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Form 3160-5 UNITED STATES <br />(February 2005) DEPARTMENT OF THE INTERIOR <br />BUREAU OF LAND MANAGEMENT <br />SUNDRY NOTICES AND REPORTS ON WELLS <br />Do not use this form for proposals to drill or to re-enter an <br />abandoned well. Use Form 3160 - 3 (APD) for such proposals. <br />SUBMIT IN TRIPLICATE- Other instructions on reverse side. <br />1. Type o(W&II <br />Od Well n Gas Well ?? Other - <br />2. NameofOperator Natural Soda, Inc. <br />3a Address 13b. Phone No. (include area code) <br />3200 RBC 31, Rifle, Co. 81650 970-878-3674 <br />4. Location of Well (Footage, Sec., T., R, M, or Swvey Description) <br />Latitude: 39.928554 N Longitude: 108.349497 W <br />SW 1/4 SW 114 Section 25 T.IS. P-98W 6th P.M. Rio Blanco County, Colorado <br />5. Lease Serial No. <br />Sodium Lease C-0118327 <br />6. If Italian, Allottee or Tribe Name <br />NA <br />7. If Unit or CA/AgteemeM Name and/or No. <br />White River Nabcolite <br />8. Well Name and Na <br />11H.1 <br />9. API Well No. <br />10. Field and Pool, or Exploratory Area <br />Boies Bed <br />11. County or Parish, State <br />Rio Blanco County, Colorado <br />12. CHECK APPROPRIATE BOX(ES) TO INDICATE NATURE OF NOTICE, REPORT, OR OTHER DATA <br />TYPE OF SUBMISSION TYPE OF ACTION <br /> <br />M Notice of Intent Acidve <br />? Alter Casing ? Deepen <br />? Fracture Treat ? ProducU., (Start/Resume) ? Water Sbut-0ff <br />? Reclamation ? Well Integrity <br />t R <br />b <br />rt <br />? S Casing Repair 21 New Constriction ? Recomplete 0 Other <br />epo <br />sequen <br />u ? Change Plans ? Plug and Abandon ? Temporarily Abandon <br />? Final Abandonment Notice El Convert to Injection ? Plug Back ? Water Disposal <br />13. Describe Proposed or Completed Operation (clearly state all Pertinent details, including estimated starting date of arty proposed work and approximate duration thereof. <br />Ifthe proposal is to deepen directionally or recomplete horizontally, give subsurface locations and measured and true vertical depths of all pertinent markers and zones. <br />Attach the Bond under which the work will be performed or provide the Bond No. on file with BLWBIA. Required subsequent reports must be filed within 30 days <br />following completion of the involved operations. If the operation results in a multiple completion or recompletion in a new interval, a Form 3160-4 must be filed once <br />testing has been completed. Final Abandonment Notices must be filed only after all requirements, including reclamation, have been completed, and the operator has <br />determined that the site is ready for final inspection.) <br />111-1-1 will be drilled in the eastern half of the 11H cavity from east to west, towards the 7H well set. The well is located more than 200 feet north <br />of the lOH cavity boundary. The Injection and Recovery wells will be located on the same well pad. <br />Please see the attached cover sheet, figures and drawings for additional information. <br />14. I hereby certify that the foregoing is true and correct <br />Name (Printed/Typed) <br />Bob Warneke Title Manufacturing Director <br />Signature 0; I Date ( ap-(t <br />THIS SPACE FOR FEDERAL OR STATE OFFICE USE <br />Approved bL Title Date <br />Conditions of approval, if any, are attached. Approval of this notice does not warrant or <br />certify that the applicant holds legal or equitable title to those rights in the subject lease Office <br />which would entitle the applicant to conduct operations thereon. <br />Tide 18 U.S.C. Searon tool and Title 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 airy false, fictitious or fraudulent statements or representations as to anymatter within its jurisdiction. <br />(Instructions on page