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Home My WebLink About20132902.tiffKERR-MCGEE OIL ANL JAS ONSHORE DIVISION ORDER WELD COUNTY COLORADO C/O BOARD OF COUNTY COMMIS 915 10TH STREET GREELEY, CO 80631 Venture Number: Property Number: Property Name: Product: Status: County/State: Effective Date: Owner Number: Interest Amt/Type: Unit Description: 330190 1118718 MELBON 12N-8HZ NBRR All Products NOT APPLICABLE WELD/ CO 7/25/2013 RV37471504 - WELD COUNTY COLORADO 0.03125000 / RI T2N-R65W SEC 8: W2SW; SEC 17: W2NW; SEC 7: E2SE; SEC 18: E2NE CONTAINING 320 ACRES, M/L, NIdBRARRA FORMATION. The undersigned certifies the ownership of their decimal interest in production or proceeds as described above payable by KERR-MCGEE OIL AND GAS ONSHORE (Payor). Payor shall be notified, in writing, of any change in ownership, decimal interest, or payment address. All such changes shall be effective the first day of the month following receipt of such notice. Payor is authorized to withhold payment pending resolution of a title dispute or adverse claim asserted regarding the interest in production claimed herein by the undersigned. The undersigned agrees to indemnify and reimburse Payor any amount attributable to an interest to which the undersigned is not entitled. Payor may accrue proceeds until the total amount equals $100, or Sept. 30 whichever occurs first, or as required by applicable state statute. This Division Order does not amend any lease or operating agreement between the undersigned and the lessee or operator or any other contracts for the purchase of oil or gas. In addition to the terms and conditions of this Division Order, the undersigned and Payor may have certain statutory rights under the laws of the state in which the property is located. Note: NADOA Model Form Division Order (Adopted 9/95) API 4- OS-123-341GS RV37471504 WELD COUNTY COLORADO C/O BOARD OF COUNTY COMMIS At t e a.t: _ _ - - �'� Clerk to the oard O �Signa e/ By: William F. Owner Signature/Corpora Deputy Clerk *Tax ID # XXX-XX-0813 **Tax ID # Owner Address (if different from above) City, State Zip Code 970-356-4000 Owner Daytime Phone * Failure to furnish your Social Security/Tax ID number will result in withholding tax in accordance with federal law and any tax withheld **Insert Tax ID number for all individual parties listed above in the Name and Address box 2013-2902 Return to: KERR-MCGEE OIL AND GAS ONSHORE P.O. Box 173779 Denver, CO 80217-3779 1-800-677-5603 MG ..44410_, Date Prepared JPrepared by: Susp: 6(,1 September 10, 2013 Zach Svendsen N LEODt3 III \\.\d\ Total Allocated .....\}}§) } 8 | !] )! ` ) Noble Energy, loc. ) ! 1`8'11]|!.! |\),l;; ; Allocation of Burdens \\ 113 .\)}| roc nKen-McGee i. ilOil et et '_ , \ / :e!!!!/ !!! !!!!!:!! ; TOTAL UNIT TOR FOR OWNER (\ '4 r4 TOTAL UNIT ORI FOR OWNER \ \))\\ 0.00045000 )) ) a ( Tract NRI (]) [;;;;[r((i tA55555 # 922)2( Q ))) ))())]){ EXHIBIT C: DIVISION OF INTERESTS: Melbon 12N-SHZ 'Township 2 North, Range 65 West section n_wrzxwid I I I I ( I __ _ I 1 I I I aeencn:et uouoacl lAs to production front Om Corlett end Niobrara formations and limited to production from the captioned wells Containing 320 acres, mere or less !! !!)