| UIC | Form: (02)
401360723
08/30/2017 | 1. Injection is not authorized until approval of SUBSEQUENT Form 33.
2. PRIOR TO PERFORMING OPERATIONS: Operator is required to contact COGCC to discuss any proposed Step Rate or Injectivity Test for Maximum Surface Injection Pressure determination.
3. PRIOR TO PERFORMING OPERATIONS: Operator is required to contact COGCC to discuss any proposed Hydraulic Fracturing and/or Acidizing job.
4. MIT with tubing set in final configuration for injection required for approval of SUBSEQUENT Form 33.
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| Engineer | Form: (02)
401360723
08/31/2017 | Provide remedial cement from 400' to surface. Verify with cement bond log.
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