| Form 27/27A |  Related  Doc |
| Date Submitted: | 8/7/2023 |
| Date Recv'd: | 8/7/2023 | Assigned by: | Alexander Ahmadian |
| DocNum: | 403486429 | Facility ID: | 473115 |
| Document Type: | FORM 27 | Project Number: | 30900 |
| Operator Information: |
| Operator: | CRESTONE PEAK RESOURCES OPERATING LLC |
| Oper. No. | 10633 |
| Address: | 555 17TH STREET SUITE 3700 DENVER CO 80202 |
| Type Of Facility: | OFF-LOCATION FLOWLINE |
| Fac. Name | Wellhead Line |
| County Name: | WELD |
| Operator contact: | Jacob Evans |
| qtrqtr: NWNW | section: 10 | township: 3N | range: 65W | meridian: 6 |
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| Remediation Details: |
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| Reason for Report: OTHER |
| Cause of Condition: OTHER |
| Potential Receptors: The Milton Reservoir is 620-ft to the SW. The Evans No. 2 Ditch is 965-ft to the NE. The Platte Vall |
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| HOW REMEDIATE: | NA |
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| INITIAL ACTION: | A site investigation will be conducted pursuant to COGCC rule 911 at the ARISTOCRAT ANGUS-63N65W 10NENW (332718) oil and gas location pertaining to the cut/cap of the ARISTOCRAT 21-10C (05-123-18775) and abandonment of the ARISTOCRAT 21-10C (12318775_FL) wellhead line. All other wells and equipment will remain active. 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: | NA |
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| Correspondence Log: |
| Final Resolution | | Date | Case Closed? | Letter Sent? | CECMC Person | | N/A | N | | John Heil | | | N/A | N | | Alexander Ahmadian | | | N/A | N | | Alexander Ahmadian | | | N/A | N | | Alexander Ahmadian | | | N/A | N | | Alexander Ahmadian | |
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| Coordinates: |
| Type | Facility ID | Facility Name/Num | Lat/Long |
| Remediation | 250972 | ARISTOCRAT
21-10C | 40.245141/-104.651881 |
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| Facility | 473115 | FEDERAL-63N65W
10NWNW | 40.246429/-104.655135 |
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| Remediation | 485359 | Aristocrat 21-10C
| 40.245141/-104.651881 |
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