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APROVE
<br /> Form 3160-5 UNITED STATES OMB No.1004 0 3I7
<br /> (June 2015) DEPARTMENT OF THE INTERIOR Expires:January 31,2018
<br /> BUREAU OF LAND MANAGEMENT 5.Lease Serial No.
<br /> 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 /> 1.Type of Well
<br /> ❑Oil Well ❑ Gas Well ❑Other 8.Well Name and No.BG-9(DS-5,2010-26-198-1 C)
<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 /> Lat:39.930306 Long:-108.352050 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 perfonned 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 31604 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 BG-9(DS-5,2010-26-198-lC)well reached the end of its useful life and has been plugged and abandoned.Prior to
<br /> P&A,the previous cement plugback in the 4.5"casing between the depths of 1,662 and 1,818 feet was drilled out to the top of the cast iron bridge(CIBP)
<br /> plug at 1,818 feet.In addition to the 16 original B-Grove recompletion casing perforations,between 1,602.6 and 1,621.6 feet,the 4.5"casing was
<br /> perforated at depths of 1,798,610,and 400 feet.Each perforation interval consists of four 0.38"holes at 90 degree phasing and with 20.5"of penetration,
<br /> Two separate cement squeeze jobs were pumped to plug the well casing and surrounding wellbore from 1,818 to 1,482 feet,permanent cement retainers
<br /> set at 1,758 feet and 1,579 feet. The first cement squeeze plug consisted 55 sacks(12.1 bbis)of 14.5 lb/gal IntegraBond Perm G cement blend. Based
<br /> on the calculated 4.5-inch casing volume for the interval from 1,818(top of CIBP)to 1,758(cement retainer),approximately 10.2 bbis of cement was
<br /> pushed out the casing partings at 1,760.9,1,782.2,and 1,782.2 feet and perforations at 1,798 feet into the adjacent casing annulus and formation. The
<br /> second squeeze plug consisted of 97.6 sacks(21.5 bbis)of 14.5 lb/gal IntegraBond Perm G cement blend. Based on the calculated volume to fill the
<br /> space between 1,695 feet(top of Stage#1 cement)and the cement retainer(at 1,579 feet),approximately 18.2 bbis of cement was squeezed out into the
<br /> formation and B-Groove Aquifer through the B-Groove Aquifer casing perforations. An additional 38.6 sacks(8.5 bbis)of 14.5 lb/gal IntegraBond Perm G
<br /> cement blend was pumped in two balanced plug lifts from the calculated stage#2 cement top of 1,482 feet to 852 feet. The final cement stage consisting
<br /> of 14.4 bbis(63 sacks)of 13.4 lb/gal Portland Type 1/II LA cement was pumped from 852 feet to ground level using the balanced plug method.The area
<br /> around the well was dug out at surface and the casing was cut off 3 feet below GL.A steel cap with the well name was welded onto the 7.0"conductor
<br /> casing and buried. For additional information please see attached As-Built Plug and Abandonment diagram.
<br /> 14.I hereby certify that the foregoing is true and correct. Name(Printed/Typed)
<br /> Gerald J.Daub Title President/Daub&Associates Inc.
<br /> Signature Date 23 Z oZ
<br /> THE SPACE FOR FEDERAL OR STATE ONCE 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 gee
<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)
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