| Form 21 |  Related  Doc |
| Date Submitted: | 1/27/2015 | MIT Assigned By: | Browning, Chuck |
| Date Recv'd: | 1/28/2015 | Facility ID: | 150200 |
| DocNum: | 1171758 | 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 | LEVISON |
| 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: | RUN NEW TUBING AND PACKERS |
| Test Date: | 1/27/2015 |
| Field Rep: | Browning, Chuck |
| Approved Date: | 1/27/2015 |
| Approved by: | Browning, Chuck |
| Last Approved MIT: | 4/8/2014 |
| Injection/Producing Formation Zones: | WEBR |
| Perforation Interval: | NA |
| Open Hole Interval: | 5932-6403 |
| Bridge/Cement Plug Depth: | NA |
| Tubing Size: | 2.875 |
| Tubing Depth: | 6338 |
| Top Packer Depth: | 5878 |
| 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 | 1200 | | 5 MIN CASE | 1200 | | CASE BEFORE | 0 | | FINAL CASE | 1200 | | FINAL TUBE | 0 | | INITIAL TUBE | 0 | | LOSS OR GAIN | 0 | | START CASE | 1200 |
| No channel test. |
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