The Bureau of Land Management (BLM) requires operators on Federal or Indian land to file Form 3160-5, also called the Sundry Notices and Reports on Wells form. The United States Department of the Interior issued this version in March 2012. It covers a range of well-related activities that fall outside the scope of drilling proposals.
Operators use this form to report modifications, reclamation work, and well abandonment procedures. Other covered actions include acidizing, fracture treatment, and conversion to injection wells. Each submission must describe the proposed or completed operation with technical details and timelines. The form applies to oil, gas, and geothermal wells regulated under 43 CFR Part 3160.
Common reasons to file Form 3160-5 include reporting a change of operator, requesting approval for well deepening, or notifying BLM about a surface restoration plan. You may also need it to report casing repairs, tubing changes, or mechanical integrity tests. Any activity that changes the status or physical condition of a permitted well typically requires this submission.
You must submit the form in triplicate to the appropriate BLM field office. Include the well API number, the exact surface location, and the lease or unit agreement number. Describe the proposed work in enough detail for BLM staff to evaluate it against applicable regulations. Supporting documents such as well schematics, plats, or previous approval letters may be required depending on the operation.
For time-sensitive operations, contact your local BLM office to ask about expedited review. Some routine actions, like minor surface disturbance repairs, may qualify for a streamlined approval process.
The form carries legal weight. You must certify the accuracy of all submitted information under penalty of law. Federal statutes outline consequences for filing false or fraudulent statements. This includes fines and potential criminal penalties under 18 U.S.C. 1001.
The form also includes privacy and information-collection disclosures. These disclosures explain how BLM handles the personal data you provide. The Paperwork Reduction Act requires that each federal form display an OMB control number, which appears on the top right of the document. This notice balances the government's need for regulatory data with your right to privacy.
| Question | Answer |
|---|---|
| Form Name | Blm Sundry Notice Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | sundry notice, blm sundry form, blm sundry form 3160 5, blm form 3160 5 |