!§] !! ])] ;] n rn \ i . !e!<; , ,!! )))))))))§) ; ;l;-! )! )(()§I ! }8([)(88188 1 ; ;r§;r;!1811 !)) )!()()(; I.,,.,, ! ,,,,,.,,, ! ,,,., \ °' \ ! .- �!t LANDOWNER ROYALTY ("LORI { , (/ (§g Weld County, Colorado - Robert A. Crowder II. and Melissa O. Crowder, joins tenants Dwain W. Poland and Chado115 L Poland, mini tenants Total Landowner Royalty Interests OVERRIDING ROYALTY INTERESTS ("ORI") !, ), ! | ;; Roper Snyder ono Dolores J. Snyder, Trustees et the Robert L Snyder That dated June 20, 1996 Robert L9lyder and Dolores J. Snyder. Trim -tees style Robert L Snyder Tons dated June 20, 1906 Robed L Snyder vW Delores .1. Snyder, Treeless MOO Robert L Snyder Tnal ' dated June 20, 1996 f!; ))) ` ! Den L Schwartz .!! ]4! ` 1 Matthew P. Saeger / f \ ! ))St ! !!!;, H !: !! Noble Energy, Inc. )) Old ) L3 ) Q co'cl- I; !)); r ,,.. rg | ; | \h' ||_: E Ed }} | , ) . § \ •` )) ~\; j \ 100.000000% ` E» \\ 9 \ ; ; $ P \ E/ \) \ / R \\ / 8188 / Q / / / | \ §] / ! H<, NM t, ,A SS Hi Interest Covered by Leese \\ R . R j R {ye©e /<\§y J tGG j b) e / 3 | j\ Re \ e {/ee A \ » ! � e • ,� it . _' ' WORKING INTERESTS ("WI")/ NET REVENUE INTERESTS ("NRI') WI XIII NRIPOW-eugw)srI sPmesrllM(wnc) Ken -McGee Oil & Gas Orrshon& LP Ken-MCGee Oat & Gas Onshore, LP Ken -McGee Oil & Gas Onshore, LP Ken -McGee O0&Gas Onshore, LP \ ! \ ) ) � §», U i w {d } i5; ) js §)ifi Q! IKeiMCGee Oil & Gag Onshore, LP ll riche Energy. Inc. Noble Energy. lnc. KerrrA/rGee Kerr-McGee Oil & Gas Onshore LP A subsidiary of Anadarko Petroleum Corporation 1099 181h Street Denver, CO 80202 720-929-6000 Department of Natural Resources Oil and Gas Conservation Commission The Chancery Building 1120 Lincoln St., Suite 801 Denver, CO 80203 January 7, 2013 7 r 1 c_cpce 'n) (),(‘ S -- 31c(eg �-c Re: 30 Day Certification Letter - 318A -e MELBON 12N-8HZ Township 2 North, Range 65 West, Section 17: SW/4NW/4 Unit Spacing: 02N -65W-7 E/2SE/4 02N -65W-8 W/2SW/4 02N -65W-17 W/2NW/4 02N -65W-18 E/2NE/4 Weld County, Colorado Ladies/Gentlemen: Kerr-McGee Oil and Gas Onshore LP ("KMG") hereby certifies to the Director that a thirty (30) day notice has been given by certified mail to all owners in the proposed wellbore spacing unit. We have not received any objections to such well location, proposed spacing unit, or additional producing formation. KMG hereby requests the Director to approve the boundary well. If you have any questions or issues regarding this permit, please contact Cheryl Light at (720) 929-6461. Very truly yours, Kerr-McGee Oil and Gas Onshore LP Lauren Kucera Regulatory Analyst I Enclosure SPACING UNIT MAP ELL LOCATION CERT:FICATE MELBON 12N-8HZ NWSEC. 17 2Y"ALUM. CAP PLS 23027 co O 0 2 N YD SEC. 17 3Ya" ALUM. CAP PLS 24310 " E 2673.45 co 0 O 2 SW SEC. 17 3Y" ALUM. CAP PLS 23501 LEGEND SECTION 17, TOWNSHIP 2 NORTH, RANGE 65 WEST, 6TH P.M, -o-BH- 2188' FSL A. 215' FWL N 89'28'22" E 2638,46' SURFACE LOCATION GROUND ELEVATION= 4956' NADS3 LATITUDE= 40.139097° LONGITUDE= 104.695075' N 89'22'45' E 2648.89' (C) LATITUDE= 40'08'20.749' LONGITUDE= 104'41'42.271° BOTTOM HOLE LOCATION NAD83 LATITUDE= 40.151965' LONGITUDE= 104.096427° LATITUDE= 