Laserfiche WebLink
Form 3160-5 UNITED STATES FORM APPROVED <br /> (August 2007) OMB No.1004-0137 <br /> DEPARTMENT OF THE INTERIOR Expires:July 31,2010 <br /> BUREAU OF LAND MANAGEMENT 5.Lease Serial No. <br /> COC-0118327 <br /> SUNDRY NOTICES AND REPORTS ON WELLS 6.If Indian,Allottee or Tribe Name <br /> Do not use this form for proposals to drill or to re-enter an <br /> abandoned well. Use Form 3160-3(APD)for such proposals. <br /> SUBMIT IN TRIPLICATE-Other instructions on page 2. 7.If Unit of CA!Agreement,Name and'or No. <br /> Natural Soda,LLC <br /> I.Type of Well <br /> 9. Name and No. <br /> ❑Oil Well ❑Gas Well m Other Ground Water Monitoring Well BGr81(DS-4)(0H-C) <br /> 2.Name of Operator 9.API Well No. <br /> Natural Soda,LLC nla <br /> 3a.Address 3b. Phone No.(include area code) 10.Field and Pool or Exploratory Area <br /> 3200 Rio Blanco County Road 31 <br /> Rifle,CO 81650 (970)878-3674 <br /> 4. Location of Well(Footage,Sec.. T.,R.,H..or Sun,ev Description) 11.Country or Parish.State <br /> 229381.50 ft.N,1200539,79 n.E(0501,NAD 27):SESE,S26,T1S,R98W.6th Pfd <br /> Rio Blanco County,Colorado <br /> 12. CHECK THE APPROPRIATE BOX(ES)TO INDICATE NATURE OF NOTICE,REPORT OR OTHER DATA <br /> TYPE OF SUBMISSION TYPE OF ACTION <br /> ❑Notice of Intent ❑Acidize ❑Deepen ❑ Production(Start/Resume) ❑ Water Shui-Off <br /> ❑Alter Casing ❑Fracture Treat ❑ Reclamation ❑ Well Integrity <br /> ©Subsequent Report ❑Casing Repair ❑New Construction ❑ Recomplete ❑ Other <br /> ❑('hangs Plans ❑Plug and Abandon ❑ Temporarily Abandon <br /> ❑Final Abandonment Notice ❑Convert to Injection m Plug Back ❑ Water Disposal <br /> 13.Describe Proposed or Completed Operation:Clearly state all pertinent details,including estimated starting date of any proposed work and approximate duration thereof If <br /> the proposal is to deepen directionally or recomplete horizontally,give subsurface locations and measured and true vertical depths of all pertinent markers and zones. <br /> Attach the Bond under which the work will be performed or provide the Bond No.on file with BLMtBIA. Required subsequent reports mast be filed within 30 days <br /> following completion of the involved operations. If the operation results in a multiple completion or recompletion in anew interval,a Form 31004 must be filed once <br /> testing has been completed. Final Abandomtent Notices must be filed only after all requirements,including reclamation,have been completed and the operator has <br /> determined that the site is ready for final inspection.) <br /> The DS-4 Groundwater Monitoring well was successfully converted to a B-Groove Aquifer Monitoring well on July 11,2016. The DS4 will be now be refered <br /> to as the BG-8 well. The well was plugged back using gravel from the Cast Iron Bridge Plug at 1952'to 1832'BGL,cement from 1832'to 16515,and <br /> bentonite from 1651.5'to 1640.5'BGL at the bottom of the B-groove Aquifer. The casing was perforated across the B-Groove aquifer interval between 1600' <br /> and 1640'using 3 shots per foot for a total of 120 shots For additional detail please refer to the attached Well Completion Diagram. <br /> 14. 1 hereby certify that the foregoing is true and correcl. <br /> Name(Printed/Typed) <br /> Gerald J.Daub Title President,Daub&Associates,Inc. <br /> Signature Date 0 - S -/'6/ <br /> THIS SPACE FOR FEDERAL OR STATE OFFICE USE <br /> Approved by <br /> Title Date <br /> Conditions of approval,if any,are attached. Approval of this notice does not warrant or certify <br /> that the applicant holds legal or equitable title to those rights in the subject lease which would Office <br /> entitle the applicant to conduct operations thereon. <br /> Title 18 U.S.C.Section 1001 and Title 43 U.S.C.Section 1212,make it a crime for any person knowingly and willfully to make to an)department or agency of the United States any false, <br /> fictitious or fraudulent statements or representations as to any matter within its jurisdiction. <br /> (Instructions on page 2) <br />