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Permittee Contact: <br />Roger L. Day <br />Permittee Company: <br />American Shale Oil, LLC <br />Address: - <br />: • . _ .. <br />P 0 Box 1470 <br />Rifle, CO 81650 <br />F'C ( / `f 70 <br />Phone Number: <br />(970) 625 -4324 <br />Fax Number: <br />(970) 625 -4318 <br />Email Address: <br />CF.PR.email <br />rogPI,da -/ t <br />Landowner Contact: <br />13 L H <br />At-In' 01+ kvci I -fPy <br />Landowner Address: <br />HeerPV' co cikill <br />Landowner Phone <br />Number: <br />q40 3E19 <br />Landowner Email <br />19. As required by rule 5.6.1(f), attach a map to this report that accurately depicts the NOI boundary, current affected <br />area, location of all previously listed featured, and all acreages listed in items 6 through 12 and item 20. These <br />activities must be identified on a site map of adequate scale to field locate these areas, and may include coordinates in <br />latitude and longitude to at least 5 decimal places, or UTM coordinates with the datum and zone specified. <br />UPDATED MAP ATTACHED: <br />20. Rule 5.7 requires submittal of final abandonment reports within 60 days for any drill hole(s) with artesian flows and <br />no later than 12 months for all other completed drill holes. <br />ABANDONMENT REPORTS ATTACHED: or.. N/A <br />Division records indicate the following permittee /landowner contact information. If this information is not current, please <br />type or print current contact information: Rule 5.6.1(a, b). <br />t7 0 mac k161. <br />Page 4 of 4 <br />I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations are <br />being con cted in accordance wit e Division approved NOI and reclamation plans. Rule 5.6.1(h). <br />Signature„iff Permittee, Corpo fficer, Owner, or Documented Designee Date <br />r/ j,3 /2 <br />