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DIVISION of Gas and Oil

Forms

Frequently used forms are now submitted using the DGO eForms system. Click here for registration instructions or to login. Printable versions of the DGO forms are available here, including those available through eForms, which can be used in special cases with prior approval from the DGO office. Please contact our office for assistance.

Table(s)

Form No. Form Name Download eForms Equivalent
DGO-GO-A Registration Form Download PDF Download MS Word Company Updates
DGO-GO-1 Application for New Permit, Permit Modification or Transfer of Permit Rights Download PDF Download MS Word Application for Permit
DGO-GO-2 Operator's Surety Bond Download PDF Download MS Word Not Available
DGO-GO-3 Operator's Cash Bond Download PDF Download MS Word Not Available
DGO-GO-4 Notice of Application for Permit Download PDF Download MS Word Application for Permit
DGO-GO-5 Persons Receiving Official Notice of Permit Application or Permit Modification Download PDF Download MS Word Application for Permit
DGO-GO-6 Notice of Publication of an Application for a Permit Download PDF Download MS Word Application for Permit
DGO-GO-7 Well Location Plat Download PDF Download MS Word Application for Permit
DGO-GO-8 Information Sheet for Applications to Transfer Permit Rights Download PDF Download MS Word Application for Permit
DGO-GO-9 Technical Data Sheet for Permit Application Under 45.1-361.29 Download PDF Download MS Word Application for Permit
DGO-GO-10 Technical Data Sheet for Gathering Pipelines Download PDF Download MS Word Application for Permit
DGO-GO-11 Technical Data Sheet for a Permit Modification to Plug or Replug Download PDF Download MS Word Application for Permit
DGO-GO-12 Operation Plan Download PDF Download MS Word Application for Permit
DGO-GO-14 Drilling Report Download PDF Download MS Word Drilling Report
DGO-GO-15 Completion Report Download PDF Download MS Word Completion Report
DGO-GO-16 Application for Disposal of Pit or Produced Fluids Download PDF Download MS Word Pit Disposal/Reclamation
DGO-GO-17 Application to Complete Abandoned Gas or Oil Well as a Water Well Download PDF Download MS Word Not Available
DGO-GO-18 Plugging Affidavit Download PDF Download MS Word Not Available
DGO-GO-19 Monthly Gas Production Report Download PDF Download MS Word Monthly Gas Production
DGO-GO-20 Monthly Oil Production Report Download PDF Download MS Word Monthly Oil Production
DGO-GO-21 Notice of Right to Object Download PDF Download MS Word Application for Permit
DGO-GO-23 License to Perform - Plugging of Orphaned Well Download PDF Download MS Word Not Available
DGO-GO-24 License to Perform - Plugging of Well/Bond Forfeiture Download PDF Download MS Word Not Available
DGO-GO-25 Affidavit & Release in Support of Surface Owner's Application to the VA DGO for use of an Orphaned Well as a Water Well Download PDF Download MS Word Not Available

Geothermal Forms

Form No. Form Name Download eForms Equivalent
DGO-G-01 Registration Form for Drillers, Owners & Operators of Geothermal Wells Download PDF Download MS Word Not Available
DGO-G-02 Application for Exploration Permit Download PDF Download MS Word Not Available
DGO-G-02A Appendix for Exploration Permit if Well Work Involves Drilling, Redrilling or Deepening Download PDF Download MS Word Not Available
DGO-G-03 Geothermal Resource Well Operator's Bond Download PDF Download MS Word Not Available
DGO-G-04 Geothermal Well Plat Download PDF Download MS Word Not Available
DGO-G-04A Certification of Location of a New Well Download PDF Download MS Word Not Available
DGO-G-05 Report on Completion of Well Work Download PDF Download MS Word Not Available
DGO-G-05A Report on Completion of Work if Drilling, Redrilling or Deepening is Involved Download PDF Download MS Word Not Available
DGO-G-05B Notice of Intent to Plug or Abandon Download PDF Download MS Word Not Available
DGO-G-05C Casing and Tubing Program Download PDF Download MS Word Not Available
DGO-G-05D Driller's Log Download PDF Download MS Word Not Available
DGO-G-06 Notice of Intent to Proceed Download PDF Download MS Word Not Available
DGO-G-07 Geothermal Resource Production or Injection Report Download PDF Download MS Word Not Available
DGO-G-08 Ground Water Monitoring Report Download PDF Download MS Word Not Available
DGO-G-09 Geothermal Fluid Monitoring Report Download PDF Download MS Word Not Available
DGO-G-10 Notification of Chemical Cleaning of a Geothermal Well Download PDF Download MS Word Not Available
DGO-G-11 Surveyor's Report on Subsidence Download PDF Download MS Word Not Available
DGO-G-12 Application for Reclassification of a Geothermal Area Download PDF Download MS Word Not Available
DGO-G-13 Request for Permission to Engage in Sequential Utilization Download PDF Download MS Word Not Available
DGO-G-14 Application for Exemption from Injection Requirement Download PDF Download MS Word Not Available