REQUIRED DATA FORM - SURFACE

Option 1: Download, fill out and fax us the Surface Input Form or
Option 2: Complete and submit the following online fields:

Contact Name:
Contact Company:
Contact Phone:
Contact Email:
Name of Project:
Project Location:
Project Elevation:
Gas Flow Rate:	MCF
Water Flow Rate:	bbl/day
Water Specific Gravity:	(Water=1.0)
Oil Flow Rate:	bbl/day
Oil API:
Pressure at Tool:	psig
Downstream Pressure:	psig
Dist to Downstream Pressure:	ft
Temperature at Tool	¡F
Pipe Size:	ID or nom
Pipe Length:	ft - to first flow upset*
Elevation Changes*:	ft
Paraffin Problems?	If yes, freq. of chemical/hot oil treatments/week

*Upsets in flow include: (1) line drips with diverter plate; (2) pig receiver; (3) increase in pipe diameter; (4) corrosion coupon (or other intrusion) and (5) sidestream more than 1/3 of flow through tool.

*The total gross uphill elevation gains for the line.