| Form 21 |  Related  Doc |
| Date Submitted: | 12/21/2011 | MIT Assigned By: | KOEHLER, BOB |
| Date Recv'd: | 4/4/2012 | Facility ID: | 150200 |
| DocNum: | 1771798 | Facility Status: | AC |
| Operator Information: |
| Oper. No. | 16700 |
| Operator: | CHEVRON USA INC |
| Address: | 6001 BOLLINGER CANYON RD SAN RAMON CA 94583 |
| Type Of Facility: | UIC ENHANCED RECOVERY | Well Status: AC |
| Facility Name | LARSON, F V |
| 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: | CASING LEAK |
| Repair Desc: | CASING REPAIR-WELL BORE FULL OF 10.5 TO 10.8# CALCHLORIDE FOR MIT TEST. WELL WILL BE TA STATUS - DUE TO P&A IN EARLY SPRING 2012. |
| Test Date: | 12/16/2011 |
| Field Rep: | |
| Approved Date: | 4/25/2012 |
| Approved by: | KOEHLER, BOB |
| Last Approved MIT: | 5/10/2006 |
| Injection/Producing Formation Zones: | WEBR |
| Perforation Interval: | NA |
| Open Hole Interval: | 5806-6402 |
| Bridge/Cement Plug Depth: | NA |
| Tubing Size: | 2.875 |
| Tubing Depth: | 5756 |
| Top Packer Depth: | 5420 |
| Multiple Packers: | Y |
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| Condition of approval: |
| OPERATOR COULD NOT FIND ORIGINAL CHART. IT WAS SCANNED AND SENT TO ARCHIVE. ACCEPTED SCAN OF CHART. (OOPS-Paper appproved 4/24/2012 but BK forgot to approve electronic version till 8/5/2013!) |
| Test Data: | Wellbore Channel Test: | | Reading Type | Pressure | | 10 MIN CASE | | | 5 MIN CASE | | | CASE BEFORE | | | FINAL CASE | 400 | | FINAL TUBE | | | INITIAL TUBE | | | LOSS OR GAIN | 0 | | START CASE | 400 |
| No channel test. |
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