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Form 3160-5 UNITED STATES FORM APPROVED <br /> OMB No. 1004-0137 <br /> (June 2019) DEPARTMENT OF THE INTERIOR Expires:October 31,2021 <br /> BUREAU OF LAND MANAGEMENT 5.Lease Serial No. COC-0118327 <br /> SUNDRY NOTICES AND REPORTS ON WELLS 6.Iflndian,Allottccor 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.90-1 <br /> 2.Name of Operator Natural Soda LLC 9.API Well No. <br /> 3b.Phone No.(include area code) 10.Field and Pool or Exploratory Area <br /> 3a.Address 3200 Rio Blanco County Rd 31 <br /> Rifle,CO.81650 (970)878-3674 Piceance Creek Basin <br /> 4.Location of Well(Footage,Sec., T.,R.,M.,or Survey Description) 11.Country or Parish,State <br /> 1500 FSL, 1800 FWL,S26,T1S,R98W,6th PM Rio Blanco County,CO <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 BLM/BIA.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 90-1 well reached the end of its useful life and has been plugged and abandoned.The nitrogen lift sampling pump and <br /> all associated tubing was pulled out of the well. A 3.75-inch tri-cone bit was advanced down the well to air lift and clean the hole with foam water injection. <br /> The 4.5-inch casing was perforated at 500,240,and 77 feet below ground level with 4 shots per foot at 90 degree phasing. All cement plugs were set <br /> using the balance method. Plug 1 cement consisted of 14.4 bbls(63 sx)of 14.3 lb/gal Portland Type 1/11 cement and was pumped in three lifts:400 <br /> gallons at a depth of 1,396 feet, 120 gallons at 1,200 feet,and 85 gallons at 1,000 feet. Plug 1 was allowed to set 18.5 hours,after which the top of <br /> cement was tagged at 641 feet. Plug 2 cement consisted of 12 bbls(52.5 sks)of 14.3 lb/gal Portland Type 1/11 cement and was pumped in two lifts,the <br /> first lift of 250 gallons from 635 feet,and the second lift of 255 gallons from 475 feet to 19.5 feet. The 4.5-inch casing was topped off to surface with 12 <br /> gallons(1.24 sacks)of cement. The well was dug out at surface and the casing was cut off 3 feet below GL.An additional 1 bbl(4.4 sks)of Portland Type <br /> 1/II cement was poured down the 4.5-inch casing annulus to fill it to surface.A steel cap with the well name was welded onto the 20.0-inch conductor <br /> casing and buried. The calculated volume of the 34 feet of 8.875"open hole and 1,223'of 4.5-inch OD cased hole was 21.6 bbls(187.13 cu ft).A total of <br /> 27.7 bbls(121.1 sks, 155.5 cu ft)of cement,28.2%excess,was used to plug and abandon the 90-1 well to surface.The well was completely plugged and <br /> abandoned on 9/23/22 <br /> 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 (2� <br /> THE SPACE FOR FEDERAL 0I3 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 />