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HomeMy WebLinkAbout20220106.tiffCHANGE OF ZONE (COZ) APPLICATION FOR PLANNING DEPARTMENT USE: :AMOUNT$ ' APPLICATION RECEIVED BY DATE RECEIVED: CASE # ASSIGNED: IGNED: PROPERTY INFORMATION (Attach a itional sheets if necessary.) Is the property currently in violation? No / Yes Violation Case Number: ❑ N ber. Site Address: '5'O t&71' Parcel Numbers: Legal Description: / L , IL? ail tAJ G Section: , Township N, Range W # of Lots: Total Acreage: Floodplain: Vo /Yes Geological Hazard: ENo /[]Yes Airport Overlay: INo / ®Yes REZONING Existing Zone District(s): }S Proposed Zone District; PROPERTY OWNER(S) (Attach additional sheets if necessary.) Name: Gi Q v-- Le.e Company: f Phone #: .1d3 £N L j - 1L2co 3 Email: I 1 i C 1.6- S' - ` 4)/. C Street Address:' = i, 'c ' -' ,1y3 City/State/Zip Code: !` . f APPLICANT/AUTHORIZED AGENT (Authorization must be included if there is an Authorized Agent.) Name: Company: Phone #: Email: Street Address: City/State/Zip Code: I (We) hereby depose and state under penalties of perjury that all statements, proposals, and/or plans submitted with or contained within the application are true and correct to the best of my (our) knowledge. All fee owners of the property must sign this application. If an Authorized Agent signs, an Authorization Form signed by all fee owners must be included with the application. If the fee owner is a corporation, evidence must be included indicating the signa)oyj' has the legal authority to sign for the corporation. )I . at Signature Date Print Change of Zone Planning Questionnaire for: 580 E. 18th St. Greeley, CO 80631 1. I am requesting a zoning change from Ag/Residential to 1-3/Mixed use so that I can make this property available for mixed use storage. I own the property directly to the west of this property (508/510 E. 16th St.), which currently has 1-3/mixed use zoning designation. I would like to be able to use this property in the same manner. 2. This property is currently Ag/Residential and has been owned by private parties who've resided in the mobile home that is located there. 3. 1 would set this up in the same way that my adjoining parcel is set up, with a residence/office mobile home in the front and storage buildings, outside storage sections around the back and perimeter areas, with the possibility of adding a shop or other permanent storage structures in the future. 4. My proposal is to change this property to meet with the surrounding area land uses. Most of the properties in the immediate area are used for the same purposes I am intending. 5. This change will make the property more compatible to the surrounding parcels as they are mostly zoned industrial. 6. There are no soil limitations on this property. 7. I believe this is more consistent with the zoning in the area. 8. 1 believe this is more compatible with the development in the area. 9. This proposal does not have any negative impacts on the health, safety or welfare of the neighbors. 10. This property is not located in an Overlay Zoning District or a Special Flood Hazard Area. Change of zone Public Works Questionnaire for: 580 E. 16th St. Greeley, CO 80631 1. The access location for this parcel is currently from E. 16th St. and would remain the same per this proposal. 2. No changes to access are anticipated. 3. There are currently no access gates included in this location. I am not proposing any access gates at this time. 4. I currently own the adjacent parcel to the west. There is an opening in the west fence line that provides access only to my other parcel, but not to the road access on E. 16th St. 5. No difficulties exist with seeing oncoming traffic from the existing access to this parcel. 6. There are no horizontal curves in the access to this property. 7. The existing access road/driveway is totally flat. Change of Zoning application for: 580 E. 16`h St. Greeley, CO 80631 Public Works Sec.24-3-220. B Traffic Narrative: Predictions are for future 1-3 usage. 1. Round -trips per day: Passenger Cars/Pickups: Approximately 6-8 per day. Tandem Trucks: Approximately 1-2 per day. Semi-Truck/Trailer/RV: Approximately 3-5 per day. 2. The site is currently one entrance in and the same exit out, with a long driveway to the back of the property (running north and south), with a circular turn -around in the far back/south end. 3. The travel distribution in and out of this property is approximately 60% coming from the west and 40% coming from the east, down E. 16th St. There are no routes going north or south. 4. The heaviest traffic would be between 7:00am-5:00pm Monday -Friday, with much less traffic on the weekends. Oil A• (7 4u Owner Relations We value our relationship with the interest owners who receive revenue from Extraction Oil & Gas operations We are committed to providing the highest level of service to all our interest owners and believe that efective communication is crucial to maintaining a good relationship. The information here is meant to answer your questions quickly and easily If you need to contact us for further assistance, piease reach out FORMS FAQ Revenue 1x99/DRW21 Ownership Revenue [ultimate-faqs include_category="revenue"] 1099/ DRW21 [ultimate-faqs include_category="1099drw2l"] Owrershi p [ultimate -fags include_category="ownership') CONTACT I N FO Owner Relations gccm Fax 720-557-8301 Unclaimed Property unclaimed .... ... e -Lain (855)112-6501 Mailing Address Extraction Oil & Gas 370 17th Street (suite 5300) Denver CO 80202 bfl.t1.1. MI Priv"ry-Tprrtl6 MATRIX ENERGY, L.L.C. 201 Linden Street, Suite 301 Ft. Collins, CO 80524 970-493-7690 Fax 970-493-8367 Surface Damages Agreement Between Floyd D. Geist and Rosemond K. Geist 580 East 16th Street Greeley, CO 80631 (970)-351-8662 and Matrix Energy, L.L.C. for a well(s) drilled on Lot 2 of the NEY4SW'/ of Section 9 Township 5 North, Range 65 West Weld, County, Colorado Matrix Energy, L.L.C agrees to take every reasonable precaution and to make every reasonable effort to minimize the disruption of the property. This includes: When leveling requires disturbance/removal of the top soil, Matrix agrees to segregate and stockpile the top soil and subsoil_ At the completion of Matrix's operations, Matrix agrees to reshape the disturbed surface as near as possible to its original contour. 2. To restore the surface and any abandoned well site and any road to a level condition, including compaction, if necessary. 3. Matrix agrees to bury all utility lines, pipelines, and flowlines below plow depth. 4. Matrix agrees to restrict its placement of wells and surface equipment to the South 2.5 acres of said 5.0 acre lot. 5. To notify the surface owner at least seven (7) days prior to entering upon the premises for drilling purposes and Matrix's intention to drill. Execution of this agreement by the parties identified below shall serve as each party's consent to waive the mandatory fourteen (14) day notice, (should such rule apply), as set forth in Rule 305 established by the Colorado Oil and Gas Conservation Commission 6. To refrain from using permanent ground anchors. 7. Restoration of the lands shall commence as soon as practicable after drilling and completion activities are concluded. Restoration shall be made as near as practicable to Its condition when Matrix first entered onto the lands. 