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

24. Using standard QtrQtr, Sec, Twp, Rng format enter entire mineral lease description upon which this proposed wellsite is
located (attach separate sheet/map if you prefer):
SEE ATTACHED SHEET TITLED "ATTACHMENT TO COGCC FORM 2 - APD - QUESTION #24 - ELK CREEK FAN BOREHOLE #1
25. Distance to Nearest Mineral Lease Line: 1960 ft 26. Total Acres in Lease: 2858
DRILLING PLANS AND PROCEDURES
27. Is H2S anticipated? Yes (X No If Yes, attach contingency plan.
28. Will salt sections be encountered during drilling? Yes FX— No
29. Will salt (>15,000 ppm TDS CL) or oil based muds be used during drilling? Yes (X( No
30. If questions 28 or 29 are yes, is this location in a sensitive area (Rule 901.e)? Yes Fx— No
31. Mud disposal: Offsite [-xOnsitep 29, or are "Yesa pit
permit be may be required.
Method: Land Farming Land Spreading Disposal Facility Other: EVAPORATION
Note: The use of an earthen pit for Recompletion fluids requires a pit permit (Rule 905b). If air/gas drilling, notify local fire officials.
Casing Type Size of Hole Size of Casing Wt/Ft Csg/Liner Top Setting Depth Sacks Cmt Cmt Btm Cmt Top
CONDUCTOR 30 24 64 0 90 4 90 0
SURF 22 18 59 0 202 7 202 3
32. BOP Equipment Type: Annular Preventer Double Ram r Rotating Head None
33. Comments SURFACE CASING TO SERVE AS PRODUCTION CASING. PLEASE CONTACT MARK AT 303-820-448 OR
[e-mail] WITH ANY QUESTIONS
34. Location ID:
35. Is this application in a Comprehensive Drilling Plan ? Yes lX No
36. Is this application part of submitted Oil and Gas Location Assessment ? Tx— Yes No
I hereby certify all statements made in this form are, to the best of my knowledge, true, correct, and complete.
Signed: Print Name: KIM RODELL
Title: PERMIT AGENT Date: 1/16/2012 Email: [e-mail]
Based on the information provided herein, this Application for Permit-to-Drill complies with COGCC Rules and applicable orders
and is hereby approved.
COGCC Approved: �, rtDirector of COGCC Date: 2/10/2012
API NUMBER Permit Number: Expiration Date: 2/9/2014
05 051 06105 00
CONDITIONS OF APPROVAL, IF ANY:
All representations, stipulations and conditions of approval stated in the Form 2A for this location shall
constitute representations, stipulations and conditions of approval for this Form 2 Permit-to-Drill and are
enforceable to the same extent as all other representations, stipulations and conditions of approval stated in
this Permit-to-Drill.
WITHIN 30 DAYS OF THIS FORM 2 APPROVAL, OPERATOR MUST SUBMIT A FORM 5 (COMPLETION REPORT)
TO COGCC INCLUDING CEMENT TICKETS FOR ALL CASING STINGS AND ANY LOGS THAT HAVE BEEN RUN.
Date Run: 21012012 Doc [#400240723] Well Name: ELK CREEK FAN BOREHOLE #1 Page 2 of 3