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Form 31645 UNITED STATES FOAM APPROVED <br />Qune 7990) DEPARTMENT OF THEINTERIOR smut sure."Narmaolas <br /> G irvs Memh3l, 19Ai <br />BUREAU OF LAND MANAGEMENT s Leaee uesignntion aMSerial Na <br /> Yankee Gulch 00.118328 <br />SUNDRY NOTICES AND REPORTS ON WELLS <br />Do not use [his form for proposals to drill or to deepen or reentry to a different reservoir. 6. Blndlan. Aeoaee orT be Nm.v <br />Use "APPLICATION FOR PERMIT-" for such N/A <br />SUBMIT Q~I TRIPLICATE r. uu,,;w "rcgn~~e.,tu~igsenon <br /> A <br />1. Type of Well & Wea Nevre ud Nu <br />^ 00 Well ^ Gas WeB ®Otlter NahcoBte Solution Minin American Soda LLP 2475 <br />2 Name of Operator 9. API Wea No. <br />American Soda, LLP. <br />3. Address and Telephone No. 1n FieM ud Pool orFipbretorynree <br />2717 C . Rd. Z15 Parachute, CO 81635 970 2&S{500 Central Piceance Creek Basin <br />4 Location of Well (Footage, Sec., T., R., M., or Survey Desuiption) lt. co,wy or Pariah, s'°ee <br />E 1295208 N 12506.40 NW Yi of NE'/i of Section 29, TIS, R97W 6~ P.M. Rio Blanco, CO <br />12. CI-IECK APPROPRIATE BOX(s) TO INDICATE NATURE OF NOTICE, REPORT OR OTFIER DATA <br />TYPE OF SUBMLSSION TYPE OF ACTION <br />^ No0ce of Intent ^ Abandonment ^ Change of Plans <br /> ^ RecompleEart ^ New Construction <br />®Subsequent Reports ^ Plugging Back ^ Non-Routhre Fracturing <br /> ^ Casing Repair ^ Water Shut-0ff <br />^ Final Abandonment Notice ^ Altering Casing ^ Conversion to Injection <br /> X Other. Long Tenn Standby ^ Dispose Water <br /> (Nac Itepvt,n"W mmoltipYmoplNw m WA <br />U, t)®LeAW~mCmP~~1~aY aeeaapaWmlaeWt, ma aKP~~.+^~^~Eam,aaemdsn~m5+"lww~wh a.mnatra+m+ar dnu,4 q~e ®eme,a mtim+ <br />mammoRamae"evatiu~a,pw,raaam.a<mammnP~mwm veep <br />This well is scheduled for long term standby. If economics improve, [his well could be brought back into production. <br />WeE 2478 dissolaHon surface at 160T. <br />6/8/2001 Rig up Key Energy on well and pull all (2365') of 4 r/z" long string. <br />6/9/2004 Set cast iron bridge plug in T' long using at 1840'. Cut 4 rh° short string at 1860' and pull 1860' of 4 S'z" short string. Set bridge plug <br />in T' short string at 1840' <br />14. 1 hereby certify that the foregoing is tme and correct. <br />Signed Max Ramey (~'b1`~ ~~Mi~"fitle Pimance Operations Manager Date fuly 1, 2001 <br />(This space for Federal or State office use) <br />Approved by <br />Condittons of approval, i(any: <br />Title 18 US.C. Section 1001, makes it a uime far any person knowingly and willfully to make to any department or agency of the United <br />States any false, fictitious or freudulerrt statements or representations as to any matter within its jurisdiction <br />'See Instmction on Reverse Side <br />