8. Access to the wellsite shall be as shown on the attached plats (See Exhibit "A")_ The tank battery/treater facilities shall be as shown on the attached Exhibit "A". Geist #23-9 Surface Damages Agreement Page 2 9. Permanent access roads shall be approximately 15 feet wide. Matrix agrees to construct the roads using a road base as necessary and install culverts to insure proper water drainage. Matrix also agrees to maintain roads accessible for ingress and egress in and to any and all wellheads and tank battery/treater facilities. Matrix agrees to maintain weed control along the access roads and around the tank battery/treater facility area. 10. Notification of Matrix's plans to recomplete or workover any well on the lands shall be given to Surface Owner 15 days prior to entering the lands with equipment. Matrix shall use all reasonable efforts to coordinate any recompletion or workover of any well on the lands with Surface Owner so as not to interfere with normal operations. 11. Matrix shall be responsible for damage to Surface Owner's water systems and fences on the lands that may be caused as a direct result of Matrix's drilling and completion operations. 12. Matrix agrees to comply with all applicable federal, state and local laws, rules and regulations including, without limitation, environmental laws in its use and enjoyment of the lands covered hereby. Surface Owner will not be held liable for any environmental damages caused as a direct result of Matrix's drilling operations. This Surface Damages Agreement is intended to cover all damages which occur as the result of the location, drilling, completion, equipping and operation of the referenced well, including, but not limited to, Matrix's re-entry upon the referenced lands for the purposes of recompletion or reworking operations on the referenced well. This Surface Damages Agreement is also intended to cover all surface damages occasioned by location and use of the access road to the well, location, use and servicing of tank batteries and flow lines or gas gathering lines on the referenced lands, Prior to the commencement of drilling operations for this well, Matrix agrees to pay the surface owner the sum of Five Thousand Dollars ($5,000) per well as payment for surface damages relating to drilling and completion of any specific well and for the installation of the production equipment and flow lines required for the production of oil and gas from that well. Execution of this Agreement by the parties identified below shall serve as each party's consent to waive the thirty (30) day notice as set forth in Rule 305 established by the Oil and Gas Conservation Commission of the State of Colorado. This Agreement is subject to that certain Oil and Gas Lease covering the above described lands, dated March 11, 1998 between Floyd D. Geist and Rosemond K. Geist, Lessors, and Matrix Energy, L.L.C., Lessee. This Agreement shall be binding on any subsequent surface owner(s) and represents the full and complete agreement between the parties. Any additional provisions would have to be agreed to in writing by both the surface owner and Matrix. Geist #23-9 Surface Damages Agreement Page 3 See Exhibit "A" attached hereto and made a part of this Agreement. Signed'L, fF ' Date: Dirk A. Schwartz, Agent for r Matrix Energy, L.L.C. By: r 1 Date: j _•. �,5 Floyd Geist Social Security No. By: t ny � Date: Rosemond K. Geist Social Security No. 5 - - y Mate: �nerrgy, L.L.C. - GET #23-9 LOT 2 OF THE NEI/4 SWI/4, SECTION 9 TOWNSHIP 5 NORTH, RANGE 65 WEST WELD COUNTY, COLORADO fWAN1 16th Avenue Geist — Residence , I I L-Th Ii TI \1 i� Not to Scale Property Line of Lot 2 T 730' Above Ground Power Lin ° Tank Battery ❑ Unoccupied Building e Wellhead an n a Access Road 0 Occupied Building —. — — Burled Buried Utility Line (Marked on Surface) — — Buried Flowline FORM I State of Colorado 6 I Oil and Gas Conservation Commission ,y+ Rev 1120 Lincoln Street, Suite 801, Denver, Colorado 00203 Phone: 1303) 884-2100 Fax: (303) 894.2109 Atli 05/18 WELL ABANDONMENT REPORT This form Is to be suhmitled as an Intent to Abandon wtronover an abandonment is planned an a borehole. Aflar the abandonment is complete, this form shall again be submitted as a Subsequent Report of the actual work completed. The approved Intent shall be valid for six months after the approval dale, after that period, a new intenl will he required, Atlactinwnls required we the tntBnt to Abandon are wellbore diagrams of the current configuration and the proposed configuration wilh plugs set. A Subsequent Report of Abandonment shall Indlcale the actual work completed Attachments required with a Subsequent Report are a wellbore diagram showing plugs that were set and casing remaining in the hole, lire job sumniaoes from all plugging contractors used, including wireiine and cementing (third party verification} and any ions that may have been run during abandonment. DE IET IDE IES Document Number: 402121155 Date Received: 07/26/2019 OGCC Operator Number: 10459 Contact Name: John Christofferson Name of Operator: EXTRACTION OIL & GAS INC Phone: (720) 974-7777 Address: 370 17TH STREET SUITE 5300 Fax: City: DENVER State: CO Zip: 80202 Email: jhristoffersont extractionog.com For "Intent" 24 hour notice required, Name: T`el: COGCC contact: Email: API Number 05-123-20145-00 Well Name: OLIN HA Location: County: Field Name: QtrQtr: NESW Section: 9 WELD WATTENBERG Well Number: 24-9 Township: 5N Range: 65W Federal, Indian or State Lease Number: Field Number: 90750 Meridian: 6 r Notice of Intent to Abandon IR Subsequent Report of Abandonment Only Complete the Following Background Information for Intent to Abandon Latitude: 40.412140 Longitude; -104.671440 GPS Data: Date of Measurement: 04/28/2011 PDOP Reading: 2.2 GPS Instrument Operator's Name'. LARRY ROBBINS Reason for Abandonment: j Dry T Production Sub -economic i Mechanical Problems ? Other Casing to be pulled: ; Yes P No Estimated Depth: Fish in Hole: P Yes P No If yes, explain details below Wellbore has Uncemented Casing leaks: j_ Yes i No If yes, explain details below Details: Current and Previously Abandoned Zones Formation Perf. Top Perf. Btm Abandoned to Method of splpticrn Plug Death NIOBRARA-CODELL I 7228 I 7822 I 04117/2019 lB PLUG CEMENT TOP I 7150 Total: 1 zone(s) Casing History Casing Type Size of Hole Size of Casing Weight Per Foot Setting Depth Sacks Cement Cement Sot Cement Top Status SURF 12+1/4 9+518 36 419 225 419 0 VISU 1ST 7+7/8 4+1/2 11.6 7,948 523 7,948 3,700 CBL S.C. 1.1 45O 450 400 CBL Date Run: 10/31/2019 Dec [#402121155) Well Name: OLIN HA 249 Page 1 of 3 CIBP #1: Depth CIBP #3: Depth CIBP #5: Depth 715 Plugging Procedure for intent and Subsequent Report 0 with 25 sacks cmt on top. CIPB #2: Depth 4295 with 2 with with sacks cmt on top. CIPB #4: Depth sacks cmt on top. Set 6 sks cmt from 998 ft. to 856 Set 40 sks cmt from 490 ft. to 265 Set 95 sks cmt from 285 ft. to a Set sks cmt from ft. to Set sks cmt from ft. to Perforate and squeeze at ft. with Perforate and squeeze at ft. with Perforate and squeeze at ft. with Set sacks half in. half out surface casing from Set sacks at surface ft. Plug Type: ft. Plug Type: - -,�-- ft. Plug Type: CASING Plug Tagged: Tft. Plug Type: Plug Tagged: T ft. Plug Type: Plug Tagged: i sacks. Leave at least 100 ft. in casing CICR Depth sacks. Leave at least 100 ft. in casing CICR Depth