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OMB No.2040-0042 Approval Expires 1 213 112 01 8 <br /> United States Environmental Protection Agency <br /> ..EPA Washington,DC 20460 <br /> PLUGGING AND ABANDONMENT PLAN <br /> Name and Address of Facility Name and Address of Owner/Operator <br /> Natural Soda LLC Natural Soda LL(' <br /> 3200 RBC Rd 31,Rifle,CO.,81650 3200 RBC Rd 31.Rifle,CO..81650 <br /> State County Permit Number <br /> o County Locate Well and Outline Unit on CO Rio Blanco Ct C030358 <br /> Section Plat•640 Acres Y <br /> N Surface Location Description <br /> I 1/4 of.N\V 114 of,SE 114 of S\1 1/4 of Section 26 Township j S Range 98\4 <br /> Locate well In two directions from nearest lines of quarter section and drilling unit <br /> I I I I I I <br /> Surface <br /> f Location 751 ft.frm(N/S),S Line of quarter section <br /> and M4 ft.from(E/W),�' Line of quarter section. <br /> I I I I I I - <br /> TYPE OF AUTHORIZATION WELL ACTIVITY <br /> W E <br /> Individual Permit CLASS 1 <br /> A Area Permit —� CLASS If <br /> I I 1I I I ( Rule Brine Disposal <br /> 1_L®1 J—L—L _ Number of Wells 7 Enhanced Recovery <br /> I I I Hydrocarbon Storage <br /> ICI CLASS III <br /> S C-0118127 12H-IR <br /> Lease Name Well Number <br /> CASING AND TUBING RECORD AFTER PLUGGING METHOD OF EMPLACEMENT OF CEMENT PLUGS <br /> SIZE WT(LBIFT) TO BE PUT IN WELL(FT) TO BE LEFT IN WELL(FT) HOLE SIZE ^ The Balance Method <br /> 16 75 120 120 24 The Dump Bailer Method <br /> 9.625 40 2275 2275 13.5 <br /> The Two-Plug Method <br /> 7.0 23 1459 1459 8.5 L Other <br /> CEMENTING TO PLUG AND ABANDON DATA: PLUG$1 PLUG fit PLUG•3 PLUG f/4 PLUG#5 PLUG$6 PLUG 07 <br /> Size of Hole or Pipe In which Plug Will Be Placed(Inche 9.625 9.625 <br /> Depth to Bottom of Tubing or Drill Pipe(ft na na <br /> Sacks of Cement To Be Used(each plug) na 757 <br /> Slurry Volume To Be Pumped(cu.ft.) na 894 <br /> Calculated Top of Plug(ft.) na 0 <br /> Measured Top of Plug(If tagged ft.) 2100 <br /> Slurry Wt.(Lb./Gal.) na 15.0 <br /> Type Cement or Other Material(Class 111) CIBP III-ILA' <br /> LIST ALL OPEN HOLE AND/OR PERFORATED INTERVALS AND INTERVALS WHERE CASING WILL BE VARIED(if any) <br /> From To From To <br /> Open Hole 2262'NID GL 3509'MD GL <br /> Estimated Cost to Plug Wells <br /> S35,000 USD <br /> Certification <br /> I certify under the penalty of law that I have personally examined and am familiar with the Information submitted In this document and all <br /> attachments and that,based on my Inquiry of those Individuals Immediately responsible for obtaining the Information,1 believe that the <br /> Information Is true,accurate,and complete. I am aware that there are significant penalties for submitting false Information,Including the <br /> possibility of fine and Imprisonment. (Raf.40 CFR 144.32) <br /> Name and Official Title (Please type or print) Signature Date SiJ/ned <br /> Gerald Daub,President,Daub&Associates,Inc. �-- <br /> EPA Form 7620.14 (Rev.12-11) <br />