HomeMy WebLinkAbout961380Form 3100 -11h
(.August l''01181
The undersigned (reverse) offers to lease all or any of the lands in Item 2 that are available for lease pursuant to the Mineral Leasing Act of 1920, as amended and supplemented (30 U.S.0
et seq.). the Mineral Leasing Act for Acquired Lands of 1947, as amended (30 U.S.0 351 -3591, the Anorney General's Opinion of April 2. 1941 (40 Op. Atty. Gen, 41), or the
2
Nanic
Street
UNI" STATES
DEPARTMEN'L JF THE INTERIOR
BUREAU OF LAND MANAGEMENT
OFFER TO LEASE AND LEASE FOR OIL AND GAS
Donald B Anderson Ltd
1200 17th St #1150
Coy, State. Zip Code Denver, 00 80202
READ INSTRUCTIONS BEFORE COMPLETING
This application /Offer /lease is for (Check only One) X. PUBLIC DOMAIN LANDS
Surface managing agency if other than BLM:USR Sal t Take r',ity, UT
Legal description of land requested: "Parcel No
ITEM 2 IN INSTRUCTIONS BELOW PRIOR TO COMPLETING PARCEL NUMBER AND SALE DATE.
T. R. Meridian State
RECEIVED 10/13/2011 at 3:26 PM
RECEIVING 961380
BOOK: 774 PAGE: 350
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
Amount remitted: Filing fcc s Rental fee s
3. Land included in lease:
DO NOT WRITE BELOW THIS LINE
T. 0230N R. 1110W 06th Meridian
sec. 018 LOTS 8 -17;
018 SESW,NESE;
018 M&B BED OF GREEN RIV
018 M&B RIPAR TO LOTS 8- 10,13 -15;
WY State
ACQUIRED LANDS (percent U.S. interest
Unit /Project S ed GJca rte e
County
Serial No.
WYW 128179
000350
'Sale Date tm /d /y)
Total acres applied for
Total S
CERTIFIED
Sweetwater °.a be a true arid comparative copy
of the official records. on file
Lincoln Cou
Type and primary term of lease:
O Noncompetitive lease (ten years) L j.. by Lr� Get lam. 5c:...i✓
THE UNITED STATES OF AMERICA
r Cr:Ty
B ik AN
(Signing Office j
Do Competitive lease ((vXXc rg (ten years) Supervisory Land Law Examiner
(Title)
Ll Other EFFECTIVE DATE OF LEASE
i :1
r HH J/f
MANAGEIVENT
DEC 2 1 1992
(Date)
JAN 0 1 1993
181
Total acres in lease 492. 0 6 0
Rental retained s 5 0
This lease is issued granting the exclusive right to drill for. omnc. extract, remove and dispose of all the oil and gas (except helium) in the lands described in Item 3 together with the right to build
and maintain necessary improvements thereupon for the term indicated below, subject to renewal or extension in accordance with the appropriate leasing atithgeity,.RtRights granted arc subject to
applicable laws, the terms, conditions, and attached stipulations of this lease. the Secretary of the Interior•s regulations and formal orders in effect as of lease issuarice: aridto regulations and formal
orders hereafter promulgated when not inconsistent with lease rights granted or specific provisions of this lease.
NOTE: This lease is issued to the high bidder pursuant to his /her duly executed bid or nomination Form submitted under 43 CFR 3120 and is subject to the provisions of that bid or
nomination and those specified on this form.
of any State or Territory:. tbereati....r all parties holding an interest in the offer are in compliance with AS 3100 and the !easing authorities. offeror 's chargeiit 'atesee.ts, direct and indirect
in either public domain lands do not exceed 246,080 acres in Federal oil and gs the same State, of which not more than 200.1)0 acres a r option, or 300,000
acres in leases and 200,00U acres in options in either leasing District in Alaska; (4) offeror is not considered a minor under the laws of the State in which the (ands covered by this offer are located;
31 offeror :s in compliance with qualifications concerning Federal coal lease holdings provided in sec. 2(a)(2)(A) of the Mineral Leasing Asa :61 °flu; or s in compliance with reclamation requirements
fix all Federal oil and gas lease holdings as required by sec, 17(g) of the Mineral Leasing Act; and (7) offeror is not in violation of see re Act.
