| Form 21 |  Related  Doc |
| Date Submitted: | 10/8/2003 | MIT Assigned By: | ADKINS, JAIME |
| Date Recv'd: | 2/2/2004 | Facility ID: | 150200 |
| DocNum: | 1241671 | Facility Status: | AC |
| Operator Information: |
| Oper. No. | 16700 |
| Operator: | CHEVRON U S A INC |
| Address: | 100 CHEVRON RD RANGELY CO 81648 |
| Type Of Facility: | UIC ENHANCED RECOVERY | Well Status: AC |
| Facility Name | GRAY |
| Operator contact: | DIANNE PETERSON |
| Location: | | qtrqtr: SENE | section: 16 | township: 2N | range: 103W | meridian: 6 |
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| MIT Details: |
| Test Type: | VERIFICATION OF REPAIRS |
| Repair Type: | TUBING/PACKER AND CASING LEAK |
| Repair Desc: | |
| Test Date: | 9/9/2003 |
| Field Rep: | |
| Approved Date: | 2/2/2002 |
| Approved by: | ADKINS, JAIME |
| Last Approved MIT: | 5/17/2001 |
| Injection/Producing Formation Zones: | WEBR |
| Perforation Interval: | 5290-5598 |
| Open Hole Interval: | NA |
| Bridge/Cement Plug Depth: | |
| Tubing Size: | 2.875 |
| Tubing Depth: | 6546 |
| Top Packer Depth: | 5999 |
| Multiple Packers: | Y |
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| Condition of approval: |
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| Test Data: | Wellbore Channel Test: | | Reading Type | Pressure | | 10 MIN CASE | 800 | | 5 MIN CASE | 800 | | CASE BEFORE | 0 | | FINAL CASE | 800 | | FINAL TUBE | 0 | | INITIAL TUBE | 0 | | LOSS OR GAIN | 0 | | START CASE | 800 |
| | Channel Test | Test Date | | TRACER SURVEY | 10/6/2003 |
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