2024-07-16_HYDROLOGY - M1983194

• Permit No: M1983194
• IBM Index Class Name: Hydrology
• Doc Date: 7/16/2024
• Doc Name: APD Redrill 18H-IR-W
• From: NSI
• To: BLM
• Type & Sequence: TR50
• Email Name: ACY
• Email Name: THM
• Media Type: D
• Archive: No

Form 3160-3 FORM APPROVED
(June 2019) OMB No. 1004-0137
UNITED STATES Expires:October 31,2021
DEPARTMENT OF THE INTERIOR 5.Lease Serial No,
BUREAU OF LAND MANAGEMENT C-0119986
APPLICATION FOR PERMITTO DRILL OR REENTER 6.If Indian,Allotee or Tribe Name
la. Type of work: ❑DRILL ❑REENTER 7,If Unit or CA Agreement,Name and No.
Wolf Ridge Mining Unit
lb. Type of Well: []Oil Well Gas Well Other 8.Lease Name and We]I No.
Ic. Type of Completion: ❑Hydraulic Fracturing Single Zone ❑Multiple Zone 18H-IR-W(Ri drill)
2. Name of Operator 9.API Well No.
Natural Soda LLC
3a, Address 3b, Phone No.(include area code) 10.Field and Pool,or Exploratory
3200 Rio Blanco County Road 31,Rifle CO,81650 [phone]
4. Location of Well(Report location clearly and in accordance with any State requirements.") 11.Sec.,T.R.M.or Blk.and Survey or Area
At surface Let:39.925223076 Long:-108.370866155 NAD 83 S34,T1 S,R98W,6th PM
At proposed prod.zone BHL Let:39.925012,Long:-108.359700 NAD 83
14.Distance in miles and direction from nearest town or post office' 12.County or Parish 13.State
--45 miles southwest of Meeker,CO Rio Blanco CO
15.Distance from proposed; 410 16.No of acres in lease 17.Spacing Unit dedicated to this well
location to nearest 8379
property or lease line,ft.
(Also to nearest drig.unit line,if any)
18 Distance from proposed location* 19.Proposed Depth 20.BLM/BIA Bond No.in file
to nearest well,drilling,completed, 35 4481'MD
applied for,on this lease,ft.
21.Elevations(Show whether DF,KDB,RT,GL,etc.) 22.Approximate date work will start* 23.Estimated duration
6684 GL September 1 10-15 days
24. Attachments
The following,completed in accordance with the requirements of Onshore Oil and Gas Order No. I,and the Hydraulic Fracturing rule per 43 CFR 3162.3-3
(as applicable)
1.Well plat certified by a registered surveyor. 4.Bond to cover the operations unless covered by an existing bond on file(see
2.A Drilling Plan. Item 20 above).
3.A Surface Use Plan(if the location is on National Forest System Lands,the 5.Operator certification.
SUPO must be filed with the appropriate Forest Service Office). 6.Such other site specific information and/or plans as may be requested by the
BLM.
25.Signature Name(Printed/Typed) Datey
i
Gerald J Daub
Title
President,Daub&Associates,Inc.
Approved by(Signature) Name(Printed/Typed) Date
Title Office
Application approval does not warrant or certify that the applicant holds legal or equitable title to those rights in the subject lease which would entitle the
applicant to conduct operations thereon.
Conditions of approval,if any,are attached.
Title 18 U.S.C.Section 1001 and Title 43 U.S.0 Section 1212,make it a crime for any person knowingly and wil Ifully 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.
(Continued on page 2) *(Instructions on page 2)