(b) Undersigned agrees that signature to this offer constitutes acceptance of this lease. including all terms, conditions. and stipulations of which offeror leas been given notice, and any amendment
ruera r '.sese t; vat may include any land described in this offer open to leasing at the time this offer was tiled but omitted for a ,eeeae from offeror further agrees that this
osier ..,once Sc withdrawn. either in whole or in part. unless the withdrawal is received by the proper BLM State Office efore his lase. an arnendmert to this ass. or a separate lease, whichever
_ovens the and described in the withdrawal, has been signed on behalf of the United States.
Tads o•i/er will he rejected and will afford offeror no priority if it is not properly completed and executed in accordance with the regulations, ter l(' it as not itccoaripassided by the required
nay 18 U.S.C. Sec. 1001 makes it a crime for any person knowingly and willfully to make to any Department or agency of the linhltsl Stases .m). lease, i cr';fstess er':trau0acient attatesneffits
arc representations as to any matter within its jurisdiction.
Duly executed this day of 19
Sec I Rentals— Rentals shall be paid to proper office of
Annual rental -ates per acre or fraction thereof are:
(a) Noncompetitive lease, 51.50 for the first 5 years:
(b) Competitive lease. 51 s^ r
(c) Other, see attachment, or
s specified in regulations at the time this lease is issued
lessor in advance of each lease year
thereafter 52.000. 40 1st es Ow
e. bob
lirstalkit $211%
If this lease or a portion thereof is committed to an approved cooperative or unit plan which
includes; a well capable of producing leased resources, and the plan contains a provision for
allocation of production, royalties shall be paid on the production allocated to this lease. However,
annual rentals shall continue to be due at the rate specified in (a). (b), or (c) for those lands
not within a participating area.
;raiture to pay annual rental, if due, on or before the anniversary date of this lease (or next
official working day if office is closed) shall automatically terminate this lease by operation of
lave. Rentals may be waived, reduced, or suspended by the Secretary upon a sufficient showing
by less
Sec. Royalties— Royalties shall be paid to proper office of lessor. Royalties shall be compute
in accordance with regulations on production removed or sold. Royalty rates are:
(a) Noncompetitive lease, 12
b) Competitive lease, 12'
tit) Other. see attachment: or
as specified in regulations at the time this lease is issued.
Lessor reserves the right to specify whether royalty is to be paid in value or in kind. and the
right to establish reasonable minimum values on products after giving lessee notice and an
opportunity to be heard. When paid in value, royalties shall be due and payable on the last day
of the month following the month in which production occurred. When paid in kind, production
shall be delivered, unless otherwise agreed to by lessor. in merchantable condition on the premises
where produced without cost to lessor. Lessee shall not be required to hold such production
in storage beyond the last day of the month following the month in which production occurred,
nor shall lessee be held liable for loss or destruction of royalty oil or other products in storage
from causes beyond the reasonable control of lessee.
Minimum royalty in lieu of rental of not less than the rental which otherwise would be required
for drat lease year shall be payable at the end of each lease year beginning on or after a discovery
in ;paying, quantities. This minimum royalty may be waived, suspended. or reduced, and the
mews royalty rates may be reduced, for all or portions of this lease if the Secretary determines
thus such action is necessary to encourage the greatest ultimate recovery of the leased resources.
or is otherwise justified.
\n interest charge shall be assessed on late royalty payments or underpayments in accordance
with the Federal Oil and Gas Royalty Management Act of 1982 (FOGRMA) (30 U.S.C. 1701).
