2008-04-14_PERMIT FILE - C1981028 ‎(2)‎

• Permit No: C1981028
• IBM Index Class Name: Permit File
• Doc Date: 4/14/2008
• Section_Exhibit Name: Appendix R-10 Drill Well Information
• Media Type: M
• Archive: No

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FORM State of Colorado
GOt0YAp0
R"v,~e5 Oil and Gas Conservation Commission "~
1120 Lincdn Street Suite 801, Denver, Colorado 80203 Phone: [phone] Fax:[phone] Olta
APPLICATION FOR PERMIT TO: c.as
1. m OriA, a Deepen. ~ Reenter, ~ Recomplete and Operate
2. TYPE OF WELL Refiling Pugging Bond Surety ID#
OIL^ GAS COALBED~ OTHER: Sidetrack
SINGLE ZONE MULTIPLE ZONES COMMINGLE ZONES complete the
3. Name or Operator: Petroleum Development Corp. 4. COGCC Operator Number: 69175 Attachment Checklist OP', Ccwcc
5. Address: 1775 Sherman St, Suite 3000 APD 0 ' & 1 Co
Ciry: Denver State: CO Zip: 80203 Fcrm 2A
6. Contact Name: James Annable Phone: [phone] Fax: Well location tat
7. Web Name: Coors Energy Well Number: 34-25 Ta o m
8. Unit Name (if apply: Unit Number: Mineral lease ma
9. Proposed 7ota1 Measured Depth: 7670' S.Irface agrmt/Surery
WELL LOCATION INFORMATION 31 Da notice letter
10. QtrQtr. SWSE Sec: 25 Twp: 3N Rng: 64W Meridian: 6th PM [`aviated Drilli Plan
latitude: 40.19046 N longitude: 104.49812 W Exceptlon Location
Re uest
Footage At Surface: 470 0 2165 a Exce lion Loc Waivers
11. Field Name: Wattenberg Field Number. 90750 H2S Conlin en Plan
12. Ground Elevatlon: 4800' 13. County: Weld Federal Dallin Permit

t4. GPS Data:
Date of Measurement 12/6/07 PDOP Reading: 6 Instrument Operators Name: Thomas G, Carlson PIS 24657
15 tt well is: ~ D'uedional ~ Horizontal (highly deviated), submit deviated drilling plan Bottomhole Sec Twp Rng:
kY
YL
FNLffSL FEL~fWL FNUFSL ~~ FH
Footage At Tap of Prod Zone: _ ~ _ Q _ ~ _ OAt Bottom Hole:_ C~ _ Q_ _ _ _ _ _ _ _ _ _ _
16. Is locaton in a high density area (Rule 603b)T 0 Yes ~ No
17. Distance to the nearest building, public road, above ground utility ar railroad: 1000'+ (rYllne)
18. Distance to Nearest Property Line: 470' 19. Distance to nearest well permittedlcompleted in the same fomlation: 939'
20, LEASE SPACING AND POO LING INFORMATION
Ob active Formation s Formation Code S adn Order Numbers Unit Acrea a Assi ned to Well Unit Con uration N12, SEl4, etc.
Dakota DKTA 499-15 320 1=2

Fee estate Federal Indian Lease #
21. Mineral Ownership:
®
22. Surface Ownership: Fea State Federal Indian
Is the Surface Owner also the Mineral OwneR Yes No Surface Surety ID# 19990086
23
.
23a. If 23 is Yes: Is the Surface Owner(s) signature on the lease? Yes ~No
tl 23 is No: Surface Owners Agreement Attached or $25,000 Blanket Surface Bond 52,000 Surface Bend 55,000 Surface Bond
23b
.
24. Using standard QUOV, Sec, Twp, Rng format enter entire mineral lease description upon which this proposed wellsite is located (attach separate sheetlmap 'rf you prefer):
S2 Sec. 25 T3N R64W
25. Distance to Nearest Mineral Lease Line: 470' 28. Total Acres in Lease: X90 ~
nou I wr sr euc eun DDMGn11RFS
un~Lbuw r Vr+nv ru.... ..~~ ~~
27. Is H2S antidpated? ~ Yes ~ No tl Yes, attach contln en plan.
28. Will salt sections be encountered dufng drifting? ~ Yes No
29. Wfll salt (>16,000 ppm TDS CI) or oil based muds be used during drilling? Yes No
30. B questlons 27 or 28 are yes, is this location in a sensitive area (Rule 903)? Yes No If 28, 29 or 30 ere "Yoe" s ph permR may be required.
31. Mud disposal: Offsite ~ Onsite
Method: ®Land farming ~ Land Spreading a Disposal Fadfdy ~ OMer.
NOTE: The use of an earthen it for Recom le8on fluids r wires a it ertnit Rule 905b. tl airl as drilii , noti local fire offldals.
De ih Sacks Cement CemF nt Bottom Cement To
tti
S
n
e
Strin Size of Hole Size of Casin Wei ht Per Foot
" 8 5/8" 24# 800' 80C' Surface
.. 0 7670' 7670' 0'
2nd Sta a 5870' 2000'

',' s' , ~ ;`:~' ,.,• ;: :. aa!s - . S e Tool
32. BOP Equipment Type: 0 Annular Preventor ~ Double Ram ~ Rotating Head ~ None
33. Comments Co o C si t b ed DC e t at t se le s of c II o io
formations Dermitted. and casino information has changed.
or is not required. Provide supporting documentation if consultation
was waived
12/4/07
,
,
34. Initial Rule 308 Consultation took place on (date)
has been waived or if good faith effort did not result in consultation.
IOR TO COMPLIANCE WITH RULE 308 CONSULTATION SHALL BE RETURNED UNAPPROVED.
PERMIT SUBMITTED TO OGCC PR
I hereby certify that a co Ito permit package has been sent to the applicable Local Government Designee(s), and all statements made in this form are,
to the best of my know) g rue, ,and complete. James Annable
Signed: ~ Print Name: _
Title: Sr. Re lato Consultant Date: 12/13/07 Email: jim.anr. able comcast.net
_ .. _ ... ... _ ~.~ i. a.r.nn o..,..- -..A nnnlin~hic nrrinrc and is hetP_t]V aDDfOVed.
Based on the information provided herein, this Application for rermn-to-unu compnes w......~~.... ,~~.~~ o„~ ~r~
COGCC Approved:
Director of COGCC Date:
Permit Number: Expiration Date:
API NUMBER CONDITIONS OF APPROVAL, IF ANY:
OS-