REP16554

• Permit No: M1999002
• IBM Index Class Name: Report
• Doc Date: 8/5/2004
• Doc Name: Plugging and Abandonment of Wells & Reports
• From: American Soda LLP
• To: DMG
• Media Type: D
• Archive: No

Fonn 31645 UNITED STATES Po2M APPaovEo
Qune 1990) DEPARTMENT OF THEINTF.RIOR auagel sum.u Nw ta4mas
Fx urs Mert~h 31, 1541
BUREAU OF LAND MANAGEMENT s. te.se ~+~rro^.ea se;a Ivw
Yankee Gulch C4118328
SUNDRY NOTICES AND REPORTS ON WELLS
Du not use this form for proposals to drill or [o deepen or reentry to a different reservoir, s. a IMuuyAllmlre or7nbe N~
Use "APPLICATION FOR PERMFI'--" for such ro s N/A
SUBMIT IN TRIPLICATE r. aOn° °` ~` A~~u °~'s°°`°^
A
1. Type of Well 8. WeIlNmie e,d Nw
D Oil Well ^ Gas Well ®Other Nahcolite Solution Minin 20-12
2. Name of Operator 9. API Well Nw
American Soda, L.L.P.
3. Address and Telephone No. ra PrW e^d Pmt^r t:xptmalory Are.
2717 C . Rd. 215 Parachute, CO 81635 970 285-6500 Central Piceance Creek Basin
4. Location of Well (Footage, Sec., T., R., M., or Survey Desorption) rr. cmuny mPerieh, slsse
14671 Eastin and 14180 Northin SE r/i of SH r/i of Section 20, TLS, R97W 6m P.M. Rio Blanco, CO
TYPE OF SUBMLSSION ~ TYPE OF ACTION
^ Notire of Intent
^ Subsequent Reports
®Final Abandonment Notice
® Abandonment ^ Change of Plant/
^ Remmple[ion ^ New Constmction
^ Plugging Back ^Nun-Routine Fracturing
^ Casing Repau ^ Water Shut-Off
^ Altering Casing ^ Conversion to Injection
Other: ^ Dispose Water
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5/]8/04 Rigged up Key Energy rig and pulled all (2138') of the 4th" long string. Set bridge plug as deep as possible at 1416'.
5/19/Q4 ]et cut 4'h" short string at 1580' and pulled 1580' of the 4 rh" short string. Set bridge plug at 1485'
5/19/04 Rigged down Key Energy.
6/4/2004 Rigged up Key Energy.
6/7/2004 Ran 1404' of 2 3/8" tubing into long string T' casing. 1404' of 7/8" coaxial able was attached to the 2 3/8" tubing for time domain
response measurements. Rigged down Key Energy.
6/17/2004 Cudd Pressure Control tripped mil mbing to 1485' in the 7" short string. Halliburton pumped 30 sacks of 15.6 #/gallon, Type G,
35% SSA, 0.2% CFR3 neat cenrent.
6/17/2004 Halliburton pumped 187 sacks of 15.6 #/galore, Type G, 35% SSA, 02% CFR-3 neat cement down the 23/8" tubing on the long 7"
casing string and displaced the inside volume of the 2 3/8" tubing with water. The 2 3/8" tubing will be lek open for future temperature
observation.
6/18/2004 Cudd Pressure Control tripped coil tubing to 1426' hr the T' short string. Halliburton pumped 22 sacks of 15.6 #/gallon, Type G,
35% SSA, 0.2% CFR$ neat mment.
6/21/2004 Cudd Pressure Control tripped coil tubing to 1263' N the 7" short string. Fiallrburton pumped 30 sacks of 15.6 #/gallon, Type G,
35% 95A, 0.2% CFRti' neat cement.
6/21/2004 Cudd Pressure Control tripped cod tubing to 1140' in the T' short string. HaBiburton pumped 167 sacks of 15.6 #/gallon, Type G,
35% SSA, 0.2% CFR-3 neat cement. Tots! Sacks m T' short string = 249 sacks (Please reference ASLLP Plugging and Long Term Standby
Summary)
7/1/2004 Baseline time domain response measurement performed.
7/7/2004 Stewart Welding cutoff short string wellhead, rapped T' short string. and labeled cap. The long T' using wellhead was left in
place fur future TDR measurements.
14. I hereby mrtify that the foregoing is tme and correct.
Signed Max Ramey ~ ' f'F ~l-~+~Title Piceanm Operations Manager Date Tuly 20, 2009
(Tfris space for Federal or State office use)
Approved by
Conditions of approval, if any:
Title 18 US.C. Section 1001, makes it a uime far any person knowingly and willfully to make to any department or agenry of the United
States any false, ffrtttlouS or fraudulent statements or representations as to any matter within its jurisdiction
See Instruction on Reverse Side