sacks. Leave at least 100 ft. in casing CICR Depth (Cast Iron Cement Retainer Depth) ft. to It. Plug Tagged: sacks cmt on top. with sacks cmt on top. NOTE: Two(2) sacks cement required on all CIBPs. CASING STUB PLUG Cut four feet below ground level, weld on plate Above Ground Dry -Hole Marker: T Yes }� No Set sacks in rat hole Set sacks in mouse hole Additipnai Plugging information for Subsequent Report Only Casing Recovered: 390 ft. 4+112 inch casing Cut and Cap Date: 06/7/2019 2 of *Wireline Contractor. *Cementing Contractor: Type of Cement and Additives Used: Flowline/Pipeline has been abandoned per Rule 1105 Yes j_- No *ATTACH JOB SUMMARY Technical Detail/Comments: The 4.5" csg was cut at 998' prior to knowing there had been a sqz or ann fill outside the csg from 450' to 400'. I hereby certify all statements made in this form are, to the best of my knowledge, true, correct, and complete. Signed: Print Name: John Christofferson Title: Production Engineer Date: 7/26/2019 Email: jchristofferson@extractionog.com Based on the information provided herein, this Well Abandonment Report (Form 6) complies with COGCC Rules and applicable orders and is hereby approved. COGCC Approved: Jacobson, Eric Date: 10/31/2019 CONDITIONS OF APPROVAL, IF ANY: GOA TYPE Description Date Run: 10/31/2019 Doc (#4029211551 Well Name: OLIN HA 24-9 Page 2 of 3 Attachment Check List Aft DocNum e 402121155 FORM 6 SUBSEQUENT SUBMITTED 402121179 WIRELINE JOB SUMMARY 402121182 CEMENT JOB SUMMARY 402121183 CEMENT JOB SUMMARY 402121184 WELLBORE DIAGRAM 402121189 CEMENT BOND LOG 402121194 OTHER 402121195 OPERATIONS SUMMARY 402123222 CEMENT JOB SUMMARY 402123223 CEMENT JOB SUMMARY 402123226 WIRELINE JOB SUMMARY 402123229 OTHER i ofai Atracn: i rues General Comments User Group comment Comment Date Stamp Upon Approval Total: 0 comment(s) Date Run: 10/31/2019 Doc (#4021211551 WeI Name: OLIN HA 24-9 Page 3 of 3 FORM Mate OT coloraao 6 Oil and Gas Conservation Commission Rev 1120 Lincoln Street, Suite 801, Denver, Colorado 80203 Phone: (303) 894-2100 Fax: (303) 02120 -2109 WELL ABANDONMENT REPORT This form is to be submitted as an Intent to Abandon whenever an abandonment is planned on a borenoie. After the abandonment is complete, this form shall again be submitted as a Subsequent Repnrr of the actual work completed. The approved intent shall be valid for six months after the approval date, after that period, a new intent will be required. Attachments required with the Intent to Abandon are wellborediagrerns of the current configuration and the proposed configuration with plugs set. A Subsequent Report of Abandonment shall irdicate the actual work completed. Attachments required with a Subsequent Report are a weltbore diagram showing plugs that were set and casing remaining in the hole, the job summaries from all plugging contractors used, including wireline and cementing (third party verification) and any logs that may have been run OGCC Operator Number: 10459 Name of Operator: EXTRACTION OIL & GAS INC Address: 370 17TH STREET SUITE 5300 City: DENVER State: CO Zip: 80202 For "Intent" 24 hour notice required, Name: COGCC contact: Email: Type of Well Abandonment Report: F Notice of Intent to Abandon API Number 05-123-20144-00 Well Name: OLIN HA Location: QtrQtr: NESW Section: 9 County: WELD Field Name: WATTENBERG E JET be ICS Document Number: 402123294 Date Received: 07126/2019 Contact Name: John Christofferson Phone: (720) 974-7777 Fax: Email: jhnstofferson@extractionog.com Tel: jg Subsequent Report of Abandonment Well Number: 34-9 Township: 5N Range: 65W Federal, Indian or State Lease Number: Field Number: 90750 Meridian: 6 Only Complete the Following Background Information for Intent to Abandon Latitude: 40.412170 Longitude: 104.671330 GPS Data: GPS Quality Value: 2.5 Type of GPS Quality Value: PROP Date of Measurement; 04/28/2011 GPS Instrument Operator's Name: LARRY ROBBINS Reason for Abandonment: E Dry T Production Sub -economic E Mechanical Problems Other Casing to be pulled: i Yes fl No Estimated Depth: Fish in Hole: �� Yes T No If yes, explain details below Wellbore has Uncemented Casing leaks: r Yes P No If yes, explain details below Details: Current nd Previously AbandonedZan Formation Perf. Ton Perf, Btm Abandoned Date Method of isotalien Ptiin f enth CODELL 8150 8160 0311712019 B PLUG CEMENT TOP 7590 NIOBRARA 7676 8060 03117/2019 B PLUG CEMENT TOP 7590 Total: 2 zone(s) _ _ I Casing History Casing Type Size of Hole Size of Casing Weight Per Foot Setting Depth Sacks Cement Cement Bot Cement Top Status SURF 12+1/4 9+5/8 36 424 220 424 0 VISU 1ST 7+7/8 4+1/2 11.6 8,286 537 8,286 4,022 CBL Date Run: 8/5/2020 Doc (#402123294) Well Name: OLIN HA 34-9 Page 1 of 3 Plugging Procedure for Intent and Subsequent Report CIBP #1: Depth 7590 with 25 sacks cmt on top. CIPB #2: Depth 4024 with 2 sacks cmt on top. CIBP #3: Depth with sacks cmt on top. CIPB #4: Depth with sacks cmt on top. CIBP #5: Depth with sacks cmt on top. NOTE: Two(2) sacks cement required on all CIBPs. Set 80 sks cmt from 1055 ft. to 738 ft. Plug Type: STUB PLUG Plug Tagged: r=. Set 44 sks cmt from 555 ft. to 452 ft. Plug Type: OPEN HOLE Plug Tagged: r Set 49 sks cmt from 452 ft. to 290 ft. Plug Type: STUB PLUG Plug Tagged: �. Set 100 sks cmt from 290 ft. to 0 ft. Plug Type: CASING Plug Tagged: r Set sks cmt from ft. to ft. Plug Type: Plug Tagged: i Perforate and squeeze at ft. with sacks. Leave at least 100 ft. in casing CICR Depth Perforate and squeeze at ft. with sacks. Leave at least 100 ft. in casing CICR Depth Perforate and squeeze at ft. with sacks. Leave at least 100 ft. in casing CICR Depth (Cast Iron Cement Retainer Depth) Set sacks half in. half out surface casing from ft to ft. Plug Tagged: Set sacks at surface Cut four feet below ground level, weld on plate Above Ground Dry -Hole Marker: T Yes 1 No Set sacks in rat hole Set sacks in mouse hole Additional Plugging Information €or Subsequ nt Report Only Casing Recovered: 1000 ft. 4+1/2 inch casing Cut and Cap Date: 06127/2019 of *Wireline Contractor *Cementing Contractor: Type of Cement and Additives Used: Flowiine/Pipeline has been abandoned per Rule 1105 IF Yes No Technical Detail/Comments: I hereby certify all statements made in this form are, to the best of my knowledge, true, correct, and complete. Signed: Print Name: John Christofferson Tide: Production Engineer Date: 7/26/2019 Email: jhnstofferson@extractionog.com Based on the information provided herein, this Well Abandonment Report (Form 6) complies with COGCC Rules and applicable orders and is hereby approved. COGCC Approved: Jacobson, Eric Date: 8/5/2020 CONDITIONS OF APPROVAL, IF ANY: COA Type Description Date Run: 8/5/2020 Dec [#4021232941 Well Name: OLIN HA 34-9 Page 2 of 3 Attachment Check List Arun Name 2349667 WIRELINE SUMMARY -3-17-2019 2349668 CEMENT JOB SUMMARY 3-20-2019 2349669 CEMENT JOB SUMMARY 3-27-2019 402123294 FORM 6 SUBSEQUENT SUBMITTED 402123312 CEMENT JOB SUMMARY 402123317 CEMENT JOB SUMMARY 402123318 CEMENT JOB SUMMARY 402123322 WELLBORE DIAGRAM 402123324 WIRELINE JOB SUMMARY 402123325 OTHER 402123328 OPERATIONS SUMMARY 402123331 WIRELINE JOB SUMMARY Total Attach: 12 Files General Comments User Group Comment Comment Date Permit • Operator sent several extra attachments via email that were uploaded to this Form: 09/26/2019 Wireline Summary (doc 02349667; 3-17-2019), Cement