2010-09-08_REPORT - M1983194

• Permit No: M1983194
• IBM Index Class Name: REPORT
• Doc Date: 9/8/2010
• Doc Name: Monitoring Well 93-2M Plugging and Abandonment
• From: Daub & Associates, Inc
• To: Paul Daggett , White River Field Office
• Email Name: THM
• Media Type: D
• Archive: No

Form 3160-5 UNITED STATES FORM APPROVED
OMB No. 1004-0137
(August 2007)
DEPARTMENT OF THE INTERIOR Expires: July 31, 2010
BUREAU OF LAND MANAGEMENT 5. Lease Serial No.
C-0118327

SUNDRY NOTICES AND REPORTS ON WELLS 6. If Indian, Allottee or Tribe Name
Do not use this form for proposals to drill or to re-enter an N/A
abandoned well. Use Form 3160-3 (APD) for such proposals.
SUBMIT IN TRIPLICATE - Other instructions on page 2. 7. If Unit of CA/Agreement, Name and/or No.
1. Type of Well
? Oil Well El Gas Well Other
m Hydrologic/Subsidence Monitor Well 8. Well Name and No.
93-2M
2. Name of Operator 9. API Well No.
Natural Soda, Inc
3a. Address 3b. Phone No. (include area code) 10. Field and Pool or Exploratory Area
3200 Rio Blanco County Road 31
Rifle, Co 81650
[phone]
4. Location of Well (Footage, Sec., T.,R.,M., or Survey Description) 11. Country or Parish, State
Latitude 39.933353236 W, Longitude 108.361759081 N (NAD 27), S26, T1S, R98W Rio Blanco County, Colorado O
12. CHECK THE APPROPRIATE BOX(ES) TO INDICATE NATURE OF NOTICE, REPORT OR OTHER DATA
TYPE OF SUBMISSION I TYPE OF ACTION
? Notice of Intent ? Acidize ? Deepen ? Production (Start/Resume) ? Water Shut-Off
? Alter Casing ? Fracture Treat ? Reclamation ? Well Integrity
Subsequent Report ? Casing Repair ? New Construction ? Recomplete ? Other
? Change Plans m Plug and Abandon ? Temporarily Abandon
? Final Abandonment Notice ? Convert to Injection ? Plug Back ? Water Disposal
13. Describe Proposed or Completed Operation: Clearly state all pertinent details, including estimated starting date of any proposed work and approximate duration thereof. If
the proposal is to deepen directionally or recomplete horizontally, give subsurface locations and measured and true vertical depths of all pertinent markers and zones.
Attach the Bond under which the work will be performed or provide the Bond No. on file with BLM/BIA. Required subsequent reports must be filed within 30 days
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
testing has been completed. Final Abandonment Notices must be filed only after all requirements, including reclamation, have been completed and the operator has
determined that the site is ready for final inspection.)
See attached report for detailed summary.
Well perforated at 1212'-1215' and 1230'-1233' for a total of 12 3/8" perforations with 120 degree phasing. Cemented with 239 sacks Type "G" (15.8 ppg, 1%
CaCI, 0.7% CFR, 1.15 cf/sack) and 30 sacks Type III cement (14.6 ppg, 2% CaCI, 0.5% CFR, 1.37 cf/sack). Cemented from 1898 ft to 0.75 ft below ground
surface.
14. I hereby certify that the foregoing is true and correct.
Name (Printed/Typed)
Gerald J Daub Title President of Daub & Associates, Inc.
Signature__'' I Date <//a
THIS SPACE FOR FEDERAL OR STATE OFFICE USE
Approved by
Conditions of approval, if any, are attached. Approval of this notice does not warrantor certify
that the applicant holds legal or equitable title to those rights in the subject lease which would Office
entitle the applicant to conduct operations thereon.
Title 18 U.S.C. Section 1001 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 States any false,
fictitious or fraudulent statements or representations as to any matter within its jurisdiction.
(Instructions on page 2)