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Form Hpprove0 01916 Igo z040-00z;z rtpprocal t;;ptres 5-s0-9 <br />^� UNITED STATES ENVIRONMENTAL- PROTECTION AGENCY <br />C WASHINGTON, DC 20460 <br />PLUGGING AND ABANDONMENT <br />American Soda L.L.P. <br />27991 County Road 5 <br />Rifle, Co, 81650 <br />NAME AND ADBRESS OF OWNER/OPERATOR <br />American Soda L.L.P. <br />2717 County Road 215 <br />Parachute, Co, 81635 <br />LOCATE WELL AND OUTLINE UNIT ON <br />SECTION PLAT 640 ACRES <br />STATE <br />C6. <br />COUNTY <br />Rio Blanco <br />PERMIT NUMBER <br />C03858-04576 <br />N <br />X <br />SURFACE LOCATION DESCRIPTION <br />I/. of NW %of NE %of %ofSection29 Township 1S Range97W <br />152' S. and 2,024' W. of NE corner of Section 29, Township 1S, Range 97W 6- P.M. <br />LOCATE WELL IN TWO DIRECTIONS FROM NEAREST LINES OF QUARTER SECTION AND DRILLING UNIT <br />Surface Location 152'(S) from section comer and 2024'(W) from NE section corner <br />Elevation Casing Head = 6424' Elevation Ground Level = 6422' <br />13,087.01 Easting 12,774.16 Northing <br />TYPE 6F AUTH6RIZATI6N <br />X Individual Permit <br />Area Permit <br />Rule <br />Number of Wells _1_ <br />Lease Name Yankee Gulch <br />WELL ACTIVITY <br />CLASS I <br />CLASS II <br />Brine Disposai <br />Enhanced Recovery <br />n,OrocaMon Storage <br />❑X CLASS III (Nahcolite Production Well) <br />Side by Side Dual 7" Cabiny completion <br />vvell AumCer 29-29 <br />W <br />E <br />S <br />CASING AND TUBING RECORD AFTER PLUGGING <br />METHOD OF EMPLACEMENT OF CEMENT PLUGS <br />The Balance Method <br />The dump Bailer Method <br />The Two -Plug Method <br />X Other <br />Tremie through Coil Tubing Unit <br />SIZE TO BE LEFT IN WELL(FT) HOLE SIZE <br />4 95# - ERW 0 - 24" <br />7" 26# - J-55 0 0 - 1888' (short 19" <br />& N-80 stria <br />7" 26# -J-55 & 0 0- 2265' (long 19" <br />N-80 stria <br />CEMENTING TO PLUG AND ABANDONED DATA PLUG #1 PLUG #2 PLUG #3 PLUG #4 PLUG #5 PLUG #6 PLUG #7 <br />Size of Hole or Pipe In which u Will e Placed (inches)7" Short 7" Lon <br />Depth to Bottom of Tubing or Drill Pipe ft. 1888' 2205' <br />Depth to Cast Iron Bride Plug ft. 1685' 1685' <br />Sacks of Cement Used eachplug) 315 315 <br />Slurry Volume Pumped cu. ft. 362 362 <br />Calculated Top of Plug ft. Surface Surface <br />Measured Top of Plug if tagged ft. Surface Surface <br />Slur Wt. Lb./Gal. 15.8 15.8 <br />Type cement or other material Class I H) Type G Type G <br />LIST ALL OPEN HOLE AND/OR PERFORATED INTERVALS WHERE CASING WILL BE VARIED if an <br />From To From To <br />8/ XX/ 2015- Di55olutirn 5urfaue at 1634'. Coil tabin6 placement of cement at bridge plus [1685'). Pumped 315 sncks uf Type G, 15.8 pounds/galls., 1.15 <br />ft'/sack cement in the short strin6 7" ca.ins. 8/XX/2015 —Coil tabin6 placzmznt of cement at bridgz plug (1685'). Pumpzd 315 5ack5 of Type G, 15.8 <br />pounds/sallun, 1.15 ft3/5azk cement in the long string 7" casing. <br />I certify under the penalty of the law that I have personally examined and am familiar with the information <br />submitted in this document and all attachments and that based on my inquiry of those individuals <br />immediately responsible for obtaining the information, I believe that the information is true, accurate, <br />and complete. 1 am aware that there are significant penalties for submitting false information, including <br />the possibility of fine and imprisonment. (Ref. 40 CFR 144.32 <br />ease typeorpnn <br />David Valvoda Plant Manager <br />SIGNATURE <br />August XX, 2015 <br />EPA Form 7620-14 <br />