40°09'07.072" LONGITUDE= 104°41'47.137" S 88'45'O6" W 2673.73' N 89'28'32" E 2638.37' N Ya SEC, 17 2" ALUM. CAP PLS 25937 0 13 m O m z w y 43 N 89'22'45' E 2647,30' (C) NOTES: 8H LOCATION PROVIDED 8Y CLIENT. LAND SURFACE USE-DRYLAND CROP SEE ATTACHED MAP FOR ADDITIONAL IMPROVEMENTS WITHIN 400'. POOP= 1,2 GPS OPERATOR: DAVID MACDONALD S Y4 SEC. 17 2Yi" ALUM. CAP ILLEGIBLE S 89'17'55" W 2655.36' WELL MELBON 12N-8HZ TO BE LOCATED 25OO' FNL AND 635' FWL = EXISTING MONUMENT • =BOTTOM HOLE O = PROPOSED WELL ' = EXISTING WELL BH = BOTTOM HOLE NOTES: 1. THIS FIELD SURVEY CONFORMS TO THE MINIMUM STANDARDS SET BY THE C.O.G.C.O., RULE NO. 215 2. HORIZONTAL POSITIONS AND ORTHOMETRIC ELEVATIONS SHOWN AT THE WELL HEAD, ARE BASED ON GPS-RTK POSITIONS DERIVED FROM MINIMUM 2 -HOUR STATIC OBSERVATIONS CORRECTED BY THE NATIONAL GEODETIC SURVEY ONLINE POSITIONING USER SERVICE, O.P.U.S. DATUM. HORIZONTAL NAD63/2007, VERTICAL = NAVD00 3. THE BASIS OF BEARINGS ARE STATE PLANE COORDINATE SYSTEM GRID BEARINGS SHOWN HEREON BETWEEN THE DESCRIBED MONUMENTS SHOWN HEREON, 4. GRID DISTANCES ARE SHOWN, AS MEASURED IN THE FIELD, WITH TIES TO WELLS MEASURED PERPENDICULAR TO SECTION LINES. SHEET 1 OI--2 OWNING DAZE: 12-14-12 ET; ':NECKED: SMF TJN WELD COUNTY, COLORADO SURFACI LOCATION: SW 1/4 NW 114, SEC. 17, T2N, R65 W, 0TH P M. NE SEC. 17 3Y4" ALUM. CAP PIS 28659 E Y, SEC. 17 2YZ ALUM. CAP ILLEGIBLE N O 0 o cJ tm m ts)O.p m to O rn SE SEC. 17 2Y2' ALUM. CAP ILLEGIBLE 500 1000 I, L. KELLEY STEVENSON, A LICENSED PROFESSIONAL LAND SCALE: i -IUUU' SURVEYOR IN THE STATE OF COLORADO DO HEREBY CERTIFY TO KERR-MCGEE OIL & GAS ONSHORE LP_ THAT THE SURVEY AND WELL LOCATION CERTIFICATE SHOWN HEREON WERE DONE BY ME OR UNDER MY DIRECT • SUPERVISION AND THAT THE DRAWING SHOWN HER -)''• i. ! ACCURATELY DEPICTS THE PROPOSED LOCATION WELL. THIS CERTIFICATE DOES NOT REPRESENT SURVEY PLAT OR IMPROVEMENT SURVEY PLAT C.R.S. 38-51-102 AND CANNOT BE RELIED UPON OWNERSHIP. L. KELLI'-Y S ILVENSON, PLS 38231 COLORADO LICENSED PROFESSIONAL LAND SURVEY FOR AND ON BEHALF OF P.F,S.; LIC NOTICE. ACCORDING TO COLORADO LAW YOU MUST COMMENCE ANY LEGAL ACTION BASED UPON ANY DEFECT IN THIS SURVEY WITHIN THREE YEARS AFTER YOU FIRST DISCOVER SUCH DEFECT. IN NO EVENT MAY ANY ACTION BASED UPON ANY DEFECT IN THIS SURVEY BE COMMENCED MORE THAN TEN YEARS FROM THIS SAID DATE OF THIS CERTIFICATION SHOWN HEREON. r'5 In/2(d C6vtv‘Acres-. ' /(00cre.5 �( �t�� r�� S's c) tO ELL LOCATION NW SEC. 8 rh 2" ALUM. CAP PLS 25937 CERTIFICATE: MEL ON 12N-8HZ SECTION 8, TOWNSHIP 2 NORTH, RANGE 65 WEST, 6TH P.M. N 89'19'22" E 2632.46' W Y4 SEC, 8 N 89.37'23 E 2635.35' PLS 25937 215' N CO N 00'01'00" E SW SEC. 8 2Y2" ALUM. CAP PLS 23027 0 BH- 2188' FSL 215' FWL co 2421' �NY SEC.8 2" ALUM. CAP PLS 25937 VT • 0 0 N 'tl I A W IN N 89'19'10" E 2632.44' I CY SEC. 8 2" ALUM. CAP PLS 25937 N 89'37'19" E 2638.02' SY SEC. 8 2" ALUM. CAP PLS 25937 NE SEC. B 3)" ALUM. CAP PIS 7242 (n O O ,Z9'SL9Z 3 „60,0 EX SEC. 8 30' W.C. 3Y," ALUM. CAP PLS 10655 3 „ZZ.