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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. 6. If Indian, Allottee or Tribe Name <br />Use Form 3160 - 3 (APD) for such proposals. <br />EPA permit C03035&06597 <br />SUBMIT IN TRIPLICATE-Other instructions on reverse side. <br />1. Type of Well <br />Oil Well Gas Well Other XX INJ. /REC. <br />2. Name of Operator NATURAL SODA, WC <br />Address 3b. Phone No. (include area <br />3a. 3200 County Road 31, Rifle Colorado 81650 code) 970-878-3674 <br />3. Location of Well (Footage, Sec., T, R., M., or Survey Description) <br />N. 229518.68 E. 1199440.96 <br />1618.42' FEL 203.42' FSL SEC 26 <br />TYPE OF SUBMISSION <br />® Notice of Intent <br />^ Subsequent Report <br />^ Final Abandonment <br />Notice <br />U Acidize <br />^ Alter Casing <br />^ Casing Repair <br />^ Change Plans <br />^ Convert to <br />Injection <br />FORM APPROVED OM B No. 1004-0135 <br />Expires: January 31, 2004 <br />TYPE OF ACTION <br />Deepen <br />Fracture Treat <br />New Construction <br />Plug and Abandon <br />5. Lease Seria] No. <br />Sodium lease C-0118327 <br />7. If Unit or CA/Agreement, Name <br />and/or No. <br />Natural Soda, Inc. <br />8. Well Name and No. <br />NSI <br />9. API Well No. <br />7H-2I <br />10. Field and Pool, or Exploratory <br />Area <br />Boies-Bed /saline zone <br />11. Cotmty or Parish, State <br />Rio Blanco ,Colorado <br />(Start/Restune) <br />^RedamaHon <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 dopths 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 Farm 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 [he opemror has determined that the site is ready for final inspection) <br />Change drilling prognosis to reflect management decision to no[ take risk of drilling into IA well cavity with new well bore. See attached revised drilling <br />prognosis and S[ep 8 of 8 point plan NSI 7H-2I program. Do not intercept 1A cavity with well bore of 7H-21 welt. <br />14. I hereby certify that the foregoing is true and wnect <br />Name <br />Signature: <br />Title: WELL FIELD SUPERVISOR <br />THIS SPACE FOR FEDERAL OR STATE OFFICE OSE <br />Approved by: <br />Title: <br />Office: <br />Conditions of approval, if any, are attached. Approval of this notice does not warrant or certify that the applicant holds legal or equitable title to <br />those rights in [he subject lease which would entitle the applicant to conduct operations thereon. Date: <br />Title 78 U.S.C. 9ectiorc 1007 and Title 43 U.S.C. Section 1212, make it a crime for any person knowingly and willfully to make [o any <br />department or agency of the United States any false, fictitious or fraudulent statements or representations as to any matter within its <br />jurisdiction. <br />(Instructions an page 2) <br />