2023-04-07_HYDROLOGY - M1983194 (9)

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Form 3160 5 UNITED STATES FORM APPROVED OMB No.1004-0137 Expires: (June 2019) DEPARTMENT OF THE INTERIOR December 31,2024 BUREAU OF LAND MANAGEMENT 5.Lease Serial No. COG-0119985 SUNDRY NOTICES AND REPORTS ON WELLS 6.If Indian,Allottee 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 instnlctions on page 2 7.If Unit of CA/Agreement,Name and/or No. 1.Type of Well ❑Oil Well ❑Gas Well m Other 8.Well Name and No.AM-2 2.Name of Operator Natural Soda LLC 9.API Well No. 3a.Address 3200 Rio Blanco County Rd 31 3h,Phone No.(include area code) 10.Field and Pool or Exploratory Area Rifle,CO.81650 (970)878-3674 Piceance Creek Basin 4.Location of Well(Footage,Sec.,T.,R.,M.,or Survey Description) i 1.Country or Parish,State 1649.7'FWL, 1126.6'FNL,S21,TIS,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 ❑Temporari ly 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.If 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 ofthe involved operations.Ifthe operation results in a multiple completion or recompletion in anew interval,a Form 3160-4 must be 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 detennined that the site is ready for final inspection.) All depths referenced to GL.Remove all existing surface and downhole equipment from well.Run in hole with a 3.75-inch bit to 84 feet and circulate and condition hole.Pour 1 bbl(0.21 cubic yards)of 3/8-inch Bentonite hole plug down hole.Mix and pour 0.16 bbls(0.03 cubic yards)of Portland Type 1111 cement down hole to fill to surface.Top off as necessary,cut off casing 3-5 feet below surface,reclaim pad. 14.1 hereby certify that the foregoing is true and correct. Name(Printed/Typed) Gerald J Daub TitlePresident Daub&Associates, Inc. Signature Date 2 dZ,T THE SPACE FOR FEDERAL O STAT OFICE USE Approved by Title Date Conditions of approval,if any,are attached.Approval of this notice does not warrantor certify that the applicant holds legal or equitable title to those rights in the subject lease Office which would entitle 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)