| Form 27/27A |  Related  Doc |
| Date Submitted: | 12/2/2022 |
| Date Recv'd: | 12/2/2022 | Assigned by: | Alexander Ahmadian |
| DocNum: | 403240169 | Facility ID: | 333160 |
| Document Type: | FORM 27 | Project Number: | 26449 |
| Operator Information: |
| Operator: | CRESTONE PEAK RESOURCES OPERATING LLC |
| Oper. No. | 10633 |
| Address: | 555 17TH STREET SUITE 3700 DENVER CO 80202 |
| Type Of Facility: | LOCATION |
| Fac. Name | MILLER-63N66W |
| County Name: | WELD |
| Operator contact: | Jacob Evans |
| qtrqtr: CSE | section: 20 | township: 3N | range: 66W | meridian: 6 |
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| Remediation Details: |
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| Reason for Report: OTHER |
| Cause of Condition: OTHER |
| Potential Receptors: No surface water within ΒΌ of a mile.
The Monitoring Well (DWR receipt 0063931, Permit # 63931-MH) a |
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| HOW REMEDIATE: | N/A |
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| INITIAL ACTION: | A site investigation will be conducted pursuant to COGCC rule 911 at the MILLER-63N66W 20NWSE (333160) oil and gas location pertaining to the decommission of production facilities and abandonment of on location flowlines. See site map exhibit for details. |
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| RECLAMATION PLAN: | Reclamation will be in accordance with COGCC 1000 Series Rules.
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| SOURCE REMOVED: | N/A |
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| Correspondence Log: |
| Final Resolution | | Date | Case Closed? | Letter Sent? | CECMC Person | | 11/2/2023 | Y | | Alexander Ahmadian | | | N/A | N | | Alexander Ahmadian | |
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| Coordinates: |
| Type | Facility ID | Facility Name/Num | Lat/Long |
| Facility | 333160 | MILLER-63N66W
20NWSE | 40.206706/-104.796261 |
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