H2S or CO2 concentration or any relevant fluid in contact with the patch
•  
  Unsual conditions or other comments
•  
  All relevant information on setting zone, or other comments
•  
  Requirement
•  
  Minimum ID required
•  
  inmm
•  
  Required Patch drift after setting
•  
  Required drawdown
•  
  PSIBarMPa
•  
  Collapse or external differential pressure rating
•  
  Required Internal Pressure
•  
  PSIBarMPa
•  
  Internal service pressure rating
•  
  Job data
•  
  Conveyencing
•  
  Tubing or Drill pipe type, diamter, weight, pressure rating…used for conveyencing
•  
  Well diagram
•  
  Well diagram available, attach if possible
•  
  Log
•  
  Log available, attach if possible
•  
  Well fluid Gravity (sg)
•  
  Specific Gravity with water
•  
  VD Fluid level
•  
  ftm
•  
  Vertical Depth of the static level during operation
•  
  Enter the characters shown in the image

  
  

  
•