Laserfiche WebLink
FORM <br /> ROVE <br /> Form 3160-5 UNITED STATES OMB N�P004 0 37 <br /> (June 2015) DEPARTMENT OF THE INTERIOR Expires:January 31,2018 <br /> BUREAU OF LAND MANAGEMENT 5.Lease Serial No. 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 /> I.Type of Well <br /> ❑Oil Well ❑ Gas Well m Other 8.Well Name and No.15H-IR-E <br /> 2.Name of Operator Natural Soda LLC 9.API Well No. <br /> 3a.Address 3200 Rio Blanco County Rd 31 3b.Phone No.(include area code) 10.Field and Pool or Exploratory Area <br /> Rifle,CO.,81650 (970)878-3674 Boies Bed <br /> 4.Location of Well(Footage,Sec., T.,R,M.,or Survey Description) 11.Country or Parish,State <br /> Let:39.927756141 Long:-108.349632558 NAD 83 Rio Blanco <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 Shut-Off <br /> ❑Alter Casing ❑Hydraulic Fracturing ❑Reclamation ❑Well Integrity <br /> ✓❑Subsequent Report ❑Casing Repair ❑New Construction ❑Recomplete ❑Other <br /> ❑Change Plans ❑Plug and Abandon ❑Temporarily Abandon <br /> ❑Final Abandonment Notice ❑Convert to Injection ©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.Attach <br /> the Bond under which the work will be performed or provide the Bond No.on file with BLMBIA.Required subsequent reports must be filed within 30 days following <br /> completion of the involved operations.If the operation results in a multiple completion or recompletion in a new interval,a Form 3160-4 must be filed once testing has been <br /> completed Final Abandonment Notices must be filed only after all requirements,including reclamation,have been completed and the operator has determined that the site <br /> is ready for final inspection.) <br /> All depths referenced to GL.The 15H-IR-E requires a pull-back to maximize mining capacity.A cast iron bridge plug(CIBP)will be set in the production <br /> liner at an approximate depth of 3190 MD GL(�500 feet from TD),and a 20-40 foot interval of the liner will be perforated. The exact CIBP setting depth <br /> and the perforation interval are yet to be determined,and rely on downhole conditions. <br /> 14.I hereby certify that the foregoing is true and correct. Name(Printed/Typed) y� <br /> Title <br /> Signature Date - Z�?_ —_2 C7 Z ( <br /> THE SPACE FOR FEDERAL OR STATE OFICE USE <br /> Approved by <br /> Title Date <br /> ----------------------------------------------------------------------- <br /> Conditions of approval,if any,are attached.Approval of this notice does not warrant or <br /> certify that the applicant holds legal or equitable title to those rights in the subject lease Office <br /> which would entitle the applicant to conduct operations thereon. <br /> Title 18 U.S.0 Section 1001 and Title 43 U.S.0 Section 1212,make it a crime for any person knowingly and willfully to make to any department or agency of the United States <br /> any false,fictitious or fraudulent statements or representations as to any matter within its jurisdiction. <br /> (Instructions on page 2) <br />