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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) for such proposals. <br />SUBMIT IN TRIPLICATE-Other instructions on reverse side. <br />L Type of Well <br />Oil Well Gas Well <br />2. Name <br />Other' Sodittm Bicarbonate <br />Solution mining injector <br />3a. 3200 County Road 31, Rifle Colorado 81650 <br />3. Location of Well (Footage, Sec., T., R., M., or Sure <br />298 FNL 673 FWL Section 35 T15 R98W <br />code) 970-878-3674 <br />area <br />FORM APPROVED OM B No. 1004-0135 <br />Expires: Januazy 31, 2004 <br />5. Lease Serial No. <br />Sodium lease C-0118327 <br />6. If Indian, Allottee or Tribe Name <br />EPA permit CO 30358-00000 <br />Z If Unit or CA/Agreement, Name <br />and/or No. <br />Natural Soda, Inc. <br />8. Well Name and No. <br />3A-4H <br />10. Field and Pool, or Exploratory <br />Area <br />saline zone Cavity 3A <br />11. County or Parish, State <br />Rio Blanco .Colorado <br />TYPE OF SUBMISSION TYPE OF ACTION <br /> <br />^ Notice of Intent ~ ^ Acidize ^ Deepen ^Production ^Water Shut-Off <br /> ^ Alter Casing ^ Fracture Treat (Start/Resume) ^[Nell Integrity <br /> <br />^ Subsequent Report ^ Casing Repair ^ New Construction ^Redamation ^Other <br /> <br />^ Change Plans <br />^ Plug and Abandon ^Re-complete <br />^ Final Abandonment ^ Convert to <br />Inj <br />tion ^Temporarfly Abandon <br />^Water Dis <br />osal <br />Notim ec p _ <br />13. Describe Proposed or Completed Operation (clearly state al] pertinent details, including estimated starting date of any proposed work and approximate <br />duration thereof. If [he 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 [he 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. tt the operation results in a multiple completion or re-completion in a new <br />interval, a Form 3160-0 shall be filed once testing has been completed. Final Abandonment Notices shall be filed only afrer all requirements, including <br />reclamation, have been completed, and the operator has determined that [he site is ready for final inspection J <br />Run in well with 5-I/Z inch tubing cutter. Cut 5-1/2 inch robing @ 2090 feet. Pull i-I/2 inch tubing. Run N we77 and set 7 inch cast iron bridge plug @ 2090 feet. <br />Pump 200 feet of class G cement. Tag cement. Test casing to 300 PSI. Pump cement to surface. Cut off well head. Install P&A marker on casing with all well <br />identification numbers. Reclaim well area per permit requirements. <br />14. I hereby certify that the foregoing is true and correct <br />Name (Printed/Typed): RodnevA Slorev Title: WELL FIELD <br />17 May, <br />THIS SPACE FOR FEDERAL OR STATE OFFICE USE <br />Signature: <br />Approved by: <br />Title: <br />Conditions of approval, if any, are attached. Approval of this notice does not warrant or <br />certify that the applicant holds legal or equitable title to those rights in the subject lease <br />'which would entitle the applicant to <ondud operations thereon. <br />Office: <br />Date: <br />Title 18 U.S.C. Section 1001 and Title 43 U.S,C. Section 1212, make it a crime far any person knowingly and wilfully to make to any <br />department or agency of the Uni[ed States any false, fictitious or fraudutent statements or representations as to any matter within its <br />jurisdiction. - <br />(Instructdons on page 2) <br />