HYDRO24576

• Permit No: M1999002
• IBM Index Class Name: Hydrology
• Doc Date: 9/20/2004
• Doc Name: Well Completion Reports
• From: American Soda L.L.P.
• To: DMG
• Media Type: D
• Archive: No

Form 3160-5 UNITED STATES FORM APPROVED

(June 1990) DEPARTMENT OF THE INTERIOR Budget Bureau No. 1819-0135
'
nes: March 37, 1973
Ex
BUREAU OF LAND MANAGEMENT 5. Lease DesigtuBon and Serial No.
Yankee Gulch CO-118328
SUNDRY NOTICES AND REPORTS ON WELLS
Do not use this Eorm for proposals to drill or to deepen or reentry to a different reservoir. 6. If lnd;an, Anonee or Tribe Name
Use"APPLICATION FOR PERMIT-" for such ro osals N/A
SUBMIT IN TRIPLICATE 7. IE Unit or CA, Agreement Desigwfion
NA
1. Type of Well 8. Well Name and No.
^ Oil Well ^ Gas Well O Other Nahcolite Solution Minin American Soda LLP 20.31
2. Name of Operator 9. API Well No.
American Soda, L.L.P.
3. Address and Telephone No. lo. Pield and PON, orExplorarory Area
2717 C . Rd. 215 Pazachute, CO 81635 970 285-6500 Central Pfceance Creek Basin
4. Location of Well (Footage, Sec, T., R., M., or Survey Description) 11. County a Parish, State
E 13429.33 N 13779.04 SE'/+ of SW r/. of Section 20, TIS, R97W 6t^ P.M, Rio Blanco, CO
TYPE OF ACFION
^Notice of Intent ^ Abandonment ^Change of Plans
^ Recompletion ^ New Construction
©Subsequent Reports ^ Plugging Back ^Non-Routine Fracturing
^ Casing P.epair ^ Water Shut-Off
^ Final Abandonment Notice ^ Altering Casing ^ Conversion to Injection
X Other: Long Term Standby ^ Dispose Water
INde: Repon rouln in muldpkcompktion on Well
Completion or RxomDletlon gepore and Log form.
U. peuribe Proposal or CampMlM Opemeions(Clnrly ataie all pertirent deuik, and give pertinem dats,ircluding esgmalnl dale of sprung any pmpaael work. Qwe116 directionally tlrillM, give subsurfam lrcaiiom
.na meuaaa.na hue ventral aepNS rnr all m.rkers ma:o~ pertirem m tld. wmkl•
This well is scheduled for long term standby. If econonucs improve, this well could be brought back into production.
We1129-26 dissolution surface at 1582'.
8/17/2004 Rig up Key Energy on well and pulled 2424' (alt) of 4 9z° long string. Set cast iron bridge plug in T long string casing at 1635'.
Cut 4'h" short string at 1700'. Pu111700' of 4 Vz' shml string. Set cast iron bridge plug in 7" short string at 1635'. Rig down Key Energy.
14. I hereby Certify that the
Signed
is true and correct.
Piceance Operations Manager Date August 18, 2004
(This space for Federal or State office use) v
Approved by Title Date
Conditions of approval, ff any:
Title 18 U.S.C. Section 1001, makes it a crime for any person knowingly and willfully to make to any depaztment or agency of the United
Slates any false, fictitious or fraudulent statements or representations as [o any matter within its jurisdiction.
'See Instruction on Reverse Side