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<br />-- <br />EPA - UNITED STATES ENVIRONMENTAL PROTECTION AGENCV <br />WASHINGTON DC 20450 <br />PLUGGING RECORD <br />NAME AND ADDRESS OF PERMITTEE <br />Natural Soda, Inc. 3200 RBC 31, Rifle, CO 81650 NAME AND ADDRESS OF CEMENTING COMPANY <br />Big 4 Cementing, LLC. P.O. Box 1817, Vernal, Utah 84078 <br />Locate Well and Outline Unit on Section <br />Plat--640 Acres STATE <br />CO COUNTY <br />Rio Blanco PERMIT NUMBER <br />EPA CO 30358-00000 <br /> Surface location description <br />SE'/. of NW '/. of SW '/, Section 26 Townshi 1S Ran a 98W <br /> x Locate Well in two directions from nearest lines of quarter section and drilling unit <br /> I I I I I I Surface Location 2888 ft. from (N/S) N Line of quarter settion <br />(E/W) E li <br />ti <br />A <br />d 3003 ft <br />f <br />f <br /> rom <br />n <br />. <br />ne o <br />uarter sec <br />on <br />_ I I I I I I Describe in detail the manner in which the fluid was placed and the <br /> <br />- I I I I I I <br />e of Permit <br />T method used in introducing it into the hole. <br /> yp <br />a E ^ Individual Well Number WELL # 91-1 V <br />- ® A <br /> rea <br /> Number of Wells <br />I I I I S i l l l 1 CLA55111 <br /> Casing and Tubing Record after Plugging Well Activity Method of Emplacement of Cement Plugs <br />Size Wt (Lb/k) Put in Well (k) Left in Well (k) Hole Size <br />1 3-3/8 54# 91 ft 91 ft 16 inch ^ Brine Disposal ^ The Balance Method <br />d R <br />c <br />^ Th <br />D <br />m <br />th <br />h <br />B <br />il <br />M <br />d <br />^ E <br />9-5/8 40# 1940 ft 1940 ft 1 Z-1 /4 ance <br />e <br />u <br />p <br />n <br />overy <br />e <br />a <br />er <br />e <br />o <br />® Brine Injection ®The Two-Plug Method <br /> <br /> Lease Name Natural Soda, Inc. Well Number Well 4-3H <br />Cementin to Plu and Abandon Data: Plu #1 Plu #2 Plu #3 Plu #4 Plu #5 Plu #6 Plu #7 <br />Cementin Dale 16 June 29, 2005 <br /> <br />Size of Hoie or Pi a in which Plu Placed (inches) 9-5/8 in 9-5/8 <br />In 9-S/8 <br />In <br />De th to Bottom of Tubin of Drill Pi a (ftJ 1 BS $ 1 302 ^ <br />Sacks of Cement Used (each lu) CIBP 190 235 <br />Slur Volume Pum ed (cu. ft. ) 21 $ 434 <br />Calcula[ed To of Plu (ft.) 1400 fL surface <br />Measured To of Plu (if to ed ft.) 1860 ft 1406 ft SUrfdCe <br />Slur W[. (Lb./GaIJ 1 S,$# 1 Z.B# <br />T eCemen[ CIBP CId55 G CId55 G <br />List all O en Hole and/or Perforated Intervals <br />From To From To <br /> <br /> <br /> <br /> <br /> <br />Signature of Cementer or Authorized Representative <br />O Signature of EPA Representative <br />CERTIFICATION <br />I certify under penalty of law that this document and all attachments were prepared under my direction or <br />supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate <br />the information submitted. Based on my inquiry of the person or persons who manage the system, or those <br />persons directly responsible for gathering the information, the information submitted is, to the best of my <br />knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting <br />false information, includin the ossibilit of fine and im risonment for knowin violation. (Re . 40 CFR 122.22). <br />Name and Official Title (P/ease type or print) <br />Rodney A. Storey <br />Well field Supervisor Signature <br />~ ~59h\~ Date Signed <br />28 June, 2005 <br />