job summary (doc 02349668; 3-20- 2019), and Cement job summary (doc 02349669; 3-27-2019). Total: I comment(s) Date Run: 815/2020 Doc (#4021232941 Well Name: OLIN HA 34-9 Page 3 of 3 FORM State of Colorado 6 Oil and Gas Conservation Commission Rey 1120 Lincoln Street, Suite 801, Denver, Colorado 80203 Phone: (303) 894-2100 Fax: (303) 894-2109 05118 WELL ABANDONMENT REPORT This form is to be submitted as an intent to Abandon whenever on ahaidanmenl Is planned on a borehole. After the ahandanment is rompleto. this form shall again be submitletf as a Subsequent Repel of the a¢lual work completed. The approved intent shall be valid for six months after Ire approve! data, after that period, a new Iofenl will he required. Attachments required wilh Ire Irrfent lo Abandon are wellbore diagrams of the cwrenl conI gurat on and the proposed canfigura0art with plugs set. A Subsequent Report of Abandonment shall indicate the actual work eampreted. Attachments required with a Subsequent Report ate a wellbore diagram stowing plugs that were sat and casing remaining in the hole. the let summaries from aH plugging contractors used. including wirerine and Gemanting [third party verification) and any logs that may have he run during atrardonmerrl. DE JET JOE JES Document Number: 402038082 Date Received: 05/09/2019 OGCC Operator Number: 10459 Contact Name: John Christofferson Name of Operator: EXTRACTION OIL & GAS INC Phone: (720) 974-7777 Address: 370 17TH STREET SUITE 5300 Fax: City: DENVER State: CO Zip: 80202 Email: jchristofferson@extractionog.com For "Intent's 24 hour notice required, Name; Tel. COGCC contact: Email: API Number 05-123-19689-00 Well Name: GEIST Well Number: 33-9R Location: OtrQtr: NESW Section: 9 Township: 5N Range: 65W Meridian: 6 County: WELD Federal, Indian or State Lease Number: Field Name: WATTENBERG -Field Number: 90750 Notice of Intent to Abandon i Subsequent Report of Abandonment Only Complete the Following Background Information for Intent to Abandon Latitude: 40.412360 Longitude: ' -104.670220 GPS Data: Date of Measurement: 10/0712008 PDOP Reading: 1.7 GPS Instrument Operators Name: HOLLY L TRACY Reason for Abandonment: V — Dry FT Production Sub -economic F Mechanical Problems FT Other Casing to be pulled: FT Yes — No Estimated Depth: Fish in Hole: FT Yes FT No If yes, explain details below Wellbore has Uncemented Casing leaks: FT Yes 1 No If yes, explain details below Details: Current and Previously Abandoned Zones IFtrrrtationPert iop Perf. Btm Abandoned Q t Method of Isolation Plug Oepth NIOBRARA 7095 7488 12/1612015 B PLUG CEMENT TOP 4200 CODELL 7636 7646 12/02/2015 B PLUG CEMENT TOP 7020 Total: 2 zone(s) Casing His#( Date Run: 8/27/2019 Dec (#402038082] Well Name: GEIST 33-9R Page 1 of 4 Casing Type Size of Hole Size of Casing Weight Per Foot Setting Depth Sacks Cement Cement Bat Cement Top Status SURF 13+114 9+5/8 36 425 320 425 0 VISU 1ST 7+7/8 4+112 11.6 7,770 300 7,770 6,152 CBL S.C. 1.1 4,490 1,777 4,496 2,890 CBL S.C. 1.2 900 300 900 150 CBL S.C. 1.3 150 50 150 65 CBL CIBP #1: Depth CIBP #3: Depth CIBP #5: Depth Plugging Procedure for intent and Subsequent Report 7020 with 2 sacks cmt on top. CIPB #2: Depth, 4200 with 2 sacks cmt on top. 1345 with 2 sacks cmt on top. CIPB #4: Depth with sacks cmt on top. with sacks cmt on top. NOTE: Two(2) sacks cement required on all CIBPs. set 25 sks cmt from 4169 ft. to 3840 ft. Plug Type: CASING Plug Tagged: Set 16 sks cmt from 1250 ft. to 1120 ft. Plug Type: CASING Plug Tagged: Set 3 sks cmt from 1030 ft. to 981 ft. Plug Type: CASING Plug Tagged: Set 71 sks cmt from 963 ft. to 0 ft. Plug Type: Plug Tagged: Set sks cmt from ft. to ft. Plug Type: Plug Tagged: Perforate and squeeze at 1300 ft. with 66 sacks. Leave at least 100 ft. in casing 1250 CICR Depth Perforate and squeeze at 1100 ft. with 37 sacks. Leave at least 100 ft, in casing 1030 CICR Depth Perforate and squeeze at 980 ft. with 277 sacks. Leave at least 100 ft. in casing 965 CICR Depth (Cast Iron Cement Retainer Depth) Set sacks half in. half out surface casing from ft. to ft. Plug Tagged: r Set sacks at surface Cut four feet below ground level, weld on plate Above Ground Dry -Hole Marker: T Yes No Set sacks in rat hole Set sacks in mouse hole Additional PluggingInform ti n for Subsequent Report Only Casing Recovered: 0 ft. inch casing Plugging Date: 04/09/2019 of *Wireline Contractor: Type of Cement and Additives Used: Flowline/Pipeline has been abandoned per Rule 1105 `Cementing Contractor: f Yes F No Technical Detail/Comments: Also perfd sqz holes at 2600', 2495' and 2000' but could not establish an injection rate into any of them. *ATTACH JOB SUMMARY I hereby certify all statements made in this form are, to the best of my knowledge, true, correct, and complete. Signed: Print Name: John Christofferson Title: Production Engineer Date: 519/2019 Email: jhristoferson@extractionog.eom Based on the information provided herein, this Well Abandonment Report (Form 6) complies with COGCC Rules and applicable orders and is hereby approved. COGCC Approved: McFarland, Nick Date: 8/27/2019 CONDITIONS OF APPROVAL, IF ANY: Date Run: 812712019 Doc [#4020380821 Well Name: GEIST 33-9R Page 2 of 4 COA Tyne Description Attachment Check List Aft Doc Num Name 402038082 FORM 6 SUBSEQUENT SUBMITTED 402038544 CEMENT JOB SUMMARY 402038786 402038801 WIRELINE JOB SUMMARY WIRELINE JOB SUMMARY 402038804 WIRELINE JOB SUMMARY 402038810 OTHER 402038815 CEMENT JOB SUMMARY 402038825 CEMENT BOND LOG 402038835 OTHER 402038838 CEMENT JOB SUMMARY 402038940 CEMENT JOB SUMMARY 402038943 OTHER 402039014 OTHER 402039016 OPERATIONS SUMMARY 402039019 WELLBORE DIAGRAM 402039025 CEMENT JOB SUMMARY 402039a38 CEMENT JOB SUMMARY i otai Attacn: 1 1 vies Date Run: 8/27/2019 Doc (#402038082) Well Name: GEIST 33-9R Page 3 of 4 General Comments Comment Date Engineer *Form 17 filed; 44 psi on bradenhead flowing vapor and water down to 1 psi. Sample was marked as taken, but the COGCC still needs to receive the sample analysis. Emailed Operator requesting analysis 8/2612019. Operator replied that the company contracted for sampling did not deliver the sample to the lab and no analysis will be available. Sample was lost. Engineer 42 filed for Towline abandonment. 48 hour ops notice given. Form 7 status set to PA. GPS location appears accurate on maps. Zones and casing history are consistent with approved intent. Procedure, WBD, and tickets are consistent. Engineer lacobsoe02/27/201910459123-1968902/27/2019Edit Eric, We started this P&A today (2122/19). We pulled out 3874' of tubing, recovering it all. Then we tagged with wireline at 4153. I believe both of those plugs are still there as we originally thought. I think the production was wrongly submitted, probably due to allocating battery -production to -both -wells when it should have only -been attributed to the Geist 23-9: Please advise. John - I am good with the tag. Please put sacks on the plug and proceed with the plugging from there up to surface. Please monitor bradenhead pressure as I see it on the Form 17. EJ 5jacobsoeD2/271201910459123-1968902/27/2019 Ed it Eric, We shot squeeze holes at 2600', could not get an injection rate. Then also shot squeeze holes at 2495' and 2000', ran a packer to 2550' to test for a suicide squeeze. We got an injection rate of 0.21 BPM at 2000#. Should we keep coming up hole to see if we can