£0.00 w .1 w S 89'28'22" W 2638.46' MELBON / 12N--8NZ O NOTES: 1. THIS FIELD SURVEY CONFORMS TO TI 1E MINIMUM STANDARDS SET BY THE C.O.G.C.C., RULE NO. 215 2. HORIZONTAL POSITIONS AND ORTHOMETRIC ELEVATIONS SHOWN AT THE WELL HEAD. ARE BASED ON GPS•RTK POSITIONS DERIVED FROM MINIMUM 2 -HOUR STATIC OBSERVATIONS CORRECTED BY THE NATIONAL GEODETIC SURVEY ONLINE POSITIONING USER SERVICE. O.P.U.S. DATUM: HORIZONTAL = NAD83/2007. VERTICAL = NAVD86 3. THE BASIS OF BEARINGS ARE STATE PLANE COORDINATE SYSTEM GRID BEARINGS SHOWN HEREON BETWEEN THE DESCRIBED MONUMENTS SHOWN HEREON. 4. GRID DISTANCES ARE SHOWN, AS MEASURED IN THE FIELD, WITH TIES TO WEI.LS MEASURED PERPENDICULAR TO SECTION LINES. SHEET 2 OF 2 Itnun II, DESFOCESSIDEC IDDI Drior,,C0AAOi FIELD BATE, 12-12-12 DIMING DATE: 12.14-12 ET; CHECKED, SMF I TJN SURFACE LOCATION, SW 114 NW 1/4, SEC. 17. T2N. R65W, 6TH P.M. WELD COUNTY, COLORADO S 89'28'32" W 2638.37' LEGEND -0-= EXISTING MONUMENT -c:4- = BOTTOM HOLE 6 = PROPOSED WELL 0 = EXISTING WELL 511 = BOTTOM HOLE .17-474 3Ci3I L. KELLEY STEVENSSP.1:441N01; ' COLORADO LICENSED PROFESSIONAL LAND SURVEYOR FOR AND ON BEHALF OF P.F,S., LLC 0 SE SEC. 8 3Y4" ALUM. CAP PLS 28650 500 1000 SCALE:11=10M =1000' NOTICE: ACCORDING TO COLORADO LAW YOU MUST COMMENCE ANY LEGAL ACTION BASED UPON ANY DEFECT IN THIS SURVEY WITHIN THREE YEARS AFTFR YOU FIRST DISCOVER SUCH DEFECT. IN NO EVENT MAY ANY ACTION BASED UPON ANY DEFECT IN THUS SUHVC-Y BE COMMENCED MORE THAN TEN YEARS FROM THIS SAID DATE OF THIS CERTIFICATION SHOWN HEREON. FORM 5 State of Colorado sn�r,OF �.� cvwuAao DE ET OE ES Rev 02/08 Oil and Gas Conservation Commission 1120 Lincoln Street, Suite 801, Denver, Colorado 80203 Phone: (303) 894-210D Fax: (303) 894-2109 r�� OIL& GAS Document Number: DRILLING COMPLETION REPORT 400464077 This form is to be submitted within 30 days of the setting of production casing, the plugging of a dry hole, the deepening or sidetracking of a well, or any lime the wellbore configuration is changed. If the well is deepened or sidetracked a new Form 5 is required. Ilan attempt has been made to complete/produce a well, then the operator shall submit Form 5A (Completed Interval Report.) lithe well has been plugged, a form 8 (Well Abandonment Report) is required. Date Received: 08/08/2013 Completion Type ig' Final completion j- Preliminary completion 1. OGCC Operator Number: 47120 4. Contact Name: JOEL MALEFYT 2. Name of Operator: KERR-MCGEE OIL & GAS ONSHORE LP Phone: (720) 929-6828 3. Address: P O BOX 173779 Fax: (720) 929-7828 City: DENVER State: CO Zip: 80217- 5. API Number 05-123-36755-00 6. County: WELD 7. Well Name: MELBON Well Number: 12N-8HZ 8. Location: QtrQtr: SWNW Section: 17 Township: 2N Range: 65W Meridian: 6 Footage at surface: Distance: 2500 feet Direction: FNL Distance: 635 feet Direction: FWL As Drilled Latitude: 40.139096 As Drilled Longitude: -104.695078 GPS Data: Data of Measurement: 06/03/2013 PDOP Reading: 1.7 GPS Instrument Operator's Name: 6/3/2013 ** If directional footage at Top of Prod. Zone Dist.: 1949 feet. Direction: FNL Dist.: 217 feet. Direction: FWL Sec: 17 Twp: 2N Rng: 65W ** If directional footage at Bottom Hole Dist.: 2163 feet. Direction: FSL Dist.: 222 feet. Direction: FWL Sec: 8 Twp: 2N Rng: 65W 9. Field Name: WATTENBERG 10. Field Number: 90750 11. Federal, Indian State Lease Number: !