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FORM State of Colorado A <br /> DE JET JOE JES <br /> 6 Oil and Gas Conservation Commission <br /> Rev 1120 Lincoln Street,Suite 801,Denver,Colorado 80203 Phone:(303)894-2100 Fax:(303)894AV'. <br /> Document Number: <br /> 05/18 2109 <br /> WELL ABANDONMENT REPORT 401851459 <br /> This form is to be submitted as an Intent to Abandon whenever an abandonment is planned on a borehole. After the Date Received: <br /> abandonment is complete,this form shall again be submitted as a Subsequent Report of the actual work completed.The <br /> approved intent shall be valid for six months after the approval date,after that period,a new intent will be required. <br /> Attachments required with the Intent to Abandon are wellbore diagrams of the current configuration and the proposed 11/27/2018 <br /> configuration with plugs set. <br /> A Subsequent Report of Abandonment shall indicate the actual work completed. Attachments required with a Subsequent <br /> Report are a wellbore diagram showing plugs that were set and casing remaining in the hole,the job summaries from all <br /> plugging contractors used,including wireline and cementing(third party verification)and any logs that may have been run <br /> during abandonment. <br /> OGCC Operator Number: 69175 Contact Name: Valerie Danson <br /> Name of Operator: PDC ENERGY INC Phone: (970)506-9272 <br /> Address: 1775 SHERMAN STREET-STE 3000 Fax: <br /> City: DENVER State: CO Zip: 80203 Email: valerie.danson@pdce.com <br /> For"Intent"24 hour notice required, Name: Tel: <br /> COGCC contact: Email: <br /> API Number 05-123-11891-00 <br /> Well Name: MOTIS Well Number: 1 <br /> Location: QtrQtr: NESE Section: 7 Township: 5N Range: 64W Meridian: 6 <br /> County: WELD Federal, Indian or State Lease Number: 56527 <br /> Field Name: KERSEY Field Number: 44600 <br /> Notice of Intent to Abandon Iz Subsequent Report of Abandonment <br /> Only Complete the Following Background Information for Intent to Abandon <br /> Latitude: 40.411280 Longitude: -104.586750 <br /> GPS Data: <br /> Date of Measurement: 08/21/2010 PDOP Reading: 1.3 GPS Instrument Operator's Name: Holly L.Tracy <br /> Reason for Abandonment: iDry 1 Production Sub-economic Mechanical Problems <br /> Other <br /> Casing to be pulled: I Yes No Estimated Depth: <br /> Fish in Hole: i Yes (_ No If yes,explain details below <br /> Wellbore has Uncemented Casing leaks: 1 Yes I No If yes,explain details below <br /> Details: <br /> Current and Previously Abandoned Zones <br /> Formation Perf.Top Perf. Btm Abandoned Date Method of Isolation Plug Depth <br /> CODELL 6842 6856 10/25/2018 B PLUG CEMENT TOP 6502 <br /> NIOBRARA 6552 6764 10/25/2018 B PLUG CEMENT TOP 6502 <br /> Total:2 zone(s) <br /> Casing History <br /> Casing Type Size of Hole Size of Casing Weight Per Foot Setting Depth Sacks Cement Cement Bot Cement Top Status <br /> SURF 12+1/4 8+5/8 24 332 270 332 0 VISU <br /> 1ST 7+7/8 5+1/2 17 7,005 375 7,005 5,283 CBL <br /> Stage Tool 2,928 700 2,928 1,100 CBL <br /> Date Run:411512019 Doc[#401851459]Well Name:MOTIS 1 Page 1 of 3 <br />