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-,, . <br />.---- , <br />Form3160-3 <br />(April 2004) <br />UNITED STATES <br />DEPARTMENT OF THE INTERIOR <br />BUREAU OF LAND MANAGEMENT <br />APPLICATION FOR PERMIT TO DRILL OR REENTER <br />la. Type of work: ~ DRILL ^ REENTER <br />FORM APPROVED <br />Oh1B No. 1004-0137 <br />Expires Match 31, 2007 <br />5. Lease Serial Na <br />C-0118327 <br />6. ff Indian, Allotee or Tribe Name <br />NA <br />I If Unit or CA Agreement, Name and No. <br />White River Nahcotlte <br />8 Lease Name and W It No <br /> <br />Ib. Type of Well: Oil Well Gas Well <br />Q <br />Other aSingle Zone Multiple Zone e <br />7H-IV <br />2 Name of Operator 9. API Well Na <br />Natural Soda, Inc. NA <br />3a. Address 3200 RBC 31, Rifle, Co 81650 3b. Phone N0. (include areo code) 10. Field and Pool, or Explorrtory <br /> 970-878-3674 Bo1ea Bed <br />4. Location of Well (Report location cle~ly and in acmrdmue with Cory Srau reguiretnentr. q 11. Sec., T. R. M. or Blk and Survey or Area <br />At surface N229595.75 E1198074.10 or 39°55'40.43706 N 108°21'42.82093 W <br />At proposed prod. zone N229595.75 E1198074.10 or 39°55'40.43706 N 108.21'42.82093 W TiS R98W Section 26 <br />14. Distance in miles and direction from nearest town or post odre' 12. County or Parish 13. State <br />45 mBes southwest of Meeker Colorado Rio Blanco Co <br />I5. Distance from proposed' .-233.36 feet 16. No. of acres in lease l7. Spacing Unit dedicated b this well <br />location to nearest <br />property or lease line, ft <br />(Also to nearest drig. unit line, if any) <br />8222.6 <br />I8. Distance from proposed location' 19. Proposed Depth 20. BLMBIA Bond No. on file <br />to nearest well, dolling, completed, <br />applied for, on tins lease, ft. ~ 500' S of 5H-1 V 2000 bgs 6149905 <br />21. Elevations (Show whether DF, KDB, RT, GL, etc.) 22 Approximate date work will start' 23. Estimated duration <br />Ortho Ht. 6682 05/20/2008 Two Weeks <br />24. Attachments <br />The following, completed in accordance with the requirements of Onshore Oil and Gas Order No.l, shall be attached to this form: <br />1. Well plat certified by a registered surveyor. 4. Bond to cover the operations unless covered by an existing bond on file (see <br />2 A Drilling Plan. Item 20 above). <br />3. A Surface Use Plan (if the location is on National Forest System Lands, the 5. Operator certification <br />SUPO shall be filed with the appropriate Forest Service Office). 6. Such other site specific information and/or plans as may be required by the <br />authorized officer. <br />25. Sig lure Name (Printed/Typed) Date <br />~~4~a ~~ ~" Bob Warneke 04/21/2008 <br />Title <br />Approved by (Signature) L~ Jl' ~ Name (Prrnted'Type Date / ~ <br />~ ~,, - ~IELD MANAGER vs/i3/a8 <br />Director of Manufacturing <br />Title <br />White River Field Office Meeker, Co. <br />Application approval does not warrant or certify that the applicant holds legal or equitable title to those rights in the subject lease which would entitle the applicant to <br />conduct operations thereon. <br />Conditions of approval, if any, are attached. <br />Title IS U.S.C. Section 1001 aid Tide 43 U.S.C. Section 1212, make it a crime for any person knowingly and willfully to make to any department or agency of the United <br />States any false, fictitious or fraudulent statements or representations as to any matter within itsjuris gichon. <br />'(Instructions an page 1) <br />