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UNITED STATES FORM APPROVED
<br /> Form 3160-5 OMB No. 1004-0137
<br /> (June 2015) DEPARTMENT OF THE INTERIOR Expires:.fanuary 31,2018
<br /> BUREAU OF LAND MANAGEMENT 5.Lease Serial No,
<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 31 50-3(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.14H-RI
<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 Boles Bed
<br /> 4.Location of Well(Footage,Sec., T.,R.,M.,or Survev Description) 11.Country or Parish,State
<br /> Lat:39.930237480 Long:-108.350408919 NAD 83-Sec.25,T1 S,R98W 1110'FSL,252'FWL Rio Blanco County,Colorado
<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 are referenced to GL.The 14H-RI well reached the end of its useful life and has been abandoned.The 7,625"casing was flushed with fresh
<br /> water prior running in the hole.A 7.625'casing scraper was run in the well and worked past possible casing damage at 613 feet, 1,698 feet,and tagged
<br /> damaged casing at 1,741 feet. Ran in the hole with open ended 2.875"tubing to 2,020.All cement plugs were set using balance method and consisted of
<br /> Portland Type 1/11 cement. Plug 1 was pumped from a depth of 2,020 feet.Plug 1 consisted of 4.76 bbis of water mixed with lost circulation material(LCM)
<br /> spacer,followed with 36 bbls(157.5 sx)of 14.2 lb/gal cement with High Early accelerant(HE)and fiber LCM added. Plug 1 was allowed of set 6.5 hours,
<br /> and pipe was run in the hole to 2,025 feet without a tag.Plug 2 was pumped from a depth of 1,955 feet.Plug 2 consisted of 24 bbis(105 sx)of 14.2 lb/gal
<br /> cement with HE and fiber LCM added.Plug 2 was allowed to set 1625 hours,pipe was run in to 1,959 feet without a tag.Plug 3 was pumped from 1,955
<br /> feet and consisted of 4.76 bbis of high viscosity LCM spacer,followed with 24 bbis(105 sx)of 14.2 lb/gal cement with HE and fiber LCM added.Plug 3
<br /> was allowed to set 124.25 hours,before the top of cement was tagged at 1,441 feet.The 7.625"casing was perforated at depths of 1,067,804,558,303,
<br /> and 75 feet.Each perforation interval consists of four 0.43"holes at 90 degree phasing and 21.5"of penetration.Plug 4 was pumped from a depth of
<br /> 1,430 feet and consisted of 36 bbls(157.5 sx)of 14.2 lb/gal with HE added.Plug 4 was allowed to set for 17:45,before the top of cement was tagged at
<br /> 798 feet.Plug 5 was pumped from a depth of 777 feet and consisted of 36 bbis(157.5 sx)of 14.2 lb/gal cement with HE added.Plug 5 was allowed to set
<br /> for 5 hours before the top of cement was tagged at 386 feet.Plug 6 was pumped from a depth of 353 feet to surface,and consisted of 19.5 bbis(84 sx)of
<br /> 14.2 lb/gal cement with HE added.A plugged and abandoned hole marker was installed per the Natural Soda WC permit,and the well was buried.The
<br /> calculated volume of the 1,955 feet of 7.625"casing is 92.24 bbis(517.86 cu ft).A total of 115.5 bbis(648.48 cu ft,504 sx)of cement,20.1%excess,was
<br /> used to plug and abandon the 14H-RI from 1,955 feet to surface. For additional information please see attached As-Built Plug and Abandonment diagram.
<br /> This work was performed under the Colorado Division of Reclamation and Mine Safety permit number M-1983-194.
<br /> 14.1 hereby certify that the foregoing is true and correct. Name(Prinred/Typed)
<br /> Gearld J.Daub Title President,Daub 8 Associates,Inc.
<br /> Signature Date
<br /> THE SPACE FOR FEDERAL OR STATE OFICE USE
<br /> Approved by
<br /> Title 1]ate
<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 19 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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