Lessen shail be liable for royalty payments on oil and gas lost or wasted from a lease site when
such loss nr waste is due to negligence on the part of the operator, or due to the failure to comply
with any sole. regulation. order. or citation issued under FOGRMA or the leasing authority.
Sex 'Sonds —A bond shall be filed and maintained for lease operations as required under
egulations.
ax. 4. Diligence, rate of development, unitization. and drainage— Lessee shall exercise reasonable
diligence in developing and producing, and shall prevent unnecessary damage to, loss of, or
waste of leased resources. Lessor reserves right to specify rates of development and production
in the public interest and to require lessee to subscribe to a cooperative or unit plan, within 30
days of notice, if deemed necessary for proper development and operation of area. field. or pool
embracing these leased lands. Lessee shall drill and produce wells necessary to protect leased
lands from drainage or pay compensatory royalty for drainage in amount determined by lessor.
Sec. 5. Documents, evidence, and inspection— Lessee shall file with proper office of lessor,
not later than 30 days after effective date thereof, any contract or evidence of other arrangement
for sale or disposal of production. At such times and in such form as lessor may prescribe. lessee
shall furnish detailed statements showing amounts and quality of all products removed and sold,
proceeds therefrom. and amount used for production purposes or unavoidably lost. Lessee may
tie. required to provide plats and schematic diagrams showing development work and
improvements. and reports with respect to parties in interest. expenditures, and depreciation
costs. In the forth prescribed by lessor. lessee shall keep a daily drilling record. a log. information
on well surveys and tests, and a record of subsurface investigations and furnish copies to lessor
when required Lessee shall keep open at all reasonable times for inspection by any authorized
officer of lessor. the leased premises and all wells. improvements, machinery. and fixtures thereon.
_nd all books. accounts. maps, and records relative to operations, surveys. or investigations
on or in the leased lands. Lessee shall maintain copies of all contracts, sales agreements, accounting
records. and documentation such as killings. invoices. or similar documentation that supports
LEASE TERMS
(Signature of Lessee or Attorney -in -fact)
000351
costs claimed as menufacruing. preparation. used /or transportation costs. All such records shall
be maintained in lessees accounting offices for future audit by lessor. Lessee shall maintain
required records for 6 years after they are .generated or an audit or investigation is underway.
until released of the obligation to maintain such records by lessor.
5 pm During existence of this lease, information obtained under this section shall be closed to
inspection by the public in accordance with fix Freedom of Information Act (5 U.S.C. 552).
Sex. 6. Conduct of operations--Less= shall conduct operations in a manner that minimizes adverse
impacts to the land. air. and water. to cultural. biological, visual, .and other resources, and to
other lard uses or users. lessee shall take reasonable measures deemed 'necessary by lessor to
accomplish the intent of this section. To the extent consistent with lease rights granted, such
measures may include. but are not limited to, rr„ .incaticis. to sealing or design of facilities, timing
of operations. and specification of interim, and final eclamation measures. Lessor reserves the
right to continue existing uses and to authorize future uses upon or in tin leased lands, including
the approval of easements or rights- of -wo'. Such uses :.hall be conditioned so as to prevent
unnecessary or unreasonable interference with righte 01 lesseee.
Prior to disturbing the surface of the leased (ands. lessee shall contact lessor to be apprised
of procedures to be followed and modifications or reclamation -insures that may be necessary.
Areas to be disturbed may require inventories or special studiestodetcrntine the extent of impacts
to other resources. Lessee may Inc required to complete minor inventories or short term special
studies under guidelines provided by lessor I n the conduct of operations, threatened or
endangered species, objects of historic or scientific interest. or substantial unanticipated
environmental effects are observed, lessec shall immediate', contact lessor. Lessee shall cease
any operations that would result el the destruction of such species or objects.
Sec. 7. Mining operations —To the extent that impacts from mining operations would be
substantially different or greater than those associated with normal drilling operations, lessor
reserves the right to deny approval of such operations.
