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<br />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 to drill or to re-enter an abandoned well. <br />Use Form 3160 - 3 (APD) /or such proposals. <br />SUBMIT IN TRIPLICATE-Other instructions on reverse side. <br />Oil Well Gas Well Other R Sodium Bicarbonate <br />Solution mining well <br />2. Name of Operator NATURAL SODA, INC <br />3a. 3200 County Road 31, Rifle Colorado 81650 <br />Location of Well (Fo <br />2716 FNL, 3168 FEL, <br />TYPE OF SUBMISSION <br />^ Notice of Intent <br />® Subsequent Report <br />^ Final Abandonment <br />Notice <br />Sec., T., R., M., or Survey <br />26 T1S R98W <br />U Acidize <br />^ Alter Casing <br />^ Casing Repair <br />^ Change Plans <br />^ Convert to <br />Injection <br />TYPE OF ACTION <br />LJ Deepen <br />^ Fracture Treat <br />^ New Construction <br />® Plug and Abandon <br />FOAM APPROVED OM B No. 1004-0135 <br />Expires: January 31, 2004 <br />5. Lease Serial No. <br />Sodium lease C-0118327 <br />6. If Indian, Allottee or Tribe Name <br />EPA permit CO 30355 <br />7. If Unit or CA/Agreement, Name <br />and/or No. <br />Natural Soda, Inc. <br />8. Well Name and No. <br />26-93-3V <br />9. API Wel] No. <br />10. Field and Pool, or Exploratory <br />Area <br />Boies-Bed /saline zone <br />Il. County or Parish, State <br />Rio Blanco ,Colorado <br />(Stazt/Resume) <br />^ReclamaHon <br />^Re-complete <br />^Temporarily Abandon <br />^ Water Disposal <br />r Shut-Off <br />Integrity <br />13. Describe Proposed or Completed Operation (clearly state all pertinent details, including estimated starting date of any proposed work and approximate <br />duration thereof. If the proposal is to deepen directionally or re-complete horizontally, give subsurface locations and measured and true 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/BIA. 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 3160-4 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 />Se[ CIBP (cast iron bridge plug) @ 1920 feet. Pump cement plug (15.8# Class G) from 1920 to 1724 fee[ inside 9-5/8 casing.. Tag top of cement Perforate 9-5/8 <br />casing @ 1720 feet. Se[ pump [hru C03P @ 1710 feet. Establish circulation to surface. Circulate cement [o surface. Pull tubing from well. Fill well with water. <br />Run Cement bond log. Pump cement plug in well bore to surface if cement is above A Groove behind casing. If cement bond log shows no cement between any <br />two aquifer zones, plug well bore, perforate, and squeeze cement plug behind casing between aquifers. Verify plug behind casing with bond logs before cementing <br />well bore to surface. Cement annulus from surface down 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 correct <br />Name (Printed/Typed): Rodne A. Store Title: WELL FIELD <br />Signature: ~"f Date 22 March 20( <br />THIS SPACE FOR FEDERAL OR STATE OFFICE USE <br />Approved by: <br />Title: <br />Conditions of approval, it any, are attached. Approval of this notice does not warrant or <br />certify that the applicant holds lega t or equitable fee to those rights in the subject lease <br />which would entitle the applicant to conduct operations thereon. <br />3b. Phone No. (include area <br />code) 970-878-3674 <br />Office: <br />Date: <br />