| Form 21 |  Related  Doc |
| Date Submitted: | 12/5/2014 | MIT Assigned By: | |
| Date Recv'd: | 12/8/2014 | Facility ID: | |
| DocNum: | 1726784 | Facility Status: | |
| Operator Information: |
| Oper. No. | 10110 |
| Operator: | GREAT WESTERN OPERATING COMPANY LLC |
| Address: | 1801 BROADWAY #500 DENVER CO 80202 |
| Type Of Facility: | | Well Status: |
| Facility Name | UPRR 60 PAN AM F |
| Operator contact: | Laura Harter |
| Location: | | qtrqtr: | section: | township: | range: | meridian: |
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| MIT Details: |
| Test Type: | SI/TA MAINTENANCE STATUS |
| Test Date: | 12/3/2014 |
| Field Rep: | Montoya, John |
| Approved Date: | 12/16/2014 |
| Approved by: | |
| Last Approved MIT: | N/A |
| Injection/Producing Formation Zones: | DSND |
| Perforation Interval: | 7588 - 7600 |
| Open Hole Interval: | |
| Bridge/Cement Plug Depth: | 7523 |
| Tubing Size: | |
| Tubing Depth: | |
| Top Packer Depth: | |
| Multiple Packers: | |
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| Condition of approval: |
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| Test Data: | Wellbore Channel Test: | | Reading Type | Pressure | | 10 MIN CASE | 500 | | 5 MIN CASE | 500 | | FINAL CASE | 500 | | START CASE | 500 |
| No channel test. |
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