Sec. 8. Extraction of helium—Lessor reserves the option -r ;.attracting or having extracted helium
from gas production in a manner specified and means provided by lessor at no expense or
loss to lessee or owner of the gas. Lessee shall include to any contract of sale of gas the provisions
of this section.
Sec. 9. Damages to property Lessee null pay lessor for damage to lessor's improvements,
and shall save and hold lessor harmless from ail _hams for damage or harm to persons or property
as a result of lease operations.
Sec. 10. Protection of diverse interests and equal opportunity Lessee shall: pay when due all
taxes legally assessed and levied tinder laws ie; the State or the United Stag: accord all employees
complete freedom of purchase: pay ail wages ae !east [5055 each month in lawful money of the
United States; maintain a safe working ens nor ren: in accordance with standard industry practices;
and take measures necessary to protect the health and safety of the public.
Lessor reserves the right to ensure tat eauction is said at ruisoaabie prices and to prevent
monopoly. if lessee operates a pipeline. or on its controlling interest in a pipeline or a company
operating a pipeline. which may be. operated accessible to oil derived from these leased lands,
lessee shall comply with section 23 of the 'alines :.easing Act of 1920.
Lessee shall comply with Executive Order No 1 1246 of September 24, 1965, as amended.
and regulations and relevant orders of the Secretary of Labor issued pursuant thereto. Neither
lessee nor lessee's subcontractors shall maintain segregated facilities.
Sec. 11. Transfer of lease interests and relinquishment if lease —As required by regulations,
lessee shall file with lessor any assignment or other transfer of an interest in this lease. Lessee
may relinquish this lease or any legal subdivision by filing in the proper office a written
relinquishment. which shall be effective as of the date of filing, subject to the continued obligation
of the lessee and surety to pay all accrued rentals and royalties.
Sec. 12. Delivery of premises —At such time as all or portions of this lease are returned to lessor.
lessee shall place affected wells in condition for suspension :x abandonment, reclaim the land
as specified by lessor and, within a reasonable period of time, remove equipment and
improvements nor deemed necessary by lessor for preservation of producible wells.
Sec. 13. Proceedings in case of default -if lessee fails ;o comply with any provisions of this
lease, and the noncompliance continues Of 3n day.. •.vrinen notice thereof. this lease shall
be subject to cancellation unless or one' de !ea, chold contains a well capable, of production
of oil or gas in paying quantities.. of the lease issiommirted to an approved cooperative or unit
plan or communitizanon agreement which ontain:, weal sapabie of production of unitized
substances in paying quantities. This provision shall not lie_ _onstrud to prevent the exercise
by lessor of any other legal and equitable remedy. including waiver of the default. Any such
remedy or waiver shall not prevent later .:ancellation for the same default occurring at any other
time. Lessee shall be subject to applicable provisions and penalties of FOGRMA (30 U.S.C. 1701).
Sec. 14. Heirs and successors- in- interes; each !'i jauon of this lease shall extend to and be
binding upon. and every benefit hereof ihall inure to 'r'e heirs, executors, administrators.
successors. beneficiaries. or assignees r isrec; es hereto,
Bed of the Green River riparian to Lots 8, 9, 10, 13, 14, 15, T23N, R111W,
6th P.M., described as follows:
Beginning at the Meander Corner of Sections 7 and 18 on the Left Bank of the
Green River; thence N. 44° 39' W., on a line normal to the median line of the
Green River a distance of 1.86 chs. to a point; thence with the median line of
the Green River, downstream; S. 45 27' W., 0.09 chs.; S. 41 57' W., 0.43
chs.; S. 38 50' W., 3.16 chs. to a point; thence N. 51 11' W., on a line
normal to the median line of the Green River a distance of 2.44 chs. to the
Meander Corner of Sections 7 and 18 on the Right Bank of the Green River;
thence with the adjusted meanders of the Right Bank of the Green River through
Section 18, downstream, based on the survey plat of T. 23 N., R. 111 W.,
approved May 29, 1912; S. 36 56' W., 4.00 chs.; S. 20 57' W., 7.21 chs.; S.
