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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 (APD) 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 51650 code) 970-878-3674 <br />Location of WeB (Footage, Sec., 1'., K., M., or Sure <br />825 FSL 1361 FWL Section 26 T1S R98W <br />TYPE OF SUBMISSION <br />^ Notice 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 Urut or CA/Agreement, Name <br />and/or No. <br />Natural Soda, Inc. <br />8. Well Name and <br />2B-3C <br />10. Field and Pool, or Exploratory <br />Area <br />Boies-Bed/saline zone Cavity 2B-3C <br />11. County or Parish, State <br />Rio Blanco ,Colorado <br />^ Acidize ^ Deepen ^Production ^Water Shut-Off <br />^ Alter Casing ^ Fracture Treat (Stazt/Resume) ^Well Integrity <br />^ Casing Repair ^ New Construction ^Redamation ^Other <br />^ Change Plans ^ Plug and Abandon ^Re-complete <br />^ Convert to ^Temporazily Abandon <br />Injecfion ^ 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 [rue vertical depths of all <br />pertinent markets and zones. Attach the Bond under which the work will be performed or provide the Bond No. on Fle 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 Fortn 316011 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 de[ennined that the site is ready for final inspection.) <br />Pull 1000 feet 3-1/2 inch tubing from well bore. <br />Run in well and set cast iron bridge plug @ 1940 feet. Put 200 feet of 15.8# class G cement on top of CIBP. Wait on cement Tes[ casing [0 300 PSI. <br />Tag cement with tubing string. <br />Pump 138 sacks class G cement to surface. <br />Remove well head from casing. <br />Weld P&A marker with all well identification onto casing <br />Reclaim location per permit requirements. <br />] 4. I hereby certify that the foregoing is true and conect <br />Name (Prinred/Typed).~ Rodnev A Storev Title: WELL FIELD <br />Signature: <br />13 May, <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 those rights in the subject lease <br />which would entitle [he 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 if a crime for any person knowingly and willfully to make to any <br />