sqz somewhere below 900'? John - Is there any pressure? After looking at the log, let's perforate once more at 1300'. Pump 40 sacks if there is injection. If no injection rate, then cement from 1500' to 1200' to cover the perfs and have a 2nd plug prior to the casing shoe plug. Eric Eric, We've seen surface csg pressure at 20, 20, 40 psi on the mornings of the 3 days we've been on the well, with no pressure on tbg or csg. It blows down quickly, consisting of gas and water. We'll perf at 1300' and see what happens and I'll keep you posted. Eric, Would you want to consider adding perfs at 1100' and performing a suicide sqz through the perfs at 1300'? If that didn't stop the SC pressure, we would still have room to sqz between 1100' and btm of cement at 900. Thanks, John John - That would be great. Approved as outlined. EJ 6strathmeE ngi neer03/15/201910459123-1968997003/15/2019 Edit Luke 970 573 0061 called in to let us know they pumped multiple squeezes over the last few days with the last one perf at 980, CICR at 965. Shut in and monitor pressure overnight. They Verified pressure was eliminated. OKAY to pump surface shoe plug, please note all additional work on 6S. Total: 3 comment(s) 08/26/2019 08/26/2019 08/26/2019 Date Run: 8/27/2019 Doc (114020380821 Well Name: GEIST 33-9R Page 40? 4 FORM State of Colorado 6 Oil and Gas Conservation Commission Rev 1120 Lincoln Street, Suite 801, Denver, Colorado 80203 Phone: (303) 894-2100 Fax: (303) 894-2109 05119 WELL ABANDONMENT REPORT This form is to be submitted as an Intent to Abandon whenever an abandonment is planned on a borehole. After the abandonment is complete, this form shall again be submitted as a Subsequent Report of the actual work completed. The approved intent shall be valid for six months after the approval date, after that period, a new intent will be required. Attachments required with the Intent to Abandon are weilbore diagrams of the current configuration and the proposed configuration with plugs set A Subsequent Report of Abandonment shall indicate the actual work completed. A4tachmoiIs required with a Subsequent Report area watlbore diagram showing plugs that were set and casing remalnfng in the hole, the job summaries from all plugging contractors used, inducting wireline and cementing (Ihard party verification) and any dogs that may have been mn durino abandonment. OGCC Operator Number: 10459 Name of Operator: EXTRACTION OIL & GAS INC Address: 370 17TH STREET SUITE 5300 City: DENVER State. CO Zip: 80202 For "Intent'" 24 hour notice required, Name: COGCC contact: Email: DL IET IoE IES Document Number: 402039098 Date Received: 05/09/2019 Contact Name: John Christofferson Phone: (720) 974-7777 Fax: Email: jhristofferson@extractionog.com Tel: API Number 05-123-19686-00 Well Name: GEIST Well Number: 23-9 Location: QtrQtr. NESW Section. 9 Township: 5N Range: 65W Meridian: 6 County. WELD Federal, Indian or State Lease Number: -Field Name: WATTENBERG -Field Number: 90750 l__ Notice of Intent to Abandon J 5 Subsequent Report of Abandonment Only Complete the Following Background Information for Intent to Abandon Latitude: 40.412330 Longitude: -104.670280 GPS-Data: Date of Measurement: 10/08/2008 PDOP Reading: 1.7 , GPS Instrument. Operator's Name: Holly L. Tracy Reason for Abandonment: r Dry i Production Sub -economic T Mechanical Problems E Other Casing to be pulled: ;— Yes E No Estimated Depth: Fish in Hole: T Yes f— No If yes. explain details below Wellbore has Uncemented Casing leaks: f— Yes fl No If yes, explain details below Details: Current and Previously Abandoned Zones Formation t?erf. Top Pen. Btm Abandoned Date Method of IsolationPu e t CODELL 1 7036 7046 7 0312112019 lB PLUG CEMENT TOP 6974 Total: 1 zone(s) Casing History Casing Type Size of Hole Size of Casing Weight Per Foot Setting Depth Sacks Cement Cement Sot Cement Top •Status SURF 12+1/4 8+518 -24 430 305 430 0 VISU 1ST 7+718 4+1/2 11.6 7,157 153 7,157 6,136 CBL S.C. 1.1 3,000 265 2,580 820 CBL Date Run: 8/16/2019 Doc 1#402039098) Well Name: GEIST 23.9 Page 1 of -3 Plugging Procedure for Intent and Subsequent Report CIBP #1: Depth 6974 with 25 sacks cmt on top. CIPB #2: Depth with sacks cmt on top. CIBP #3: Depth with sacks cmt on top. CIPB #4: Depth with sacks cmt on top. CIBP #5: Depth with sacks cmt on top. NOTE; Two(2) sacks cement required on all CIBPs. Set 25 sks cmt from 6974 ft. to 6542 ft. Plug Type: CASING Plug Tagged'. Set 25 sks cmt from 544 ft. to 230 ft. Plug Type: CASING Plug Tagged: F Set 26 sks cmt from 205 ft. to 0 ft. Plug Type; CASING Plug Tagged: Set sks cmt from ft. to ft. Plug Type: Plug Tagged: Set sks cmt from ft. to ft. Plug Type: Plug Tagged: Perforate and squeeze at 4300 ft. with 26 sacks. Leave at least 100 ft. in casing 4248 CICR Depth Perforate and squeeze at ft. with sacks. Leave at least 100 ft. in casing CICR Depth Perforate and squeeze at ft. with sacks. Leave at least 100 ft. in casing CICR Depth (Cast Iran Cement Retainer Depth) Set sacks half in. half out surface c Set sacks at surface Cut four feet below ground level, weld on plate Set sacks in rat hole Additional Plu Casing Recovered: 0 ft. of rasing from ft. to ft. Plug Tagged: F Above Ground Dry -Hole Marker: F Yes F No Set sacks in mouse hole gging fnformation for Subsequent Report Only inch casing ` Plugging Date: 0410912019 *Wireline Contractor: Type of Cement and Additives Used: Flowline!Pipeline has been abandoned per Rule 1105 Technical Detail/Comments: "Cementing Contractor: F Yes F No *ATTACH JOB SUMMARY I hereby certify all statements made in this form are, to the best of my knowledge, true, correct, and complete. Signed: Print Name: John Christofferson Title: Production Engineer Date: 519/2019 Email: jhnstoferson@extractionog.com Based on the information provided herein, this Well Abandonment Report (Form 6) complies with COGCC Rules and applicable orders and is hereby approved. COGCC Approved: Jacobson, Eric Date: 8/16/2019 CONDITIONS OF APPROVAL, IF ANY: COA Tyne Descripon Date Run: 8/16/2019 Doc (#4020390981 Well Name: GEIST 23-9 Page 2 of 3 Att_Doc Num Attachment Check List Name Total Attach: 10 Files User Group Comment General Comments Comment Date Stamp Upon Approval Total: 0 comment(s) 402039098 FORM 6 SUBSEQUENT SUBMITTED 402039113 OPERATIONS SUMMARY 402039126 WELLBORE DIAGRAM 402039129 OTHER 402039131 CEMENT JOB SUMMARY 402039133 CEMENT BOND LOG 402039136 WIRELINE JOB SUMMARY 402039140 CEMENT JOB SUMMARY 402039142 CEMENT JOB SUMMARY 402039143 OTHER claw gun: W7W/2079 Doc L#4020390981 Well Name: GEIST 23-9 Page 3 of 3 FORM State of Colorado 6 Oil and Gas Conservation Commission Rev 1120 Lincoln Street, Suite 801, Denver, Colorado 80203 Phone: (303) 894-2100 Fax: (303) 894-2109 0511 t3 WELL ABANDONMENT REPORT This form is to be submitted as an I ntent to Abandon whenever an abandonment is planned on a borehole. After the abandonment is compete, this farm shall again be submitted as a Subsequent Report of the actual work completed. The approved intent shall be valid for six months after the approval date, after that period, a new intent will be required. Attachments required with the Intent to Abandon are wellbore diagrams of the current configuration and the proposed configuration with plugs set A Subsequent Report of Abandonment shall indicate the actual work camploled. Attachments required with a Subsequent