19 26' W., 3.10 chs.; S. 0° 01' E., 10.62 chs.; S. 22 58' E., 6.81 chs.; S.
74 39' E., 10.01 chs.; N. 71 36' E., 13.60 chs.; N. 66 06' E., 14.39 chs.;
N. 69 51' E., 4.10 chs.; N. 66 51' E., 5.20 chs. to the Meander Corner of
Sections 17 and 18 on the Right Bank of the Green River; thence N. 12 50' W,
on a line normal to the median line of the Green River a distance of 3.11
chs. to a point; thence with the median line of the Green River, downstream;
N. 77 12' E., 1.02 chs.; N. 78° 44' E., 0.27 chs. to a point; thence N. 11
12' W., on a line normal to the median line of the Green River a distance of
3.00 chs. to the Meander Corner of Sections 17 and 18 on the Left Bank of the
Green River; thence with
River through Section 18,
6.69 chs.; S. 53 49' W.,
5.00 chs.; S. 61 49' W.,
5.80 chs.; N. 24 57' W.,
5.01 chs.; N. 23 59' E.,
6.66 chs. to the Meander
the adjusted meanders of
upstream; S. 82° 19' W.,
5.49 chs.; S. 69° 04' W.
4.60 chs.; S. 77 04' W.
3.50 chs.; N. 0 31' E.,
3.50 chs.; N. 30° 59' E.
Corner of Sections 7 and
Green River, the place of beginning., containing 39.87 acres.
the Left Bank of the Green
9.10 chs.; S. 51 18' W.,
6.40 chs.; S. 75 49' W.,
4.30 chs.; N. 43° 26' W.,
3.51 chs.; N. 13 15' E.,
3.60 chs.; N. 29 43' E.,
18 on the Left Bank of the
tc be.a true and vu copy
of the official r y1 ijca fo
WYW128179
000352
B t LANDIAiNAI'GILEr
City
UNITED STATES
DEPARTMENT OF THE INTERIOR
BUREAU OF LAND MANAGEMENT
COMPETITIVE OIL AND GAS OR
GEOTHERMAL RESOURCES LEASE SID
30 U.S.C. 181 et seq.; 30 U.S.C. 351 -353;
30 U.S.C. 1001 -1025; 42 U.S.C. 6508
PARCEL NUMBER
THE ,I'D IS FOR (Check one)
Oil and Gas Parcel Number 3 Y3
Geothermal Parcel Number
Name of Known Geothermal Resource Area (KG RA)
bc21.-)A LC> Nab Crs J
Print or Type Name of Lessee
/Z oo 17 a S7 cc7 ,SU /re
Address of t,essee
0
State
INSTRUCTIONS FOR OIL AND GAS BID
(Except NPR-A)
gO Z,_ o Z
Zip Code
1. Separate bid for each parcel is required. Identify parcel by the parcel
number assigned in the Notice of Competitive Lease Sale.
2. Bid must be accompanied by the national minimum acceptable bid,
the first year's rental and the administrative fee. The remittance must
be in the form specified in 43 CFR 3103.1 -1. The remainder of the
bonus bid, if any, must he submitted to the proper BLM office within
10 working days after the last day of the oral auction. Failure to
submit the remainder of the bonus bid within 10 working days will
result in rejection of the bid offer and forfeiture of all monies paid.
3. If kidder is not the sole party in interest in the lease for which the bid
is submitted, all other parties in interest may be required to furnish
evidence of their qualifications upon written request by the authorized
officer.
4. This hid may be executed (signed) before the oral auction. if signed
before the oral auction, this form cannot he modified without being
executed again.