- L12.Spud Date: (when the 1st bit hit the dirt) 02/26/2013 13. Date TD: 04/28/2013 14. Date Casing Set or D&A: 04/30/2013 15. Well Classification: F. Dry (X:, Oil J-, Gas/Coalbed r Disposal r Stratigraphic —. Enhanced Recovery rStorage L`• Observation 16. Total Depth MD 11634 TVD** 7132 17 Plug Back Total Depth MD 11610 TVD** 7132 18. Elevations GR 4956 KB 4972 One paper copy of all electric and mud logs must be submitted, along with one digital LAS copy as available. 19. List Electric Logs Run: ICBL; GR; MUD 20. Casing, Liner and Cement: CASING Casing Type Size of Hole Size of Casing Wt/Ft Csg/Liner Top Setting Depth Sacks Cmt Cmt Top Cmt Bot Status SURF 13+1/2 9+5/8 36 , , 0 1,063 455 0 1,063 ..:VISU„ 1ST 8+3/4 7 26 0 7,522 751 100 7,522 CBL 1ST LINER 6+1/8 4+1/2 11.6 6542 11,619 Date Run: 8/29/2013 Doc (#400464077] Well Name: MELBON 92N-8HZ Page 1 of 3 STAGE/TOP OUT/REMEDIAL CEMENT Cement work date: Method used String Cementing tool setting/perf depth Cement volume Cement top Cement bottom Details of work: 21. Formation log intervals and test zones: FORMATION LOG INTERVALS AND TEST ZONES FORMATION NAME Measured Depth Check if applies COMMENTS (All DST and Core Analyses must be submitted to COGCC) Top Bottom DST Cored SHARON SPRINGS 7,097 F F NIOBRARA 7,214 I- I - Comment: Due to anti -collision needs and the variability of directional drilling, our as -drilled BHL could be different than the permitted. I hereby certify all statements made in this form are, to the best of my knowledge, true, correct, and complete. Signed: Title: REGULATORY ANALYST Print Name: JOEL MALEFYT Date: 8/8/2013 Email: RSCDJPOSTDRILL@ANADARKO.COM Attachment Check List Att Doc Num !Document Name Attachment Checklist 400464107 CMT Summary * Core Analysis 400464106 Directional Survey ** DST Analysis Logs Other Other Attachments 400464077 FORM 5 SUBMITTED 4OO464O89 PDF-CEMENT BOND 400464108 DIRECTIONAL DATA 400464721 LAS -GAMMA RAY 400464722 PDF-GAMMA RAY 400464723 PDF-GAMMA RAY 400464724 LAS -MUD 400464725 LAS -MUD 400464726 PDF-MUD 400464728 PDF-MUD attached ? Yes r No iT Yes r-• No l5t Yes V, No 1-; Yes n No IA Yes 17 No r-; Yes No Yes rx No r. Yes r No r-1 Yes R No r; Yes R No T Yes R No r, Yes I>< No n Yes R No I.I Yes R No ri Yes Ix. No IT Yes rX. No r Date Run: 8/29/2013 Doc (#400464077) Well Name: MELBON 12N -811Z Page 2 of 3 General Comments User Group Comment Comment Date Permit Operator concurs with TPZ footage. Made the correction, ready to pass. 8/27/2013 3:50:51 PM Permit Calculated 1949 FNL for TPZ. Conferring w/operator. 8/27/2013 2:38:24 PM Total: 2 comment(s) Date Run: 8/29/2013 Doc (114004640771 Well Name: MELBON 12N-8HZ Page 3 of 3 FORM 5A Rev 06/12 State of Colorado Oil and Gas Conservation Commission 1120 Lincoln Street, Suite 801, Denver, Colorado 80203 Phone: (303) 894.2100 Fax: (303) 894-2109 COMPLETED INTERVAL REPORT The completed Interval Report, Form 5A, shall be submitted within thirty (30) days of completing a fomiaton (successful or not), when a formation is temporarily abandoned or permanently abandoned, for a recompletion, reperforatlon or restimulation, or when a formation Is