Report are a welthore diagram showing plugs that were set and casing remaining in the hale, It 10 summaries from all plugging conlractors used, including wireline and cemerling (Third party verification) and any lags that may have been run during abandonment. OGCC Operator Number: 10459 Name of Operator: EXTRACTION OIL & GAS INC Address: 370 17TH STREET SUITE 5300 City: DENVER State: CO Zip: 80202 For Intent" 24 hour notice required, COGCC contact: Name: Email: E IET ICE IES Document Number: 402039098 Date Received: 05/09/2019 Contact Name: John Christofferson Phone: (720) 974-7777 Fax: Email: ichristoffersonr extractionoo.cam Tel: API Number 05-123-19686-00 Well Name: GEIST Well Number: 23-9 Location: QtrQtr: NESW Section: 9 Township: 5N Range: 65W Meridian: 6 County: WELD Federal, Indian or State Lease Number: -Field Name: WATTENBERG -Field Number: 90750 Notice of Intent to Abandon [ Subsequent Report of Abandonment Only Complete the Following Background Information for intent to Abandon Latitude: 40.412330 Longitude: -104.670280 GPS Data: Date of Measurement.,1010812008 PDOP Reading: 1.7 GPS Instrument Operator's Name: Holly L. Tracy Reason for Abandonment: P Dry P Production Sub -economic P Mechanical Problems `— Other Casing to be pulled: ; — Yes (— No Estimated Depth: Fish in Hole: ? Yes r -No If yes, explain details below Wellbore has Uncemented Casing leaks: fl Yes 1 No If yes, explain details below Details: Formation `CODELL `Total: 1 zone(s) Current and Previously Abandoned Zones Pert. Top EerF, Btm Abandoned Date Method of isolation Plug Depth 7036 7046 03121/2019 _]B PLUG CEMENT TOP 16974 Casing History Casing Type Size of Hole Size of Casing Weight Per Foot Setting Depth Sacks Cement Cement Bat Cement Top Status SURF 12+1/4 8+5/8 24 430 305 430 D VISU 1ST 7+718 4+112 11.6 7,157 153 7,157 6,136 CBL S.C. 1.1 3,000 265 2,580 820 CBL Date Run: 8/16/2019 Doc f#4020390983 Well Name: GEIST 23.9 Page 1 of 3 Plugging Procedure for Intent and Subsequent Report CIBP #1: Depth 6974 with 25 sacks cmt on top. CIPB #2: Depth with sacks cmt on top. CIBP #3: Depth with sacks cmt on top. CIPB #4: Depth with sacks cmt on top. CIBP #5: Depth with sacks cmt on top. NOTE: Two(2) sacks cement required on all CIBPs. Set 25 sks cmt from 6974 ft. to 6542 ft. Plug Type: CASING Plug Togged: Set 25 sks cmt from 544 ft. to 230 ft. Plug Type: CASING Plug Tagged: Set 26 sks cmt from 205 ft. to 0 ft. Plug Type: CASING Plug Tagged: Set sks cmt from ft. to ft. Plug Type: Plug Tagged: Set sks cmt from ft. to ft. Plug Type: Plug Tagged: Perforate and squeeze at 4300 ft. with 26 sacks. Leave at least 100 ft. in casing 4248 CICR Depth Perforate and squeeze at ft. with sacks. Leave at least 100 ft. in casing CICR Depth Perforate and squeeze at ft. with sacks. Leave at least 100 ft. in casing CICR Depth (Cast Iron Cement Retainer Depth) Set sacks half in. half out surface casing from ft. to ft. Plug Tagged: Set sacks at surface Cut four feet below ground level, weld on plate Above Ground Dry -Hole Marker: 1 Yes r No Set sacks in rat hole Set sacks in mouse hole Additional Plugging information for SubsequentSubseguntBeport Only Casing Recovered: 0 ft. inch casing Plugging Date: 04/0912019 of *wireline Contractor: *Cementing Contractor: Type of Cement and Additives Used: FlowlinelPipeline has been abandoned per Rule 1105 Yes T No *ATTACH JOB SUMMARY Technical Detail/Comments: I hereby certify all statements made in this form are, to the best of my knowledge, true, correct, and complete. Signed: Print Name: John Christofferson Title: Production Engineer Date: 519/2019 Email: jchri•stofferson@extractionog.com Based on the information provided herein, this Well Abandonment Report (Form 6) complies with COGCC Rules and applicable orders and is hereby approved. COGCC Approved: Jacobson, Eric Date: 8/16/2019 CONDITIONS OF APPROVAL, IF ANY: Date Run; 8/16/2019 Dec ('#4020390981 Well Name: GEIST 23.9 Page 2 of 3 Attachment Check List Att Doc Num Name 402039098 FORM 6 SUBSEQUENT SUBMITTED 402039113 OPERATIONS SUMMARY 402039126 WELLBORE DIAGRAM 402039129 OTHER 402039131 CEMENT JOB SUMMARY 402039133 CEMENT BOND LOG 402039136 WIRELINE JOB SUMMARY 402039140 CEMENT JOB SUMMARY 402039142 CEMENT JOB SUMMARY 402039143 OTHER Fotal Attach: 10 Files General Comments User Group Comment Total: 0 comment(s) Comment Date Stamp Upon Approval Date Run: 8/16/2019 Doc [#402039098j Well Name: GEIST 23-9 Page 3 of 3 FORM I State of Colorado 6 I Oil and Gas Conservation Commission Q 8v 1120 Lincoln Street, Suite 801, Denver, Colorado 80203 Phone: (303) 894-2100 Fax: (303) 894-2109 17 WELL ABANDONMENT REPORT This form is to he submitted as an intent lo Abandon whenever an ahandonmanl is planned an a hurehole, After the abandonment is complete. This form small again bB submitted as a Subsequent Repel or the asival work completed. Tho approved intent shall he valid for six months altar the approval date. after that enod, a new intort will ba required. Ahachments required with the intent to Alaandan are wailb❑ra diagrams of the current conflguralion and the proposed ronfigurali❑n with plugs set A Subsequent Rapert of At andonmenl iliall Indicate the actual work completed, Attachments required with a Subsequent Report area welIbore diagram showing plugs that were sot acrd casing remaining in the hole, the lob summaries from all plugging contractors used. including wlreline and cemenllnq (third party venfra1on] and any logs Ihal may have been run durlrio abandonment. OGCC Operator Number: 10459 Name of Operator: EXTRACTION OIL & GAS INC Address: 370 17TH STREET SUITE 5300 City: DENVER State: CO Zip; 80202 For "Intent" 24 hour notice required, Name: COGCC contact: Email: DE IET I0E IES Document Number: 402119917 Date Received: 07126/2019 Contact Name: John Christofferson Phone: (720) 974-7777 Fax: Email: jchristofferson@extractionog.com Tel: API Number O5-123-2O573-OO Well Name: OLIN HA Well Number: 13-9 Location: QtrQtr: NESW Section: 9 Township: 5N Range: 65W Meridian: 6 County: WELD Federal, Indian or State Lease Number: -Field Name: WATTENBERG Field Number: 9O75O Notice of intent to Abandon fx Subsequent Report of Abandonment Only Complete the Following Background Information for Intent to Abandon Latitude: 40.412080 Longitude: -104.671440 -GPS Data: Date of Measurement: 04/26!2011 PDOP Reading: , 2.2 GPS Instrument Operator's Name: LARRY ROBBINS Reason for Abandonment: 1 Dry 7 Production Sub -economic L Mechanical Problems F Other Casing to be pulled: T—" Yes fl No Estimated Depth: Fish in Hole: i Yes 1T No If yes, explain details below Wellbore has Uncemented Casing leaks: f— Yes No If yes, explain details below Details: Current and Previously Abandoned Zones Formation Perf. Top Pi1. Btm Abandoned Date Method of Isolation Pluc Depth CODELL 7295 7305 0210112019 IB PLUG CEMENT TOP 5944 Total: I zone(s) Casing HistOrV Casing Type Size of Hole Size of Casing Weight Per Foot Setting Depth Sacks Cement Cement Bot Cement Top J Status SURF 12+114 9+5/8 -36 400 -265 400 0 VISU 1ST 7+7/8 4+112 11.6 7,427 355 7,427 3,090 J CBL Date Run: 10/31/2019 Doc f#4021199171 Well Name: OLIN HA 13=9 Page 1 of 3 CIBP #1: Depth CIBP#3: Depth CIBP #5: Depth Plugging Procedure for Intent and Subsequent Report 5940 with 25 sacks cmt on top. CIPB #2: Depth 4300 with 2 sacks cmt on top. with sacks cmt on top. CIPB #4: Depth with