5. In view of the above requirement (4), bidder may wish to leave
AMOUNT OF BID section blank so that final bid amount may be
either completed by the bidder or the Bureau of Land Management
at the oral auction.
State
INSTRUCTIONS
FORM APPROVED
OMB NO. 1004 -0074
Expires: April 30, 1994
WY' 128179
Date of sale
WY o--)
AMOUNT OF BID (See Instructions below)
TOTAL BID
0
y
EAU
Signature of Lessee or Bidder
000353
PAYMENT SUBMITTED
WITH BID'
tot :t at true a: a ,faarstive copy
he official. records on file
INSTRUCTIONS FOR GEOTHERMAL OR
NPR -A OIL AND GAS BID
D MANAGE
The appropriate regulations applicable to this bid are: (1) for oil and gas leases -43 CFR 3120; (2) for Nationa Petroleum Reserve Alaska (NPR -A)
leases- -43 CFR 3132; and (3) for Geothermal resources leases -43 CFR 3220. (See details concerning lease qualifications an reverse.)
1 CERTIFY THAT l have read and am in compliance with, and not in violation of, the lessee qualification requirements under the applicable regulations
for this bid.
I CERTIFY THAT this bid is not in violation of 18 U.S.C. 1860 which prohibits unlawful combination or intimidation of bidders. I further certify that
this bid was arrived at independently and is tendered without collusion with any other bidder for the purpose of restricting competition.
IMPORTANT NOTICE: Execution of this form, where the offer is the high bid, constitutes a binding lease offer, including all applicable terms and
conditions. Failure to comply with the applicable laws and regulations under which this bid is made shall result in rejection of the bid and forfeiture of
all monies submitted.
I. Separate bid for each parcel is required. Identify parcel by the
number assigned to a tract.
2. Bid must be accompanied by one -fifth of the total amount of bid. The
remittance must he in the form specified in 43 CFR 3220.4 for a
Geothermal Resources bid and 3132.2 for a NPR -A lease bid.
3. Mark envelope Bid for Geothermal Resources Lease in (Name of
KGRA) or Bid for NPR -A Lease, as appropriate. Be sure correct
parcel number of tract on which bid is submitted and date of bid
opening are noted plainly on envelope. No bid may be modified or
withdrawn unless such modification or withdrawal is received prior
to time fixed for opening of bids.
4. Mail or deliver bid to the proper BLM office or place indicated in the
Notice of Competitive Lease Sale.
5. If bidder is not the sole party in interest in the lease for which bid is
submitted, all other parties in interest may be required to furnish
evidence of their qualifications upon written request by the authorized
officer.
Title 18 U.S.C. Section 1001, makes it a crime for any person knowingly and willfully to make to any department or agency of the United States any
false. fictitious or fraudulent statements or representations as to any matter within its jurisdiction.
:o may :ie. ,l,sued as 3 resui of J is azie L. _c,._....
,easii;o,a it rt The Act) of a 920, as amended, the watts h.wiele: m Be
a citizen iI' itc !nited States; an association (including par:n s, s:; =.G
citizens:a municipality; oracorporaiio o; uncle.
Pe i0':, 0: .,,c L cited States or of any State or Territory thereof; (2) Be
comr, ,ran. with acreage limitation requirements wherein ,:ae bidder
uli and indirect, in oil and gas leases in the State .denuiied
r i _Nce ou 246,080 acres each in public domain or sc
including acreage covered by this bid, of which not more than 200,000
acre:; are under options. if this bid is submitted for lands in Alaska, the
l holdings in each of the Alaska leasing districts do not eocecd
I0 �1,.
>Lf. ac of which no more than 200,000 acres are ender options in
each di:,t: ic., (3) Be in compliance with Federal coal lease holdings as
provided :n sec. 2(a)(2)(A) of the Act; (4) Be in compliance with
reclamation requirements for all Federal oil and gas holdings as
required by sec. 17 of the Act; (5) Not be in violation of sec. 41 of the Ace,
and (6) Certify that all parties in interest in this bid are in compliance
with 47 C. 7R Groups 3000 and 3100 and the ':easing authorities cited
herein..
