| Form 21 |  Related  Doc |
| Date Submitted: | 5/3/2010 | MIT Assigned By: | KOEHLER, BOB |
| Date Recv'd: | 5/7/2010 | Facility ID: | 150200 |
| DocNum: | 1770731 | Facility Status: | AC |
| Operator Information: |
| Oper. No. | 16700 |
| Operator: | CHEVRON U S A INC |
| Address: | 100 CHEVRON ROAD RANGELY CO 81648 |
| Type Of Facility: | UIC ENHANCED RECOVERY | Well Status: AC |
| Facility Name | UNION PACIFIC |
| Operator contact: | DIANE L 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 LEAK |
| Repair Desc: | RUN FIBERLINED TUBING AND FREECAP PACKER. |
| Test Date: | 5/3/2010 |
| Field Rep: | |
| Approved Date: | 5/10/2010 |
| Approved by: | KOEHLER, BOB |
| Last Approved MIT: | 3/10/2010 |
| Injection/Producing Formation Zones: | WEBR |
| Perforation Interval: | 5832-6350 |
| Open Hole Interval: | NA |
| Bridge/Cement Plug Depth: | 6356 |
| Tubing Size: | 2.875 |
| Tubing Depth: | 6310 |
| Top Packer Depth: | 5561 |
| Multiple Packers: | Y |
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| Condition of approval: |
| Borehole diagram submitted with Form 21 mentions casing leak between 5564' and 5709'. This was actually the packer leaking which was repaired. Email from DLP to Bob Koehler 5/12/2010. |
| Test Data: | Wellbore Channel Test: | | Reading Type | Pressure | | 10 MIN CASE | | | 5 MIN CASE | | | CASE BEFORE | | | FINAL CASE | 800 | | FINAL TUBE | | | INITIAL TUBE | | | LOSS OR GAIN | 0 | | START CASE | 800 |
| No channel test. |
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