commingled. Fill out a section for each formation. Attach as many pages as required to fully describe the work. List In order of completion, DE ET OE ES Document Number: 400468753 Date Received: 09/12/2013 1. OGCC Operator Number: 47120 4. Contact Name: Katie Kistner 2. Name of Operator: KERR-MCGEE OIL & GAS ONSHORE LP Phone: (720) 9294317 3. Address: P O BOX 173779 Fax: City: DENVER State: CO Zip: 8O217- 5. API Number 05-123-36755-00 6. County: WELD 7. Well Name: MELBON Well Number: 12N-8HZ 8. Location: QtrQtr: SWNW Section: 17 Township: 2N Range: 65W Meridian: 6 9. Field Name: WATTENBERG Field Code: 9O75O Date Run: 9/30/2013 Doc (#400468753) Well Name: MELBON 12N-8HZ Page 1 of 3 trod Completed Interval FORMATION: NI0BRARA Treatment Date: 07/08/2013 Perforations Top: 7586 Status: PRODUCING End Date: 07/10/2013 Bottom: 11634 Provide a brief summary of the formation treatment: Treatment Type: FRACTURE STI fi Date of First Production this formation: 07/25/2013 No. Holes: 0 Hole size: '0 Open Hole: IR OPEN HOLE COMPLETION FROM 7586-11634. 6964 BBL CROSSLINK GEL, 1227 BBL LINEAR GEL, 72566 BBL SLICKWATER, 80757 BBL TOTAL FLUID. 1980761# 40/70 SAND, 207120# 30/50 SAND, 2187881# TOTAL SAND. This formation is commingled with another formation: Total fluid used In treatment (bbl): 1..._ Yes )Xl No 80757 Max pressure during treatment (psi): 7548 Total gas used in treatment (mcf): 0 Type of gas used in treatment: Total acid used in treatment (bbl): 0 Recycled water used in treatment (bbl): 0 Fresh water used in treatment (bbl): 0 Total proppant used (Ibs): 2187881 Fluid density at initial fracture (lbs/gal): 8,30 Min frac gradient (psi/ft): 0.90 Number of staged intervals: 32 Flowback volume recovered (bbl): 7018 Disposition method for flowback: DISPOSAL Rule 805 green completion techniques were utilized: Reason why green completion not utilized: Fracture stimulations must be reported on FracFocus.org Test Information: Date: 07/31/2013 Hours: 24 Calculated 24 hour rate: BbI oil: 134 Test Method: FLOWING Gas Disposition: SOLD Bbl oil: 134 Mcf Gas: 256 Casing PSI: 2085 Gas Type: WET Tubing Size: 2 + 3/8 Tubing Setting Depth: 7065 Reason for Non -Production: Date formation Abandoned: ** Bridge Plug Depth: Mcf Gas: 256 BbI H2O: 420 Tubing PSI: 1615 rl Bbl H2O: 420 GOR: 1910 Choke Size: 12/64 Btu Gas: 1287 API Gravity Oil: 48 Tbg setting date: 07/27/2013 Packer Depth: Squeeze: )T Yes 17 No ** Sacks cement on top: If yes, number of sacks cmt ** Wireline and Cement Job Summary must be attached. Comment: I hereby certify all statements made in this form are, to the best of my knowledge, true, correct, and complete. Signed: Print Name: Katie Kistner Title: Regulatory Analyst Date: 9/12/2013 Email rscdjpostdrill@anadarko.com Att Doc Num Name Attachment Check List 1400468753 'FORM 5A SUBMITTED Total Attach: 1 Files Date Run: 9/30/2013 Doc (#4004687531 Well Name: MELBON 12N -811Z Page 2 of 3 General Comments User Group Comment Comment Date Permit Corrected total fluid used in treatment (operator entered TO). Ready to pass. 9/30/2013 9:55:39 AM Total: 1 comment(s) Date Run: 9/30/2013 Doc (#400468753] Well Name: MELBON 12N-8NZ Page 3 of 3 Hello