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RECEI V EL) <br /> ;AS CONSERVATION COMMISSION SEP G 1973 <br /> TMENT OF NATURAL RESOURCES <br /> 99 999 'HE STATE OF COLORADO_, s �.ar•ni,QN�i L oared rnr��_��;_�;�� <br /> Nplicate for Patented and Federal lands. <br /> File in triplicate for State lands. <br /> SUNDRY NOTICES AND REPORTS ON WELLS d• Ir INDIAN, ALLOTTRR OR TRIPS NAME <br /> (Do not use this form for propoSala to drill or to deepen or plus Fact to a different reservoir. <br /> Use"APPLICATION FOR PERMIT—"for such plopaRla) <br /> �J T. UNIT AQRSEMENT NAME <br /> OIL GAS <br /> WELL ❑ WELL ❑ OTHER Dry <br /> 2. NAME Or OPERATOR S. PARM OR LEASE NAME <br /> Cauctus Energy & LeClair-Westwood, Inc., Agent Charles Brown 1� <br /> S. ADDasse OP OPERATOR 9. WELL NO. <br /> 388 Denver Club Building, Denver, Colorado 80202 1 <br /> 4. LOCATIDN Or TELL (Report location clearly and III accordance with any State requirements. 10. r1SLD AND POOL,OR WILDCAT <br /> See also space 1T below.) <br /> At surface Wildcat <br /> At proposed vrod. gone 750' FSL & 650' FEL Section 3, T3N, R61W 11• sac, <br /> r., o:"A0OIL L%.A" <br /> Section 3, T3N R61W <br /> 14. PERMIT NO. 15. =xvATIONe (Show whether DP,ST.US,Ste.) 12. COUNTS 23. ETATE <br /> 78-632 I 4619' KB 4613' GR Weld Colorado <br /> 16. Check Appropnate Box to Indicate Nature of Notice, Report, or Other Data <br /> NOTICE Or INTENTION TO: BUSBWBNT 131PORT OP: <br /> TEST WATER a9UT-OPP PULL OR ALTER CASINO WATER SEUT47/ REPAIRING WELL <br /> PBACTURC TREAT MULTIPLE COMPLETE ,PRACTURS TREATMENT ALTRRINO CASINO <br /> SHOOT OR ACIDIZE ABANDON $BOOTING OB ACIDIEINO ARANDONMBNT CK <br /> REPAIR WELL CHANGE PLANS (Other) <br /> (NOTE: Report results of multiple Completion on Well <br /> (Other) _ Completion or Recompletion Report and Los form.) <br /> LT. DESCRIBE PR01,089D OR CO}IPLETED OPERATIONS (Clenrly State all pertineut detal1w. and give pertinent dates, including estimated date of starting any <br /> proposed work. If well is directionally drilled. give subsurface locations and measured and true vertical depth■ for all markers and zones pertl- <br /> nent to this work.) <br /> Date of work 712 2/78 .1� <br /> Well was plugged with 15 sacks bottom of surface casing and 10 sacks top of <br /> surface casing. <br /> MR1 <br /> FJP <br /> JA4.� <br /> J J.^. <br /> RLS <br /> ��II��11 1 I�III� LC <br /> GS! <br /> 18. I hereby certifyt at f ins is true and correct <br /> SIGNZD�L TITLE ProdLcti on Engi_near DATE 71.28.17R <br /> (This space for Feder r State o ) %,+ <br /> APPROVED BY TITLE h i tv y''I' DATE S E P / 1978 <br /> CONDITIONS PR AL, I A <br />