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28b Production-Interval C <br /> Date I irst Test Date Hours Test Oil Gas Water Of Gras ity Gas Production Method <br /> Produced Tested Production BBI. MCF, 1313I. Corr API Gravity <br /> —► <br /> Choke Thg Press Csg 24 Hr Oil Gas Water Gas/Od Well Status <br /> Size Fhyg Press Rate BBL MCF BBL Ratio <br /> SI <br /> 28c Production•Interval D <br /> Date First 'rest Date Hours Test Oil Gas Water Oil Gravit_< Gas Production Method <br /> Produced Tested Production BBI. MCF BBL Corr API Graven <br /> Choke Tbg Press Csg 24 Hr Oil Gas Water Gas/Oil Well Status <br /> Size Flvvg Press Rate BBI. MCF BBL Ratio <br /> SI <br /> 24 Disposition of Gas(Solid.used for fuel.rented.etc.) <br /> 30 Summary of Porous Zones(Include Aquifers) 31 Formation(Log)Markers <br /> Shoe all important zones of porosity and contents thereof Cored intervals and all drill-stem tests, <br /> including depth interval tested,cushion used.tone tool open.flowing and shut-in pressures and <br /> reco%eries <br /> Fop <br /> Formation Top Bottom Descriptions,Contents,etc Name <br /> Meas Depth <br /> Uintah 0 1075 Massive sandstone with marl intertoungues <br /> Green River 1075 1685.5 Oil Shale <br /> 32 Additional remarks(include plugging procedure) <br /> Following CBL and prior to drill out,the intermediate annulus was topped off with Portland II cement to surface. <br /> 33 Indicate which items have been attached by placing a check in the appropriate bores <br /> ❑Electrical Mechanical t oes t I fidI set req d) ❑Geologic Report ❑DST Repon ❑Directional Surve\ <br /> ❑Sundn\once foi plugging and cement rerificauon ❑Core 4nahsis ❑ihhet <br /> 34 I hereby certiA,that the foregoing and attached information is complete and correct as determined from all a\ailable records(see attached instructions)* <br /> Name(please pnnrl Gerald J Daub Title President <br /> Signature Date Z_ezzz 2 0 2 <br /> Title 181)S C Section 1001 and Title 43 U S C Section 1212,make it a crime for any person knomngly and willfully to make to any department or agency ofthe United States any <br /> false,fictitious or tiauidulent statements or representanons as to any matter within its jurisdiction <br /> (Continued on pace 3) (Form 3160-4.page 2) <br />