| Form 21 |  Related  Doc | | Date Submitted: | 6/14/2012 | MIT Assigned By: | BROWNING, CHUCK | | Date Recv'd: | 6/15/2012 | Facility ID: | 150200 | | DocNum: | 1171394 | Facility Status: | AC | | Operator Information: | | Oper. No. | 16700 | | Operator: | CHEVRON PRODUCTION COMPANY | | Address: | 100 CHEVRON RD RANGELY CO 81648 | | Type Of Facility: | UIC ENHANCED RECOVERY | Well Status: AC | | Facility Name | M.B. LARSON A | | Operator contact: | DIANE PETERSON | | Location: | | qtrqtr: SENE | section: 16 | township: 2N | range: 103W | meridian: 6 |
| | MIT Details: | | Test Type: | VERIFICATION OF REPAIRS | | Repair Type: | TUBING/PACKER LEAK | | Repair Desc: | R/R tubing and packer | | Test Date: | 6/14/2012 | | Field Rep: | BROWNING, CHUCK | | Approved Date: | 6/14/2012 | | Approved by: | BROWNING, CHUCK | | Last Approved MIT: | 1/17/2007 | | Injection/Producing Formation Zones: | WEBR | | Perforation Interval: | NA | | Open Hole Interval: | 6495-6772 | | Bridge/Cement Plug Depth: | | | Tubing Size: | 2.875 | | Tubing Depth: | 6511 | | Top Packer Depth: | 6425 | | Multiple Packers: | Y | | | | Condition of approval: | | | Test Data: | Wellbore Channel Test: | | Reading Type | Pressure | | 10 MIN CASE | 1200 | | 5 MIN CASE | 1200 | | CASE BEFORE | 0 | | FINAL CASE | 1200 | | FINAL TUBE | | | INITIAL TUBE | | | LOSS OR GAIN | 0 | | START CASE | 1200 |
| No channel test. |
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