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Form 3160.5 UNITED STATES ~~ nreROVt~ <br />Qune 1990) DEPARTMENTOF THEINTF.RIOR BuigetHwe•u Na 1004QiTi <br /> G•I,Irs Much3t, 19Ri <br />BUREAU OF LAND MANAGEMENT s. Iemo t>m;~ro•..w sew Nn <br /> Yankee Gulch C4118328 <br />SUNDRY NOTICES AND REPORTS ON WELLS <br />Do not use this form for proposals to drill or to deepen or reentry to a different reservoir, fl u lodun l~iM~e. orrm,e rv.me <br />Use "APPLICATION FOR PERMR--" for such s N/A <br />~- <br />SUBMIT W TRIPLICATE r. uusu or cnn~~l ~+~xma <br />_ A <br />1. Type of WeB 8. WeL Nm~e ud Nn <br />q Od We0 ^ Gas Well ®Other Nahcolite Solution Minin American Soda LI.P 2'173 <br />2 Name of Operator s. nrl w•a Nn <br />Ameican Soda, L.LP. <br />3. Address and Telephone No, In F;aa •"d>~l, o'F:P~°7'~• <br />2717 C . Rd. 215 Parachute, CO 81635 970 2&S6S00 Central Piceance Creek Basin <br />4. location of Well (Footage, Sec., T., R„ M., or Survey Description) u. C"~Y o<r..ishst.v <br />E 14,ti13.38 N 1234057 NB Yi of NE r/i of Section 29, TLS, R97W 6~ P.M. Rio Blanca CO <br />t2. CHECK APPROPRIATE BOX(s) TO INDICATE NATURE OF NOTICE, REPORT OR OT[-IER DATA <br />TYPE OF SUBMLSSION TYPE OF ACTION <br />^ Notlm of Intent ^ Abandonment ^ Change of Plans <br /> ^ Remmpletion ^ New Construction <br />®Subsequent Reports ^ Plugging Back ^Non-Routine Fm<turirlg <br /> ^ Casing Repair ^ WaterShut-0ff <br />^ Final Abandonment Notice ^ Altering Casing q Conversion b Injection <br /> X Other. Long Term Standby ^ Dispose Water <br /> M•~ vgwomwmmdup. ~gm®aewm <br />v. a®~n<re.saac t~o-aapmuam(asar ra•,spmreua.m~.mtp.Tv+u~mnmmu.g.sdmea a.~deen°s••y l•wmm.~ u.mbwa.~.q amra. d.~vame•am,m <br />and mta•vd and a•even:~.l dep W. ror m wM+ma wn pmo~ m mb.mdcY <br />This web is scheduled Eor long term standby. E ewnomirs improve, this well could be brought bads into production. <br />Well29-73 dissolution surfarn at 1564'. <br />8/12/2004 Rig up Key Energy oat well and pulled 2298' (aE) of 41h" long string. Set ms[ iron bridge plug at 1610'. Pulled 1863' (a6) of 4'h" <br />short string. Set cast iron bridge plug at 1615'. <br />8/73/2004 Rig down Key Energy. <br />19, I hereby certify that the foregoing is true and mrrect. <br />Signed <br />(This space for Federal or State office use) <br />Approved by <br />Conditions of approval, if any: <br />TiOe 18 US.G Section 1001, makes it a crime for any person knowingly and willfully b make b any department or agency of the United <br />Stag any false, fictitious or fraudulent statements or representations as to any matter within its jurisdiction <br />'See hlstmction on Reverse Side <br />