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Form 3160-5 UNITED STATES ~~~RO~ <br />Qune ]990) DEPARTMINT OF THE INTERIOR thd~t ~u N° toowtas <br /> F~ i a: March 31, 19'9[1 <br />BUREAU OF LAND MANAGEMENT s. ta.ne tl~;s.,a:u., e.,a seriv No. <br /> Yankee Gulch CO-]18328 <br />SUNDRY NOTICES AND REPORTS ON WELLS <br />).~ ROt nse [1119 fO111t foi proposals t0 drill 02 t0 deepeR o[ reeRtiy t0 a dlffetent IlWeN032. 6 a Wim, Allwfee or7'rLe Nerve <br />Use"APPLICATION FOR PERMIT--" fm such ro N/A <br />SUBMIT 1N TRIPLICATE r' 0OM orCa, Ag~eemwa Dm~gu~ee <br /> A <br />1. Type of Well a wdt Name.M N° <br />^ Oil WeB ^ Gas Well [$I Othei Nahcolite Sa]uHon Minin American Soda LLP 29.27 <br />2 Name of Operator 9. Apt well Nu <br />American Soda, L.LP. <br />3. Address and Telephone No. to Fte7d m,d pew, er Explvretay Area <br />2717 C . Rd. 215 Parachute, CO 61635 970 TBS6500 Central Piceance Cnxk Basfn <br />4. Location of Well (Footage, Sec., T., R., M., m Survey Description) tl. romy o<p.aebs<.rc <br />H 14,34270 N 1181218 NE t/i of NE Yi of Section 29, T1S, R97W 6® P.M. Rio Blanco, CO <br />12. CHECK APPROPRIATE BOX(s) TO INDICATE NATURE OF NOTTCE, REPORT OR OTHER DATA <br />TYPE OF SUBMI~ION TYPE OF ACTION <br />^ Notice of Intent ^ Abandonment ^ Change of Plane <br />^ Remmpletion ^ New Construction <br />©5ubsecluent Reports ^ Plugging Bark ^ Non-Routine Fxachtriug <br />O Casing Repair O Water Shut-0ff <br />^ Final Abandonment Notice ^ Altering Casing ^ Conversion to Injection <br />X Other. Long Term Standby ^ Dispose Water <br />(Nae sepon.®mmm.eip.~mgmmmwm <br />r? o.,,~.e.,pm.aac~o.Fw~aopmmca.,ar ma.upeu.maam., maeNewu^ems..mmmes..,mmaareer~ma~F.epoma.,a; a..nrmemm.nymma. p.eaeaea aou® <br />as m~aea ma we w,nw a,pw ~ m mwa. memo ~ m ms -ter <br />This well is scheduled fm long tens standby. If economics improve, this well could be brought back into production. <br />Well 24-27 dissolution suifaae at 1560'. <br />7/ L7/2004 Rig up Key Energy on well and pull 2288' (all) of 9 4z" long string. <br />7/28/2004 Set cast icon bridge plug on 7" long casing at 1610'. Pull 18ST (all) of 4 Yx" short string. Set nst iron bridge plug at 1610' on T' <br />alutrt casing. Rig down Key Energy. <br />14. I hereby certify that the foregoing is tme and correct. <br />Signed <br />(This space tm Fedesal m Stale office use) <br />Approved by <br />Conditions of approval, if any: <br />Title 18 US.C. Section 1001, makes it a mme for any person knowingly and willfully to rruake to any depatLnmt or agency of the United <br />States any false, fictitious or fraudulent s[atemtents or representations as to any maNer within its jurisdiction. <br />'See Instruction on Reverse Side <br />