sacks cmt on top. with sacks cmt on top. NOTE: Two(2) sacks cement required on all CIBPs. Set 30 sks cmt from 1050 ft. to 896 ft. Plug Type: STUB PLUG Plug Tagged: jx Set 202 sks cmt from 896 ft. to 500 ft. Plug Type: OPEN HOLE Plug Tagged: j5 Set 25 sks cmt from 500 ft. to 450 ft. Plug Type: OPEN HOLE Plug Tagged: [ Set 137 sks cmt from 450 ft. to 300 ft. Plug Type: CASING Plug Tagged; ? Set 100 sks cmt from 300 ft. to 0 ft. Plug Type: CASING Plug Tagged: Perforate and squeeze at ft. with sacks. Leave at least 100 ft. in casing CICR Depth Perforate and squeeze at ft. with sacks. Leave at least 100 ft. in casing CICR Depth Perforate and squeeze at ft. with sacks. Leave at least 100 ft. in casing CICR Depth (Cast Iron Cement Retainer Depth) Set sacks half in. half out surface casing from ft. to ft. Plug Tagged: T Set sacks at surface Cut four feet below ground level, weld on plate Above Ground Dry -Hole Marker: I Yes ; No Set sacks in rat hole Set sacks in mouse hole Additional Plugging. information for Subsequent Report Only Casing Recovered: 1000 ft. 4+1/2 inch casing Cut and Cap Date: 06/27/2019 of *Wireline Contractor: "Cementing Contractor: Type of Cement and Additives Used: Flowline/Pipeline has been abandoned per Rule 1105 T Yes j No *ATTACH JOB SUMMARY Technical Detail/Comments: Tubing was stuck and plugged, backed off at 5970'. Multiple cement plugs were pumped attempting to stop gas migration. Some of those plugs were either completely drilled out or partially drilled out. See Ops Summary for details. I hereby certify all statements made in this form are, to the best of my knowledge, true, correct, and complete. Signed: Print Name: John Christofferson Title: Production Engineer Date: 7/26/2019 Email: jchristoffersonta3extractionog.com Based on the information provided herein, this Well Abandonment Report (Form 6) complies with COGCC Rules and applicable orders and is hereby approved. COGCC Approved: Jacobson, Eric Date: 10/31/2019 CONDITIONS OF APPROVAL, IF ANY: C0A Type PeciiPtiOfl Date Run: ;10/31/2019 Doc (#402119917] Well Name: OLIN HA 13-9 Page 2 of 3 Attachment Check List Att Doc Num Name 2349666 CEMENT JOB SUMMARY 402119917 FORM 6 SUBSEQUENT SUBMITTED 402119976 WELLBORE DIAGRAM 402119981 OPERATIONS SUMMARY 402119983 WIRELINE JOB SUMMARY 402119984 WIRELINE JOB SUMMARY 402119986 CEMENT JOB SUMMARY 402119991 CEMENT JOB SUMMARY 402119997 CEMENT JOB SUMMARY 402119999 CEMENT JOB SUMMARY 402120002 WIRELINE JOB SUMMARY 402123241 OTHER Total Attach: 12 Files General Comments User Group Comment mment Data Permit * Additional cement job summary sent by operator via email; uploaded to this Form as doe 09/26/2019 02349666. Total: 1 comment(s) Date Run: 90/31/2079 Doc (#402119917] Well Name: OLIN HA 13-9 Page 3 of 3 FORM ta><e or ol'oraao 6 Oil and Gas Conservation Commission 05/18 1120 Lincoln Street, Suite 801, Denver, Colorado 80203 Phone: (303) 894-2100 Fax: (303) 894-2109 WELL ABANDONMENT REPORT This form is to he suttmirled as en Intent la Abandon whenever an abandonment is planned on a borehole. After the abandonment Is uamptate, ibis farm shall aaaln be subm Ited as a Subsequent Report of the actual work completed, lie approvee intent, shalt be va!!d for six months after the approval dale, after Iii at poriad, a new intent wilt be required. Attachments required with the Inlent to Abandon are weltbore diagrams of the current confgwatl'on arid the proposed configuratir,n with plugs set. A Subsequent Report of Abandonment shall Indicate the actual work completed. Attachments regtrlred with a Subsequent Report are a weltbore diagram showing plugs Thal were set arid rasiremaining in the hole. the job summaries from all plugging contractors used, including wireline and cementing (third palhlr vedfcadon and any 1095 that may have been run duringabandonment. ET IOE IES Document Number: 402123787 Date Received: 07/26/2019 OGCC Operator Number: 10459 Contact Name: John Christofferson Name of Operator: EXTRACTION OIL & GAS INC Phone: (720) 974-7777 Address: 370 17TH STREET SUITE 5300 Fax: City: DENVER State: CO Zip: 80202 Email: jchristoffersontr7"7-extrectionoq.com For "Intent" 24 hour notice required, Name: Tel: COGCC contact: Email: API Number 05-123-20566-00 Well Name: OLIN HA Well Number: 14-9 Location: QtrQtr: NESW Section: 9 Township: 5N Range: 65W Meridian: 6 County: WELD Federal, Indian or State Lease Number: -Field Name: WATTENBERG -Field Number: 90750 Notice of Intent to Abandon 15` Subsequent Report of Abandonment Only Complete the Following Background Information for Intent to Abandon Latitude: 40.412080 Longitude: -104.671360 GPS Data: Date of Measurement: 04/28/2011 PDOP Reading: 2.2 .GPS Instrument Operator's Name: LARRY ROBBINS Reason for Abandonment: T Dry T° Production Sub -economic 1 Mechanical Problems ]— Other Casing to be pulled: t,—., Yes ' No Estimated Depth: Fish in Hole: 7 -Yes r` -No If yes, explain details below Wellbore has Uncemented Casing leaks: `-` Yes T No If yes, explain details below Details: Eomiation Current and Previously Abandoned Zones Perf. Top Perf. m Abandoned Date Method of Isolation PLUaLmh CODELL 7893 ] 7903 04102/2019 B PLUG CEMENT TOP 7825 Total: 1 zone(s) Casing History Casing Type Size of Hole Size of Casing Weight Per Foot Setting Depth Sacks Cement Cement Bat Cement Top Status SURF 12+1t4 9+518 36 411 -225 411 -0 VISU 1ST 7+7/8 4+112 11.6 8,003 562 8,003 2,655 CBL Date Run: 10/30/2019 Doc (#402123787) Well Name: OLIN HA 14-9 Page 7 of 3 Plugging Procedure for Intent and Subsequent Report CIBP #1: Depth 7825 with 45 sacks cmt on top. CIPB #2: Depth 4300 with 2 sacks cmt on top. CIBP #3: Depth 966 with 15 sacks cmt on top. CIPB #4: Depth 440 with 37 sacks cmt on top. CIBP #5: Depth with sacks cmt on top. NOTE: Two(2) sacks cement required on all CIBPs. Set 35 sks cmt from 580 ft. to son ft. Plug Type: OPEN HOLE Plug Tagged: iX Set 441 sks cmt from 500 ft. to 450 ft. Plug Type: OPEN HOLE Plug Tagged: Set 37 sks cmt from 440 ft. to 420 ft. Plug Type: OPEN HOLE Plug Tagged: Set 28 sks cmt from 420 ft. to 400 ft. Plug Type: CASING Plug Tagged: FX Set 156 sks cmt from 400 ft. to 0 ft. Plug Type: CASING Plug Tagged: Perforate and squeeze at 2550 ft. with 135 sacks. Leave at least 100 ft. in casing 2104 CICR Depth Perforate and squeeze at 2O00 ft. with 85 sacks. Leave at least 100 ft. in casing 1766 CICR Depth Perforate and squeeze at 1690 ft. with 137 sacks. Leave at least 100 ft. in casing 1186 CICR Depth (Cast Iron Cement Retainer Depth) Set sacks half in. half out surface -casing from ft. to ft. Plug Tagged: rF Set sacks at surface Cut four feet below ground level, weld on plate Above Ground Dry -Hole Marker: i Yes i ' No Set sacks in rat hole Set sacks in mouse hole Additional Pjugrnq Information for Subsequent Report Only Casing Recovered: 602 ft. 4+112 inch casing Cut and Cap Date: 06/27/2019 -of - "`Wireline Contractor: Cementing Contractor: Type of Cement and Additives Used: Flowline/Pipeline has been abandoned per Rule 1105 7 Yes ` No *ATTACH JOB SUMMARY Technical Detail/Comments:.. Multiple perforations and sqz jobs, multiple drill outs. See Ops Summary for complete details. Still waiting on some field tickets to come in. I hereby certify all statements made in this form are, to the best of my knowledge, true, correct, and complete. Signed: Print Name: John Christofferson Title: Production Engineer Date: 7/26/2019 Email: jchristofferson4extractionog.com Based on the information provided herein, this Well Abandonment Report (Form 8) complies with COGCC Rules and applicable orders and is hereby approved. COGCC Approved: Jacobson, Eric Date: 10130120/9 CONDITIONS OF APPROVAL, IF ANY: I COA 11! Description Date Run: 10/3012019 Dec (#402123787) Well Name: OLIN HA 14-9 Page 2 of 3 Attachment Check List AttDocNum Name 2349878 CEMENT BOND_PDF 2349679 CEMENT JOB SUMMARY PLUG 2349680 DIAGRAM PACKERS 2349681 WIRELINE TICKET 402123787 FORM 6 SUBSEQUENT SUBMITTED 402123821 WELLBORE DIAGRAM 402123823 INVOICE 402123825 OPERATIONS SUMMARY Total Attach: 8 Files General Comments User User Group Comment Comment Date Permit • CBL run 4/3/2019 received and uploaded as doc 02349678. 