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Fonn 31605 UNITED STATES wxM APPROVED <br />Qtme 1990) DEPARTMENT OF THE INTERIOR Budget Bureau No.111040135 <br /> Ex ves: March 31, 1993 <br />BUREAU OF LAND MANAGEMENT s. Ivase Desigtmtion and Serial No. <br /> Yankee Gulch CO.118328 <br />SUNDRY NOTICES AND REPORTS ON WELLS <br />Do not use this form for proposals to drill or m deepen or reentry to a different reservoir, s. u maraP, Allotlee o. Tate Name <br />Use "APPLICATION FOR PERMIT--" for such ro N/A <br />SUBMIT IN TRIPLICATE ~. uU.dt tlr G, Agreement Desigwtion <br /> NA <br />1. Type Of WeB B. Well Nameand NO. <br />^ Oil Well ^ Gas Well ~ Other Nahcolite Solution Minim American Soda t l? 2431 <br />2. Name of Operator 9. API Well No. <br />American Soda, LL.P. <br />3. Address and Telephone No. to. E~1a ana Poo4 or Exptorstory area <br />2717 C . Rd. 215 Parachute, CO 81635 970 265-65fq Central Piceance Creek Basin <br />4. Location of Well (Footage, Sec., T., R., M., or Survey Description) u. cowry ar Pattsh stare ' <br />E 13429.33 N 13T79.04 SE r/a of SW ~/. of Section 2D, TIS, R97W 6m P.M. Rio Blanco, CO <br />TYPE OF SUBMISSION ~ TYPE OF ACTION <br />^ Notice of Intent m Abandonment <br />^ Recompletion <br />^ Subsequent Reports ^ Plugging Back <br />^ Casing Repair <br />OFinal Abandonment Notice ^ Altering Casing <br />Other: <br />^ Change of Plans <br />^ New Construction <br />^ Non-Routine Fracturing <br />^ Water Shut-Off <br />^ Conversion m hgection <br />^ Dispose Water <br />(NN¢: Bepm[t®WlsmmoWWemmPleamlml Well <br />11 Wn3e Propa¢d mCOmPa~~F °tl°~l~^dy gota all pdWem dMik,a,d/J~e ry~4ceN data vrhtli~p atimaled daR O(sLUtinp, anYPW~dwoh.If welludvMimmBy M9e~Wwe d~beudax ld9tlas <br />and memumd eM bae vmrzl depM1SforaO mukenaM was Penitent to dos woet)' <br />Well 29-26 dissolution surface at 1587. <br />8/17/2004 Rig up ICey Energy lm well and pulled 2424' (all) of 4 ]fi" long string. Set cast iron bridge plug in T' long string casing at 1635'. <br />Cut 41h" short string at 17(p'. Pull 1700' of 41h" short string. Set cast inm bridge plug in T' short string at 163.5'. Rig down Key Energy. <br />An DdTT was perfonned on 8/26/04. Both T' casing strings failed the MIT. <br />On 9/7/04, Cudd Pressure Contml tripped coil tubing to the bridge plugs and I-Ialliburton pumped 230 sacks of Type G, 35% SSA-1, 0.2% <br />CFR~, 15.6 #/gal, 1.55 ft3/sack cement in long string T casing and 233 sacks in the short string casing of the same blend for a total of 463 <br />sacks for the well <br />On 9/10/04, the wellhead was cutdown and the 7" casings capped. <br />14. I hereby ca'tify that the <br />Signed <br />and correct. <br />(Phis space for Federal or State office use) <br />Approved by <br />Comlitions of approval, iE any: <br />Piceance Ooerations Manager Date September 14, 2004 <br />Title 18 U.S.C. Section 1001, makes it a crime for any person knowingly and willfully to make to any departmtmt or agency of the United <br />States any false, fictitious or haudulent statements or representations as to any matter within its jurisdiction. <br />*See Instruction on Reverse Side <br />