The I.ct of i 974 and the regulation in 43 CFR 2.48 ei; provide
that you oe 'urnished the following information. in connection wiiii
nfoi required by this bid for a Competitive Oil and Gas c
Geis t, 'mar Resources Lease.
7- 30 U.S.C. 181 et seq.; 30 U.S.C. 759; 30 U.S.C.
1001 1025 ;42 U.S.C. 6508
PRINCIPLE PURPOSE: The information is to be used to process your
bid.
QUALIFICATIONS
NC C O.
r lea
_oiherrr:a. S
c.t :zen u;
aeon t,,
�caic 01 .err.
.matron
three t. d
easing au:
eme is I
(1) Be a
ens a municipality:
to:6. ..hc �li,et; States or of an'.
and (2) }$e ct. :',ipiiance with ac,,,age
direct and
,201. and that all parries in
r_ Group 3200 and the
Deplattaer;;
Bc
admitted
>ipu,at )tat pi 0; any
'Mate or or, ;1p 01. nationals,
resident _.lc,.: ut plitat, public r municlpa; corporations, and (2)
;rerti;y is
t1 Old d5.
n compliance FNltil 43
CFR Pal 3 'f and he leasing authorities cited .Herein.
en •,u•rc a pr .as
000354
The Paperwork Reduction Act of 1980 (44 U.S.C. 350) et seq.) requires us to inform you that:
This information is being collected in accordance with 43 CFR 3120, 43 CFR 3130, or 43 CFR 3220.
This information will be used to determine the bidder submitting the highest bid.
Response to this request is required to obtain a benefit.
an 0210-
Of rnu'i.l tpa:
3i... ed:i. .21 :0 o. 1 rlgnl he
2soui... bid i., .i u'„tlmentation ,,1
u V C
,.oi 1 s,e: oap 0 )1, at )L:C;i comment
�i 'Ih
of Cun5:ii .0.1i ed prior to granting a 'lght in rands or
resources. '4)(.;) l.nfortnatiorl From the record a;idt.or the record; will be
tran`;ier"ce1 .0 appropriate :do.'ai. 'itatc. local or foreign agencies,
When reitn ant o t, _;'Ir nai 01 t:guiatury in7estlgations or prosecu-
tions.
EFFECT OF NOT PROVIDING INFORMATION: Disclosure of the
information is voluntary. If all the irtlormatron is not provided, your bid
may he rejected.
BURDEN HOURS STATEMENT
Public reporting burden for this form is estimated to average 2 hours per response, including the time for reviewing instructions, cat ssrir,g and maintaining data, and
coinpleting and reviewing the form. Direct comments regarding the burden estimate or any other aspect of this form to U.S. Department-of the interior, Bureau of Land
Management, (Alternate) Bureau Clearance Officer; (WO -771), 1849 C Street, N.W., Washington, D.C. 20240, and the Office of ivianagement and Budget, Peperv:ork
Reduction Project (1004 -0074), Washington, D.C. 20503.
NOTICE TO LESSEE
28179
000355
Provisions of the Mineral Leasing Act (MLA) of 1920, as amended by the Federal
Coal Leasing Amendments Act of 1976, affect an entity's qualifications to
obtain an oil and gas lease. Section 2(a)(2)(A) of the MLA,, 30 U.S.C. 201
(a)(2)(A), requires that any entity that holds and has held a Federal coal
lease for 10 years beginning on or after August 4, 1976, and who is not
producing coal in commercial quantities from each such lease, cannot qualify
for the issuance of any other lease granted under the MLA. Compliance by coal
lessees with Section 2(a)(2)(A) is explained in 43 CFR 3472.
