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COGIS - Mechanical Integrity Test Report

Facility Type	Facility ID/ API	Facility Name/ Number	Operator Name/ Number	Status	Field Name/ Number	Location	Location ID	Related Facilities
WELL	05-103-05758	LACY, S B 4	SCOUT ENERGY MANAGEMENT LLC 10779	AC 3/1/2023	RANGELY 72370	RIO BLANCO 103 NWNW 24 2N103W 6	314463	Related

Form 21

Date Submitted:

9/27/2000

MIT Assigned By:

ADKINS, JAIME

Date Recv'd:

4/15/2003

Facility ID:

150200

DocNum:

856617

Facility Status:

AC

Operator Information:

Oper. No.

16700

Operator:

CHEVRON U S A INC

Address:

P O BOX 4791 HOUSTON TX 77210-4791

Type Of Facility:

UIC ENHANCED RECOVERY

Well Status: AC

Facility Name

LACY, S B

Operator contact:

Location:

qtrqtr: SENE

section: 16

township: 2N

range: 103W

meridian: 6

MIT Details:

Test Type:

VERIFICATION OF REPAIRS

Repair Type:

TUBING/PACKER AND CASING LEAK

Repair Desc:

Test Date:

9/6/2000

Field Rep:

Approved Date:

4/24/2001

Approved by:

ADKINS, JAIME

Last Approved MIT:

4/30/1996

Injection/Producing Formation Zones:

WEBR

Perforation Interval:

6050 - 6526

Open Hole Interval:

NA

Bridge/Cement Plug Depth:

Tubing Size:

2.875

Tubing Depth:

6527

Top Packer Depth:

5775

Multiple Packers:

Y

Condition of approval:

Test Data:

Wellbore Channel Test:

Reading Type	Pressure
10 MIN CASE	850
5 MIN CASE	850
CASE BEFORE	0
FINAL CASE	800
FINAL TUBE	0
INITIAL TUBE	0
LOSS OR GAIN	50
START CASE	850

No channel test.