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Form 3100-5 UNITED STATES FottM navfaovHo <br />(June 1940) DEPARTMENT OF THE INTERIOR B"°B.sBurt'°Nwt°°°m~ <br /> (i ~ MerN31, l9Ri <br />BUREAU OF LAND MANAGEMENT s. tR..r od~ne..a sm.t rvw <br />SUNDRY NOTICES AND REPORTS ON WELLS Yankee Gulch CO-118328 <br />1?o not use this form fox proposals ro drill or ro deepen or reentry to a different reservoir. a tf 4.aam, atoetee or Te°e N.me <br />Use"APPLICATION FOR PERMIT--" for such N/A <br />SUBMIT IN TRIPWCATE 7. If Umr orCA Ag+xmnc 9®fe.wiow <br /> A <br />_ <br />1. TVpe 02 W(Il & WellN~eamlNw <br />^ Oil WeB Q Gas We]I ®Other Nahcolite Solution Mfnin American Soda LLP 2934 <br />2. Name of Operator s. nn w.u rvw <br />American Soda, L.L.P. <br />3. Address and Telephone No. to Fmte.aa Pwot or erptormmy Poa. <br />2717 C' . Rd. 215 Pazachute, CO 81635 970 2856500 Central Piceance Cxeek Basin <br />4. Location of Well (Footage, Sec., T., R., M., ox Survey Description) tt. couray weu.n,Str. <br />E 1291i9S0 N 12790.00 NBYi erF NWr/i erf Section 29, TIS, R97W 6° P.M. Rfo Blanco, CO <br />C <br />12 CHECK APPROPRIATE BOX(s) TO INDICATE NATURE OF NOTICE, REPORT OR OTHER DATA <br />TYPE OF SUBML4SION TYPE OF ACTION <br />^ Notice of Intent ^ Abandonment ^ Change of Plans <br />^ Recompletion ^ New Construction <br />031Subsequent Reports ^ Plugging Back ^tion-Routine Fracturing <br />D Casing Repau O Water Shut-Off <br />^ Final Abandonment Notice ^ Altering Casing ^ Conversion to Injection <br />X Other. Lon6Term Standby ^ Dispose Water <br />rr+.~ aepaaarua+aadWtrmnpaes®wm <br />u naocer r~goo+a.c ewaopm~cas.nme.u pvwme,mttimag.<v~a.e,. ocmm~samad emw:awr.^f ww~«a-~u..uaaune®.q m°.a pw<:e.,n,a mv~ <br />ma m®am me em. vaed a.rem ter all mataa u W rma pwmmr a im .air <br />This well is scheduled for long term standby. tf economies improve, [ids weB could)>e brought back into production. <br />Well 2934 dissolution surface at 1598'. <br />8/24/21104 Rig up Key Energy on we0. Pu112378' (a0) of 4 fix" long strrtrg. Set cast "von bridge plug in T' long string casing at IciS(Y. Cut 4'h" <br />short string at 1845'. Could not pull 4 Yz' short string. <br />8/25/2004 Cut 4th" short string at 1680. Could not pu114 Yi' short string. Cut 4 Yx" short string at 1626'. Pull 1626' of 4'K' short string. Set <br />cast trop bridge plug in 7° short string at 1625'. Rig down Key Fmergy. <br />14. I hereby certify that the foregoing is true and correct. <br />Signed <br />(This Spam for Federal or State office use) <br />Approved by <br />Conditions of approval, if any: <br />Titfe 18 US.C. Section I(10t, makes i! a crime for any person Imowingly and willfully Io make to any department or agenry of the United <br />States any take, fictitious or fraudulent statements or representations as to any matter within its jurisdiction. <br />'See instruction on Reverse Side , <br />~ , <br />