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RESOURCES AGENCY OF CALIFORNIA <br /> DEPARTMENT OF CONSERVATION <br /> DIVISION OF OIL,GAS,AND GEOTHERMAL RESOURCES <br /> NOTICE OF INTENTION TO DRILL NEW WELL <br /> C.E.Q.A.INFORMATION FOR DIVISION USE ONLY <br /> DOCUMENTNOT MAP FORMS <br /> EXEMPT ❑ NEG.DEC. ❑ E.I.R. ❑ REQUIRED BY MAP BOOK CARDS BOND 114 1 121 <br /> LOCAL <br /> CLASS S.C.H.NO. S.C.H.NO. ,JURISDICTION El <br /> See Reverse Side <br /> In compliance with Section 3203, Division 3, Public Resources Code, notice is hereby given that it is our intention to commence <br /> drilling well well type API No. <br /> (Assigned by Division) <br /> Sec. B.&M., Field, County. <br /> Legal description of mineral-right lease, consisting of acres(attach map or plat to scale), is as follows: <br /> Do mineral and surface leases coincide? Yes ❑ No ❑ . If answer is no, attach legal description of both surface and mineral <br /> leases, and map or plat to scale. <br /> Location of well feet along section ❑ /property❑ line and feet <br /> (Direction) (Check one) (Direction) <br /> at right angles to said line from the corner of section ❑ /property❑ or <br /> (Check one) <br /> Is this a critical well according to the definition on the next page of this form? Yes ❑ No ❑ <br /> If well is to be directionally drilled, show proposed coordinates(from surface location)and true vertical depth at total drilled depth: <br /> feet and feet Estimated true vertical depth Elevation of ground above <br /> (Direction) (Direction) <br /> sea level feet.All depth measurements taken from top of that is feet above ground. <br /> (Derrick Floor,Rotary Table,or Kelly Bushing) <br /> PROPOSED CASING PROGRAM <br /> CALCULATED FILL <br /> SIZE OF CASING WEIGHT GRADE AND TYPE TOP BOTTOM CEMENTING BEHIND CASING <br /> INCHES API DEPTHS (Linear Feet) <br /> LL <br /> (A complete drilling program is preferred and may be submitted in lieu of the above program.) <br /> Intended zone(s) <br /> of completion Estimated total depth <br /> (Name,depth,and expected pressure) (Feet) <br /> It is understood that if changes to this plan become necessary,we are to notify you immediately. <br /> Name of Operator Type of Organization(Corporation,Partnership,Individual,etc.) <br /> Address City Zip Code <br /> Telephone Number Name of Person Filing Notice Signature Date <br /> This notice and an indemnity or cash bond shall be filed, and approval given, before drilling begins. If operations have not <br /> commenced within one year of receipt of the notice,this notice will be considered cancelled. <br /> OG105 (1/08) <br />