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28b Production-Interval C <br /> Date First Test Date Hours Test Oil Gas Water Oil Gravity Gas Production Method <br /> Produced Tested Production BBL MCF BBL Corr API Gravity <br /> aim. <br /> Choke Tbg Press Csg 24 Hr Oil Gas Water Gas/011 Well Status <br /> Size Flwg Press Rate BBL MCF BBL Ratio <br /> SI <br /> amt. <br /> 28c Production-Interval D <br /> Date First Test Date Hours Test Oil Gas Water Oil Gravity Gas Production Method <br /> Produced Tested Production BBL MCF BBL Corr API Gravity <br /> — <br /> Choke Tbg Press Csg 24 Hr Oil Gas Water Gas/Oil Well Status <br /> Size Flwg Press Rate BBL MCF BBL Ratio <br /> SI tam. <br /> 29 Disposition of Gas(Solid,used for fuel.vented.etc.) <br /> 30 Summary of Porous Zones(Include Aquifers) 31 Formation(Log)Markers <br /> Show all important zones of porosity and contents thereof Cored intervals and all drill-stem tests. <br /> including depth interval tested,cushion used,time tool open,flowing and shut-in pressures and <br /> recoveries <br /> Top <br /> Formation Top Bottom Descriptions,Contents,etc Name <br /> Meas Depth <br /> Uinta 0 1130 Sandstone,marl tongues 0 <br /> Green River 1130 1910 Oil shale 1130 <br /> (TVD TD) <br /> 32 Additional remarks(include plugging procedure) <br /> 33 Indicate which items have been attached by placing a check in the appropriate boxes <br /> m Electrical'Mechanical Logs(1 full set req'd 1 ❑Geologic Report El DST Report m Directional Stine) <br /> ED Sundry Notice for plugging and cement tenfication 0 Core Analysis 0 Other <br /> 34 I hereby certify that the foregoing and attached information is complete and correct as determined from all available records(see attached instructions)* <br /> Name(please print) Gera J Dau Title President of aub&Ass ciates,Inc. <br /> Signature, Date 25- <br /> Title 18 U.S C Section 1001 <br /> and tle 43 U S C Section 1212,make it a cnme for any person knowingly and willfully to make to any department or agency of the United States any <br /> false,fictitious or fraudulent statements or representations as to any matter within its jurisdiction <br /> (Continued on page 3) (Form 3160-4,page 2) <br />