2009-01-30_REPORT - M1999002

• Permit No: M1999002
• IBM Index Class Name: REPORT
• Doc Date: 1/30/2009
• Doc Name: 33rd quarterly report
• From: American Soda, LLP
• To: DRMS
• Email Name: THM
• Media Type: D
• Archive: No

Form 3160-5 UNITED STATES FORM APPROVED
(fune 1990) DEPARTMENT OF THE INTERIOR Budget Bureau No. 1004-0135
Expires: March 31, 1993
BUREAU OF LAND MANAGEMENT 5. Lease Designation and Serial No.
Yankee Gulch CO-118328
SUNDRY NOTICES AND REPORTS ON WELLS
Do not use this form for proposals to drill or to deepen or reentry to a different reservoir. 6. If Indian, Allottee or Tribe Name
Use "APPLICATION FOR PERMIT-" for such proposals N/A
SUBMIT IN TRIPLICATE 7. If Unit or CA, Agreement Designation
wA
1. Type of Well 8. Well Name and No.
? Oil Well ? Gas Well ?x Other Nacholite Solution Mining American Soda L.L.P. 20-19
EPA Class III C03858-04556
2. Name of Operator 9. API Well No.
American Soda, L. L. P.
3. Address and Telephone No. 10. Field and Pool, or Exploratory Area
2717 County Road 215, Parachute, Colorado 81635 Central Piceance Creek Basin
4. Location of Well (Footage, Sec., T., R., M., or Survey Description) 11. County or Parish, State
14,558.19 Easting SE '% of SE % of Section 20, T1 S, R97W 6th P.M. Rio Blanco, Colorado
13,383.35 Northing
12. CHECK APPROPRIATE BOX(s) TO INDICATE NATURE OF NOTICE, REPORT OR OTHER DATA
TYPE OF SUBMISSION TYPE OF ACTION
? Notice of Intent ? Abandonment ? Change of Plans
? Recompletion ? New Construction
? Subsequent Reports ? Plugging Back ? Non-Routine Fracturing
? Casing Repair ? Water Shut-Off
OFinal Abandonment Notice ? Altering Casing ? Conversion to Injection
? Other ? Dispose Water
(Note. Report results in multiple completion on Well
Completion or Recompletion Report and Log form.
13. Describe Proposed or Completed Operations (Clearly state all pertinent details, and give pertinent dates, including estimated date of
starting any proposed work. If well is directionally drilled, give subsurface locations and measured and true vertical depths for all
markers and zones pertinent to this work.)*
• Well 20-19 dissolution surface at 1465'. Cast Iron Bridge Plug set at 1515' on 7" long string.
• On 9/11/2008 the 7* long string failed MIT.
• On 12/17/2008 - Halliburton tripped coil tubing3to the cast iron bridge plug at 1515' and pumped 280
sacks of Type G cement, 15.8 #/gallon, 1.15 ft /sack cement, slurry volume 322 ft3 in long string 7"
casing.
• A cap is in place on the long string casing indicating the date of plugging and abandonment and the
well identification.
• The wellhead is not cut down at this time since the short string 7" casing remains after passing MIT on
9/11/2008.
14. I hereby certify that the tforegoing is true and correct.
Signed9 -w -^ Tirlo

Plant Manager Date January 27, 2008
(This space for Federal or State office use)
Approved by Title Date
Conditions of approval, if any:
Title 18 U.S.C. Section 1001, makes it a crime for any person knowingly and willfully to make to any department or agency of the United
States any false, fictitious or fraudulent statements or representations as to any matter within its jurisdiction.
*See Instruction on Reverse Side