2015-11-06_PERMIT FILE - C1981022 ‎(2)‎

• Permit No: C1981022
• IBM Index Class Name: Permit File
• Doc Date: 11/6/2015
• Doc Name: Colorado Oil And Gas Conservation Commission
• Media Type: D
• Archive: No

Date planned to commence construction: 06/10/2010 Size of disturbed area during construction in acres: 0.10
Estimated date that interim reclamation will begin: 06/01/2012 Size of location after interim reclamation in acres: 0.10
Estimated post-construction ground elevation: 6407 Will a closed loop system be used for drilling fluids: Yes
Will salt sections be encountered during drilling: Yes No jx Is H2S anticipated? Yes No jx
Will salt (>15,000 ppm TDS CI) or oil based muds be used: Yes No jx
Mud disposal: Offsite Onsite Fx- Method: Land Farming Land Spreading Disposal Facility
Other: EVAPORATION
7. Surface Owner:
Name: Phone:
Address: Fax:
Address: Email:
City: State: Zip: Date of Rule 306 surface owner consultation:
Surface Owner: )- Fee State Federal Indian
Mineral Owner: (X Fee State Federal Indian
The surface owner is: Fx- the mineral owner >f committed to an oil and gas lease
is the executer of the oil and gas lease the applicant
The right to construct the location is granted by: FX oil and gas lease Surface Use Agreement Right of Way
applicant is owner
Surface damage assurance if no agreement is in place: $2000 $5000 Blanket Surety ID
8. Reclamation Financial Assurance:
r Well Surety ID: 20050098 Gas Facility Surety ID: Waste Mgnt. Surety ID:
9. Cultural:
Is the location in a high density area (Rule 603.b.): Yes No >t
Distance, in feet, to nearest building: 90 , public road: 220 above ground utilit: 3850
, railroad: 3835 property line: 1960
10. Current Land Use (Check all that apply):
Crop Land: Irrigated Dry land Improved Pasture Hay Meadow CRP
Non-Crop Land: (X Rangeland Fx_ Timber Recreational Other (describe):
Subdivided: Industrial Commercial Residential
11. Future Land Use (Check all that apply):
Crop Land: Irrigated Dry land Improved Pasture Hay Meadow CRP
Non-Crop Land: FX Rangeland jx Timber Recreational Other (describe):
Subdivided: Industrial Commercial Residential
12. Soils:
List all soil map units that occur within the proposed location. Attach the National Resource Conservation Service (NRCS)
report showing the "Map Unit Description" report listing the soil typical vertical profile. This data is to used when
segregating topsoil.
The required information can be obtained from the NRCS web site at http://soildatamart.nres.usda.gov/ or from the
COGCC web site GIS Online map page found at http://colorado.gov/cogcc. Instructions are provided within the COGCC
web site help section.
NRCS Map Unit Name: 75 TORRIORTHENTS - ROCK OUTCROP, SANDSTONE, COMPLEX
Date Run: V10/2012 Doc [#400240957] Loc Name: ELK CREEK FAN BOREHOLE #1 Page 2 of 5