| Form 21 |  Related  Doc |
| Date Submitted: | 8/9/2005 | MIT Assigned By: | KRABACHER, JAY |
| Date Recv'd: | 8/17/2005 | Facility ID: | 150200 |
| DocNum: | 1170777 | 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 | LACY, S B |
| Operator contact: | DIANE 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: | ran 136 jts tbg. J.Adkins approved T&A procedure. |
| Test Date: | 8/5/2005 |
| Field Rep: | |
| Approved Date: | 8/17/2005 |
| Approved by: | KRABACHER, JAY |
| Last Approved MIT: | 5/24/2000 |
| Injection/Producing Formation Zones: | WEBR |
| Perforation Interval: | 5960 - 6580 |
| Open Hole Interval: | NA |
| Bridge/Cement Plug Depth: | |
| Tubing Size: | 2.875 |
| Tubing Depth: | 5857 |
| Top Packer Depth: | 4140 |
| 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 | 790 | | 5 MIN CASE | 790 | | CASE BEFORE | 0 | | FINAL CASE | 790 | | FINAL TUBE | 0 | | INITIAL TUBE | 0 | | LOSS OR GAIN | 0 | | START CASE | 790 |
| No channel test. |
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