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Form 3160-4 <br /> (August 2007) UNITED STATES <br /> FORM APPROVED <br /> DEPARTMENT OF THE INTERIOR OMB NO. 1004-0137 <br /> BUREAU OF LAND MANAGEMENT Expires:July 31,2010 <br /> WELL COMPLETION OR RECOMPLETION REPORT AND LOG 5. Lease Serial No. <br /> C-0118327 <br /> Ia. Type of Well Ud&WjII Gas Well Dry Other 6. If Indian,Allottee or Tribe Name <br /> b. 'Type of Completion: ®New Well Work Ovc H Deepen ❑Plug Back ❑ Diff.Resvr., <br /> 7. Unit or CA Agreement Name and No. <br /> Otber: <br /> 2. Name of Operator 8. Lease Name and Well No. <br /> Natural Soda LLC Federal Sodium Lease,well 15H-SSMW <br /> 3. Address 3200 RBC 31,Rine CO.,81650 3a Phone No.(include area code) 9. AFl Well No. <br /> (888)464-7632 <br /> 4. Location of Well (Report location clearh and in accordance with Federal requirements)• 10. Field and Pool or Exploratory <br /> 39.9272700 <br /> At surface 108.3679500 1 I. Sec.,T.,R.. on Block and <br /> Survey or Area <br /> sec 26,T1S,R98W <br /> At top prod.interval reported below 12. County or Parish 13. State <br /> Rio Blanco CO <br /> At total depth <br /> 14. Date Spudded 15. Date T.D.Reached 16. Date Completed 06/20/2016 17. Elevations (DF,RhB,RT,GL)` <br /> 06/1512016 06/19/2016 D&A MReady to Prod. GL 6686.6 <br /> 18. Total Depth: MD 1765.0 19. Plug Back T.D.: MD 20. Depth Bridge Plug Set: MD <br /> TVD I TVD TVD <br /> 21. Type Electric&Other Mechanical Logs Run (Submit copy of each) 22 Was well cored? 0 No ❑Yes (Submit analysis) <br /> Was DST run' ®No ❑Yes (Submit report) <br /> Gamma/density/CCL,CBL Directional Survey'? ONo Yes Submit co <br /> 23. Casingand Liner Record (Report all strings set in well <br /> Wt.(q'@.) Top (MD) Bottom (MD) Stage Cementer No. of Sks. Slurry Vol. Cement Top` Amount Pulled <br /> Hole Size SizeiGrade <br /> Depth T of Cement (BBL) <br /> 9.75 7.625 126.4 0 88 15 Portland surface <br /> 6.5 4.5 111.6 0 1763.4 232 Extendace 1.5 feet <br /> 24. Tubing Record <br /> SizeI Depth Set (MD) Packer De tb(MD) Size De th Set MD) Packer De th(MD) Size De th Set MD Packer De th(MD <br /> 25. Producing Intervals 26. Perforation Record <br /> Formation To Bottom Perforated Interval Size No.Holes Perf.Status <br /> A) na <br /> B) <br /> C) <br /> D) <br /> 27. .Acid,Fracture,Treatment,Cement Squeeze,etc. <br /> Depth Interval Amount and Type of Material <br /> na <br /> 28. Production-interval A <br /> Date First Test Date lours Test it as Water it Gravity Gas Production Method <br /> Produced Tested Production Bl. CI' BI- Corr.AN ,ravity <br /> Choke Tbg.Press.CSg. 24 Hr. it Gas Water ias�Oil Well Status <br /> Size Flwg, Press. Rate BL MCF JBI_ Ratio <br /> 28a. Production-Interval B. <br /> Date First fesi Date lours esi it as Water it Gravity Gas roduction Method <br /> Produced esled roduction Bl. CF BBL Corr.API Gravity <br /> e g.Press. sg. 4 Hr. it as Water as/OiI ell Status <br /> �. Iwg. Press, Rate BL MCF 13BL Ratio <br /> *(See instructions and spaces for additional data on page 2) <br />