10/15/2019 • Cement Job Summary (41212019) received and uploaded as doc 02349679. • Packer diagram received and uploaded as doc 02349680. • Wireline Ticket (4/2/2019) received and uploaded as doc 02349681. Total: I comment(s) Date Run: 10/30/2019 Doc (#402123787] Well Name: OLIN HA 14-9 Page 3 of 3 Change of Zone Environmental Health Questionnaire for: 580 E. 16(11 St. Greeley, CO 80631 1. This property is currently on a public water system with North Weld Water. There are no changes proposed to the potable water source. 2. The property is on a septic system and there are no changes proposed to the existing septic system for sewage disposal. Northern Colorado Geotech September 8, 2021 2956 29th Street, Unit 21 Greeley, Colorado 60631 Phone: (970) 506-9244 Fax: (970) 506-9242 Gary Lee 7201 Hiding Elk Lane Loveland, Colorado 80538 Re: Mineral and Aggregate Evaluation 580 East 16th Street - Greeley, CO Northern Colorado Geotech Project No. 193-21 Northern Colorado Geotech has been asked to provide a mineral and aggregate evaluation for a proposed change of zoning for a parcel located at 580 East 16th Street in Greeley, Colorado. The site is a 4 acre, rectangular shaped property that has a residence on the northwest corner of the property and oil/gas wells near the southwest corner of the site. Northern Colorado Geotech has reviewed the USDA Soil Conservation Service "soil survey of Weld County, Colorado Southern Part" to identify the site soils. The property location is located in an area mapped as Otero sandy loam. The Soil Conservation Service (SCS) indicates this soil is generally comprised of a surface layer that is a brown sandy loam. The,surface layer is underlain by a pale brown calcareous fine sandy loam. The layer is listed as having rapid permeability, slow surface runoff and low erosion hazard. A quote directly from SCS, "Rapid expansion of Greeley and the surrounding area has resulted in urbanization of much of this Otero soil. This soil has excellent potential for urban and recreational development." The proposed development is located within the Colorado Piedmont section of the Great Plains physiographic province. The Colorado Piedmont is located near the western border of the Great Plains province and was formed during Late Tertiary and Early Quaternary time (approximately 2,000,000 years ago). The Colorado Piedmont is a broad, erosional trench which separates the Southern Rocky Mountains from the High Plains. Structurally, the site lies near the axis of the Denver Basin. During the mountain building of the Laramide Orogeny (approximately 70,000,000 years ago), intense tectonic activity occurred, causing the uplifting of the Front Range and associated downwarping of the Denver Basin to the east. Due to the erosional action of wind and streams, relatively flat uplands and broad valleys characterize the present-day topography of the Colorado Piedmont in this region. Quaternary alluvial deposits are located near the surface. The alluvium is Pine Creek age and younger according to the Geologic Map of Colorado. Based on projects Northern Colorado Geotech has performed along East 16th Street and our experience with this geologic setting, we expect some sand and gravel aggregate to underlie the site at depths greater than 10 feet. Based on our literature search, experience with projects Mineral and Aggregate Evaluation 580 East 16th Street — Greeley, CO Northern Colorado Geotech Project No. 193-21 Page 2 of 2 adjacent tQ,'the property and the very small footprint of the site (4 acres), it is our opinion that there are no economic deposits of sand or gravel at the site. Additionally, due to the size of the property and the lack of economic quantities of quarry rock or minerals, it is our opinion that the property does not contain economic deposits of aggregate, quarry rock or minerals. The presence of oil/gas wells on the southwest portion of the property indicate that reserves of oil and gas are present at significant depths below the surface and are' already being extracted. Provided necessary setbacks are maintained, the presence of the current oil and gas operations at the site should have no impact on the change of zone. If you have any questions concerning this report or any of our consulting services, please do not hesitate to contact us at (970) 506-9244. Sincerely, NORTHERN COLORADO GEOTECH Prepared by: DiuL Li IkJ^94 PI Ib9lm{Bran L' U 1., !1 In.OW IA •'H+[m1rr CH!Vnrh-f.N=rF'xglNMdrry i �•'Z',,, k_ _,13 L{ W Raw-0n.{.m U�•wVrx of rh��dnurnanr i , � - - ♦ -;fry Leafgrn �,1�13 r Olin:'021 GY u 15.537'ii Doug Leafgren,Ip.y11nM F5N Ian' FO 15 - I f President ..-.i. .i /rl •'•V,'2•' J: Copies to: Addressee (2) L] Ir trPetal r1 CODE O iCFIS kj APFS FE 1.A NFHL E-PERN11 CErV—ER. : Other L~cArga..cs Weld County Assessor's Office Certified Ownership Listings Mineral Ownership Listing By Legal Desc. for Section: 09 Township. 05 Range: 65 =C1 r,: 2t 'C!, There are ri records fe r tih is regU est, , Beck Weld County Treasurer Statement of Taxes Due Account Number R0015393 Parcel 096109300083 Assessed To LEE GARY V 7201 HIDING ELK LN LOVELAND, CO 80538-9199 Legal Descriplion Sites Address 12288-F LOT 2 NE4SW4 95 65 580 E 16TH ST WELD Year Tax Ajrcnta Interest Fees Paymeata Balance Tax Charge 2020 5'3f,I.51, 50.00 $0.0f} 6,cx1 $vlsl56y $0.011 Total Tax Charge $0.00 Grand Total Due as of09/10f2021 $0.00 Tax Billed at 2020 Rates for Tax Area 0632 - 0632 Authority WELD COUNTY SCHOOL DIST #6 NORTHERN COLORADO WATER (NC WESTERN HILLS FIRE AIMS JUNIOR COLLEGE HIGH PLAINS LIBRARY Taxes Billed 2020 SENIOR Net Taxes Billed for 2020 * Credit Levy Mill Levy Amount 15.0380000* $276.85 50.3730000 $927.37 1.0000000 $18.41 Values Actual Assessed SINGLE FAM.RES.- $114,950 $8,220 LAND SINGLE FAM.RES- $142,534 $10,190 IMPROVEMTS 9.49900006 $174,88 Total $257,484 $18,410 6,3050000 $116.07 3.1810000 $58.56 85.3960000 $1,572.14 ($610.58) $961.56 ALL TAX LIEN SALE AMOUNTS ARE SUBJECT TO CHANGE DUE TO ENDORSEMENT OF CURRENT TAXES BY THE LIENHOLDER OR TO ADVERTISING AND DISTRAINT WARRANT FEES. CHANGES MAY OCCUR AND THE TREASURER'S OFFICE WILL NEED TO BE CONTACTED PRIOR TO REMITTANCE AFTER THE FOLLOWING DATES: PERSONAL PROPERTY, REAL PROPERTY, AND MOBILE HOMES - AUGUST 1. TAX LIEN SALE REDEMPTION AMOUNTS MUST BE PAID BY CASH OR CASHIER'S CHECK. POSTMARKS ARE NOT ACCEPTED ON TAX LIEN SALE REDEMPTION PAYMENTS. PAYMENTS MUST BE IN OUR OFFICE AND PROCESSED BY THE LAST BUSINESS DAY OF THE MONTH. 1400 N. 17th Avenue, Greeley, CO 80631. PO Box 458, Greeley, CO 80632. (970) 400-3290 Page 1 of 1 Hello