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• ~~ <br />UNITED EI FIFE ENVIP.ONMEMAL PROTECl10N PGF NCY loan Appovetl <br />WASHINGTON, DC ZDe60 OMB Mo. ?Pe0•DOf] <br />Approve/ f>piry 5.30.!6 <br />`~ ~ ~e COMFLE110N REPGRT FOR BRINE DISPOSAL, <br />HYDROCARBON STORAGE, OR ENHANCED RECOVERY WELL <br />NPME PND PDDPEBS OF E%15TING PERMITtEE NPME AND ADDPESS OF SURfP[E OWNER <br /> 57ATF COUNTY DERMA NUMBER <br /> LOCPTE WELL PND O UTLINE UNIT ON <br />RES <br /> E. CTION PLAT - 6 a0 PC E UFfPCE IOCPTION DESCRIPTION <br /> N `A OF `f Oi k SECTION TOWNSHIP RANGE <br /> ~~~ <br /> <br /> <br />TTT ~ 1 <br />+' I <br />TTT <br />1 lOCi7F WELL IN TWO DIRECIIDNE FROM NEPRf51 CINfS Of OUAR7ER SECTION PND DRILLING Ut7t <br />Sunett <br />Location _ h. nom IN/SI _- Line rN awns senipn <br />fIW _ h. fiom E _ lief of cuener senior <br /> --~--{---~- "~'-""'-~ WELL ACTIVITY TYPE OF PERMIT <br /> <br />W <br /> <br />1_J.._1 <br /> <br />1_LJ- E ^ Erine Disposal ^ Intliviouel Es1iTe1t0 Franure Pressure <br />^ EnMncetl Recovery ^ Aref o1 Injection 2oM <br />^ NyarocerDOn Storepe Number of WelN__ <br /> II <br />I y Am¢iDateo Daily Injenion Yolumr IEEISI Injectbn Inierral <br /> ~y <br />! 1 <br />1J-1 yy <br />I 1 1 <br />1-L1 Arf rfp[ Ma>imum Feet to FNt <br /> Amiu fretl Dtil In eaion FrfEWrf PSI Depth to 6onom of lowermost Freshwper iorrMtion <br /> ` Pvfrape Ma>imum IFeet) <br /> 7ypf of Injection f luitl lCMd the epprop+is4 DlocflsB <br /> <br />h Waler ^ Fresh Wetsr <br />di <br />^ <br />LeeR Nsme <br />Well NumMr <br /> Bra <br />s <br />^ SsN Wstar <br />^ Lquitl NYmocerDOn ^ D1Mr Name of Injection Zane <br /> Date Drilling 6epen Dsu Well CompletrM Pormespiliry of Inpaion 2orr i <br />i <br /> bete Drillitp Complelao Porosity of Inj<nion Zon <br /> CPSIN6 AND TUBING - ~ CFMEM HOLE <br /> OD Sue Wt/Ff - Grath -New or Useo Demh Seces Clsss Depth Bit Dxmeter <br /> <br /> <br /> <br /> <br /> <br /> INJECTION ZONF STIMULPTION N+IRF TINE LOGS. 1157 EACH TYPE <br /> Imerval Leeletl MeterieN entl Arrwum Usetl lop Types L Imervsk <br /> <br /> <br /> <br /> <br /> <br /> CprrtDltlt Atl6chmtnt6 A - E IiF7td 00 TAB IBVBfSl. <br /> CERTIFICATION <br /> !certify under the penalty ol/aw that 1 have personally examined and am lamiliar with the information <br />submitted in this document and s// strachmenrs and Fhai, based on my inquiry of those individuals <br />immediately responsib/e for obtaining the inlormation, /believe that [he inlormation is true, accurate, <br />and complete. !em aware that there are signilicant penakies for submitting false information, including <br />the possibility o/ fine and imprisonment (Rel. 40 CfR 744.32J. <br /> NAME PND OFFIDIAI TRLE lP/etn trOe a perM/ - DATE SIGNED <br />