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

Form 3L6P5 UNITED STATES FORM APPROVED
Qune 1990) DEPARTMENT OF THEINTERIOR Eudget eumeu Nwlm4-0135
Fs ims Much 31, 1993
BUREAU OF LAND MANAGEMENT s. I.eeee Deaignssion and Serial Nw
Yankee Gulch 00.118328
SUNDRY NOTICES AND REPORTS ON WELLS
Do not use this form for proposals to drill or to deepen or reentry to a different reservoir. 6 v hd:.n, umae or rube Nmie
Use "APPLICATION FOR PERMIT-" for such N/A
SUBMIT IN TRIPLICATE r' v uw;t °` G'' `~`~iei° o~:g.~ue„
A
1. Type of Well & Weu NerveaM Nw
^ Oil Well ^ Gas Well ®Other Nahcalite Solution Minim American Soda LLP 21-16
2. Name of Operator 9. API Wea Nw
American Soda, L.LP.
3. Address and Telephone No. la Pvrd and Pool or ExpbrHOry Are.
2717 Ct.. Rd. 215 Parachute, CO 81635 970 285-650(1 Central Piceance Creek Basin
4. Location of Well (Footage, Sec., T., R., M., or Survey Description) 11. creamy or Perish, Slate
E 15,3123 N 13167.2 SW Yi of SW r/i of Section 21, TIS, R97W 6LL P.M. Rio Blanco, CO
12. CHECK APPROPRIATE BOX(s) TO INDICATE NATURE OF NOTICE, REPORT OR OTHER BATA
TYPE OF SUBMLSSION ~ TYPE OF ACTION
^ Notice of Intent
^ Subsequent Reports
©Final Abandonment Notice
®Abandonment
^ Recompletion
^ Plugging Back
^ Casing Repair
^ Altering Casing
Other:
^ Cftange of Plans
^ New Construction
^ Non-Routine Fracturing
^ Water Shut-0ff
O Conversion to Injection
^ Dispose Water
Puce Eepmr,e®mte meMgeompleu®mw.a
l3. DemEe' PmImMmCmeplwmopmam,(OmE9>u~eaO Pntom~ee,vty mngwwmmdan, ieaeNe6namao-d dvleHeanos mrwwOn ~oLL aweavdvealmaar'MOM. gve mbnae aru®
sea mmo,ea area aee.unr.I avw. te+o o.>.tm ®a ~ P~ m rob wo,cP
Well 2]-l5 dissolution surface at 1499'.
5/26/04 Rig up Key Energy on well and pull all (2221') of 4 Yr" long string .
5/27/04 Cut 4 Yz' short string at 155T and puB 155T Set bridge plug in 7" long string at 1700' Set bridge plug in short string at 1556'
6/15/04 Cudd Pressure Control tripped to 1697 feet with mil tubing unit into long 7" casing string. Hall;}n,rtnn pumped 239 sacks of 15.6
#/gal Type G, 35% SSA, 0.2% CFR„' neat cement and displaced mil tubing with water.
6/15/04 Cudd Pressure Control [ripped to 1551 feet with coll tubing unit unto short T' casing string. Hallibur[on pumped 221 sacks of 15.6
#/gal Type G, 35% SSA, 0.2% CFR3 neat cement and dreulated 1 sack of cement to surface.. (Please reference ASLLP Plugging and Long
Term Standby Summary)
7/8/2004 Stewart Welding cut oft wellhead, upped both casings, and labeled weB location on rap
14. I hereby certify fiat the foregoing is true and correct.
Signed Max Ramey 1 14J)C T1Ne Pic~nce Operations Manager Date fuly Z0, 2004
(This space for Federal or State office use)
Approved by
Conditions of approval, i any:
Title 18 US.G Section 1001, makes it a ¢ime for any peeson knowingly and willfully to make m any department or agency of the United
S[a[es any false, fictitious or fraudulent statements or representations as [o any matter within its jurisdiction
`See Instruction on Reverse Side