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F°`~ State of Colorado ~~
<br />ZA Oil and Gas Conservation Commission
<br />Rev 6199
<br />1120 Lincoln Street, Suite 801, Denver, Colorado 80203 (3031894.2100 Fax (303) 894.2109 BAs
<br />DRILL SITE/ACCESS ROAD RECLAMATION FORM
<br />This form shall be submitted in duplicate with the application for permit-to-drill (OGCC Form 2)
<br />unless a Federal 13-point surface plan is included. Also required are a minimum of two
<br />photographs (site and access road). Soil and plant community information is from United
<br />States Natural Resources Conservation Services (USNRCS).
<br />FOR OGCC USE ONLY
<br />1.OGCC Operator Number' 69175 4. Contact Name and Telephone:
<br />Petroleum Development Corporation Jamea Anaable
<br />2. Name of Operator:
<br />No: 1303) 905-4340
<br />3. Address: 1775 Sherman st, suite 3000
<br />Cky_ Denver CO p: 80203 FeK.
<br />State: Zi
<br />5. Well Name and No.: coora Energy #24-25 6. County: Wela
<br />7. Location (OtrQtr, Sec, Twp, Rng, Meridian): sssw - 25 - x3x
<br />R64W 6th PM
<br />Pre-Drilling Information
<br />Current Land Use
<br />Complete the '
<br />Attachment Checklist
<br />Sation 101 doomnutim
<br />8. Crop Land: ^ Irrigated ^ Dry Land ^ Improved Pasture ^ Hay Meadow ^ CRP
<br />9. Non-Crop Land: Q Rangeland ^ Txnber ^ Recreational ^ Other (describe):
<br />10. Subdivided: ^ Industrial ^ Commerdal ^ Residential
<br />Attach color photographs of drill site and access road; Identify each photo by date, well name and Iowtlon.
<br />SoilB
<br />11. Soil map unRs from USNRCS survey: Sheet No: xRCS site Soil Complex/Series No: 70
<br />Soils Series Name: yalent Sand 3-9~ slopes Horizon thldcness(in inches): a' o-g~ ' B: : C: 8-60^,
<br />Soils Series Name: Horizon thickness (in inches): A• ' B: ' C~
<br />Plant Commun
<br />Complete this section only if operations are to be conducted upon non_eroo land.
<br />12. Plant species from: ^USNRCS or /^ Field Observation Date of observation: 12/6/07
<br />List individual species:
<br />13. Check one predominant plant community for the drill site:
<br />^ Disturbed Grassland (Callus, Yucca, Cheatgrass, Rye, Thistle)
<br />Q Grassland (Bluestem, Grama, Wheatgrass, Buffalograss, Fescue, Oatgrass, Brome).
<br />^ Shrub and Brush Land (Mahogany, Oak, Sage, Serviceberry, Chokecherry)
<br />^ Plains Deciduous Riparian (Cottonwood, Willow, Aspen, Maple, Poplar, Russian Olive, Tamarisk)
<br />^ Mountain Conifer Riparian (Spruce, Flr, Ponderosa Pine)
<br />^ Evergreen Forest Land (Spruce, Fir, Ponderosa Pine, Lodgepole Pine, Juniper, Pinyon)
<br />^ Aquatic (Bullrush, Sedges, Cattail, Arrowhead)
<br />^ Tundra (Alpine, Willow, Currant, Raspberry)
<br />^ Other (describe):
<br />14. Was an Army Corps of Engineers Section 404 Permit filed? ^ Yes /^ No N yes, attach appropriate documentation.
<br />I hereby certify that 1, or persons under my dived supervision, have inspected the proposed drill site an° access roa°; rnar i am ramumr wun uio
<br />conditions which presently exist, that the statements made in this form are, to the best of my knowledge, true, correct, and complete.
<br />Print Name: `T
<br />Signed:
<br />le
<br />Title: Sr. Regulatory Consultant Date: 12/13/07
<br />i
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