Bob Davis Form

Black Hawk-- 24-- rig Ticket

* Indicates required field

Date *

Office Use *

Company *

Lease *

Well Number *

State and County *

Time Work Start *

Time work Stop *

Description of Work *

Time work Start *

Time work Stop *

Description of Work *

Alternative - List time period and task in description box *

Rig Rate: Qty x Rate = Cost *

Crew Travel: Qty x Rate = Cost -(63150) *

Extra Men: Qty x Rate = Cost *

Supervisor: Qty x Rate = Cost *

Air Unit Cost *

Geronimo Skid Cost *

B.O.P. Cost *

Total All Equipment Expenses For the Day *

First Tour Start Time and Stop Time *

Operator: Travel Time, Work Time, Shop Time *

Drk: Travel Time, Work Time Shop Time *

Flr: Travel Time, Work Time, Shop Time *

Accidents *

Yes No

Tour Two Start Time and Stop Time *

Submit