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Form 3160-5 UNITED STATES <br />{September 2001) DEPARTMENT OF THE INTERIOR <br />BUREAU OF LAND MANAGEMENT <br />SUNDRY NOTICES AND REPORTS ON WELLS <br />Do not use this form for proposals fo drill or to re-enter an abandoned well. <br />Use Fonn 3160 - 3 (APD) for such proposals. <br />5. Lease Serial No. <br />Sodium lease C- <br />0118327 <br />6. u lndtan, Atlottee or 1 nbe Name <br />EPA permit CO 30358-00000 <br />SUBMIT IN TRIPLICATE-Other instructions on reverse side. <br />1. Type of Well <br />Ctil Well Gas Well Other R Sodium Bicarbonate <br />Solution mining well <br />7. If Unit or CA/Agreement, Name <br />and/or No. <br />Natural Soda, Inc. <br />8. Well Name and No. <br />91-1 V <br />FORM APPROVED OM B No. 1004-0135 <br />Expires: January 31, 2004 <br />r+aaress so. rnone No. unnuae area <br />3a. 3200 County Road 31, Rifle Colorado 81650 code) 970-878-3674 <br />10, Field and Pool, or Exploratory <br />3. Locafion of Well (Footage, Sec., T., R., M., or Suraey Description) Area <br />3003 FEL, 2888 FNL, SEC 26, T1S, R98W Boies-Bed /saline zone <br />11. Cotmty or Parish, State <br />Rio Blanco ,Colorado <br />TYPE OF SUBMISSION <br />^ Notice of Intent <br />® Subsequent Report <br />^ Final Abandonment <br />Notice <br />LJ Acidize <br />^ Alter Casing <br />^ Casing Repair <br />^ Change Plans <br />^ Convert to <br />Injection <br />TYPE OF ACTION <br />Deepen <br />Fracture Treat <br />New Construction <br />Plug and Abandon <br />(Start/Resume) <br />^Reclamation <br />^Re-complete <br />^Temporarily Abandon <br />^Water Disposal <br />~.r Shut-Off <br />Integrity <br />l3. Describe Proposed or Completed Operation (clearly state all pertinent details, including estimated starting date of any proposed work and approximate <br />duration thereof. ]f the proposal is to deepen directionally or re-complete horizontally, give subsurface locations and measured and [rue vertical depths of all <br />pertinent markers and zones. Attach the Bond under which the work will be performed or provide the Bond No. on file with BLM/B[A. Required subsequent <br />reports shall be filed within 30 days following completion of the involved operations. If the operation results in a multiple completion or re-completion in a new <br />interval, a Form 3160-0 shall be filed once testing has been completed. Final Abandonment Notices shall be filed only after all requirements, including <br />reclamation, have been completed, and the operator has determined that the site is ready for final Inspection.) <br />Rig up work over rig on well. <br />Set CIBP (cast iron bridge plug) @ ]860 feet due to obstructed well bore. Could not get 8-3/4 bit below 1860 fr. Suspect bad casing collar..Verbal approval from <br />EPA and BLM was given.. Pump cement plug (15.8# Class G) from 1860 to 1406 feet inside 9-5/8 casing.. Tag top of cement @ 1406 fr.. Perforate 9-5/8@ <br />1380 ft. Re-perforated @ 1250 ft.. Pressured up on casing to ]000 #. Could not get circulation behind casing to surface. Goc verbal approval to cement casing to <br />surface. Pumped 235 sacks light 12.8 # cement from 1302 to surface, covering holes perforated incasing. Pulled pipe from well Cement well from surface down <br />until full. Install dry hole marker on well. Reclaim location as per BLM requirements. <br />14. I hereby certify that the foregoing is true and coned <br />Name <br />Signature: <br />Approved by: <br />Title: <br />Conditions of approval, if any, are attached. Approval of [his notice does not warrantor <br />certify that the applicant holds legal or equitable title to those rights in the subject lease <br />which would entitle the applicant to conduct operations thereon. <br />Title: WELL FIELD <br />28 JUNE <br />Office: <br />Date: <br />