2023-04-07_HYDROLOGY - M1983194 (9)

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Form 3160-5 UNITED STATES FORM APPROVED OMB No. 1004-0137Expires: (June 2019) DEPARTMENT OF THE INTERIOR December 31,2024 BUREAU OF LAND MANAGEMENT 5.Lease Serial No. COC-0118327 SUNDRY NOTICES AND REPORTS ON WELLS 6.If Indian,A]lottee or Tribe Name Do not use this form for proposals to drill or to re-enter an abandoned well.Use Form 3160-3 APD)for such proposals. SUBMIT IN TRIPLICATE-Other instructions on page 2 7.If Unit of CA/Agreement,Name and/or No. 1.Type of Well ❑Oil Well ❑ Gas Well ©Other S.Well Name and No.14H-RI 2.Name of Operator Natural Soda LLC 9.API Well No. 3a.Address 3200 Rio Blanco County Rd 31 3b.Phone No.(include area code) 10.Field and Pool or Exploratory Area Rifle,CO.81650 (970)878-3674 Piceanoe Creek Basin 4,Location of Well(Footage,Sec.,T.,R.,M.,or Survey Description) 11.Country or Parish,State 1110 FSL,252 FWL,S25,T1S,R98W,6th PM Rio Blanco County,CO 12.CHECK THE APPROPRIATE BOX(ES)TO INDICATE NATURE OF NOTICE,REPORT OR OTHER DATA TYPE OF SUBMISSION TYPE OF ACTION ©Notice of Intent ❑Acidize ❑Deepen ❑Production(Start/Resume) ❑Water Shut-Off ❑Alter Casing ❑Hydraulic Fracturing ❑Reclamation ❑Well Integrity ❑Subsequent Report ❑Casing Repair ❑New Construction ❑Recomplete ❑Other ❑Change Plans ©Plug and Abandon ❑Temporarily Abandon ❑Final Abandonment Notice ❑Convert to Injection ❑Plug Back ❑Water Disposal 13. Describe Proposed or Completed Operation:Clearly state all pertinent details,including estimated starting date of any proposed work and approximate duration thereof.I£ 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 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 completion of the involved operations.If the operation results in a multiple completion or recompletion in a new interval,a Form 3160-4 must he filed once testing has been completed-Final Abandonment Notices must be filed only after all requirements,including reclamation,have been completed and the operator has determined that the site is ready for final inspection.) Remove all existing surface and downhole equipment from well. Run in the well with casing scraper to approximately—2060 feet,circulate and clean well. Run in the hole with a 7.625-inch cast iron bridge plug(CIBP),set CIBP at•-2050.Run in hole with perforation gun and perforate(4 spf,90 or 120 degree phasing)7.625-inch intermediate casing. Perforation zones:1,050,800,550,300,and 75 feet. Cement to surface in stages with—120.9 bbls(25.1 cubic yards)of Portland 1/11 cement(Based on 25%excess).For additional detail please refer to the attached Drilling and Well Completion Diagram. This activity is anticipated to occur over a period of three to four days during the second or third quarter of 2023. This work will be performed under the Colorado Division of Reclamation and Mine Safety permit number M-1983-194. t 4.1 hereby certify that the foregoing is true and correct. Name(Printed/Typed) Gerald J Daub Title President Daub&Associates, Inc. Signature Date 2 THE SPACE FOR FEDERAL OR STA E OFICE USE Approved by Title Date Conditions of approval,if any,are attached.Approval of this notice does not warrant or certify that the applicant holds legal or equitable title to those rights in the subject lease Office which would entitic the applicant to conduct operations thereon. 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 any false,fictitious or fraudulent statements or representations as to any matter within its jurisdiction. (Instructions on page 2)