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HYDRO28615
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Last modified
8/24/2016 8:47:47 PM
Creation date
11/20/2007 9:39:51 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1983194
IBM Index Class Name
Hydrology
Doc Date
5/19/2004
Doc Name
Injection Wells Conversion of Production Well 2A-2V to a Raw Water Supply Well
From
Natural Soda Inc.
To
DMG
Media Type
D
Archive
No
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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 (APO) for such proposals. <br />TYPE OF ACTION <br />EPA permit CO 30358-00000 <br />SUBMIT IN TRIPLICATE-Other instructions on reverse side. <br />1. Type of Well <br />Oil Well Gas Well Other ~ Sodium Bicarbonate <br />Solution mining injector <br />2. Name of Operator NATURAL SODA, INC <br />Address 3b. Phone No. (include area <br />3a. 3200 County Road 31, Rifle Colorado 81650 code) 970-878-3674 <br />Location of Well (Footage, Sec., T., R., M., or Su <br />25 FSL 539 FWL Section 26 T1S R98W <br />TYPE OF SUBMISSION <br />^ Notce of Intent <br />^ Subsequent Report <br />^ Final Abandonment <br />Notice <br />FORM 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 />7. if Unit or CA/Agreement, Name <br />and/or No. <br />Natural Soda, Inc. <br />8. Well Name and No. <br />4-3H <br />10. Field and Pool, or Exploratory <br />Area <br />Boies-Bed/saline zone Cavity 4A <br />11. County or Parish, State <br />Rio Blanco ,Colorado <br />^ Acidize ^ Deepen ^Production ^Water Shut-Off <br />^ Alter Casing ^ Fracture Treat (Start/Resume) ^Well Integrity <br />^ Casing Repair ^ New Construcfion ^Reclamafion ^Other <br />^ Change Plans ^ Plug and Abandon ^Re-complete <br />^ Convert to ^Temporarily Abandon <br />Injection ^Water Disposal <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 [he Bond No. on file with BLM/BIA. Required subsequent <br />repons 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 3I60~ 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 />Run in well with 2-7/8 inch work string with 7 inch tubing cutter. Cut production suing @ 2100 feet. PuII 7 inch and lay down. Set 9-5/8 inch cast iron bridge plug <br />@ 2100 feet. Pump 200 feel of 15.8# class G cement on [op of CIBP. Wait on cement. Pressure test casing to 300 PSI. Tag cement Pump 15.8 N class G cement to <br />surface. Cut off well head. Install P&A marker with all well identification on top of casing. <br />Re-claim location per permit requirements. <br />14. I hereby certify that the foregoing is true and correct <br />Name (Printed/Typed): Rodnev A Storev Title: WELL FIELD SUPERVISOR <br />Signature: <br />13 <br />THIS SPACE FOR FEDERAL OR STATE OFFICE USE <br />Approved by: <br />Title: <br />Conditions of approval, if any, are attached. Approval of this notice does not warrantor <br />certify that the applicant holds legal or equitable title to [hose rights in the subject lease <br />which would entitle the applicant to conduct 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 for any person knowingly and willfully to make to any <br />department ar agency of the United States any false, fictitious or fraudulent statements or representations as to any matter within its <br />jurisdiction. <br />
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