In accordance with the terms of this oil and gas lease, with respect to
compliance by the initial lessee with qualifications concerning Federal coal
lease holdings, all assignees and transferees are hereby notified that this
oil and gas lease is subject to cancellation if: (1) the initial lessee as
assignor or as transferor has falsely certified compliance with Section
2(a)(2)(A), or (2) because of a denial or disapproval by a State Office of a
pending coal action, i.e., arms length assignment, relinquishment, or logical
mining unit, the initial lessee as assignor or as transferor is no longer in
compliance with Section 2(a)(2)(A). The assignee, sublessee or transferee
does not qualify as a bona fide purchaser and, thus, has no rights to bona
fide purchaser protection in the event of cancellation of this lease due to
noncompliance with Section 2(a)(2)(A)..
Information regarding assignor, sublessor or transferor compliance with
Section 2(a)(2)(A) is contained in the lease case file as well as in other
Bureau of Land Management records available through the State Office issuing
this lease.
CERTIFIED
•to b e a trueorrpi. <r
0f.ihe official reccros on filCOpY
ir)ir`b7 (Pit ort
B "JO AO O LAN[ MA v' A GEME JT
LEASE NOTICE NO. 1
1. Slopes in excess of 25 percent.
2. Within 500 feet of surface water and /or riparian areas.
3. Construction with frozen material or during periods when the soil
material is saturated or when watershed damage is likely to occur.
5. Within 1/4 mile of occupied dwellings.
GUIDANCE:
'YYV128179
000356
Under Regulation 43 CFR 3101.1 -2 and terms of the lease (BLM Form 3100 -11),
the authorized officer may require reasonable measures to minimize adverse
impacts to other resource values, land uses, and users not addressed in lease
stipulations at the time operations are proposed. Such reasonable measures
may include, but are not limited to, modification of siting or design of
facilities, timing of operations, and specification of interim and final
reclamation measures, which may require relocating proposed operations up to
200 meters, but not off the leasehold, and prohibiting surface disturbance
activities for up to 60 days.
The lands within this lease may include areas not specifically addressed by
lease stipulations that may contain special values, may be needed for special
purposes, or may require special attention to prevent damage to surface and /or
other resources. Possible special areas are identified below. Any surface
use or occupancy within such special areas will be strictly controlled or, if
absolutely necessary, prohibited. Appropriate modifications to imposed
restrictions will be made for the maintenance and operation of producing
wells.
4. Within 500 feet of Interstate highways and 200 feet of other existing
rights -of -way (i.e., U.S. and State highways, roads, railroads,
pipelines, powerlines).
The intent of this notice is to inform interested parties (potential lessees,
permittees, operators) that when one or more of the above conditions exist,
surface disturbing activities will be prohibited unless or until the permittee
or the designated representative and the surface management agency (SMA)
arrive at an acceptable plan for mitigation of anticipated impacts. This
negotiation will occur prior to development and become a condition for
approval when authorizing the action.
Specific threshold criteria (e.g., 500 feet from water) have been established
based upon the best information available. However, geographical areas and
time periods of concern must be delineated at the field level (i.e., "surface
water and /or riparian areas" may include both intermittent and ephemeral water
sources or may be limited to perennial surface water).
CERTIFIED
to beat rue anti cam, �ti, cf. 1y
of the official records on ;iii;
g nL
r' u 4 .0
x
BUREAU OF LAND MU,A AGE, E
4
On the lands described below:
Sec 18: Lots 10, 11;
For the purpose of:
protecting a national trail.
CONTROLLED SURFACE USE STIPULATION CSU
Surface occupancy or use is subject to the following special operating
constraints.
WYW128179
000357
Surface disturbance or occupancy within 1320 feet of the Slate Creek Cutoff of
the Emigrant Trail may be prohibited depending on site specific circumstances
including, but not limited to, trail condition and setting, topography, visual
horizon from trail, and nature and extent of proposed activity;
Any changes to this stipulation will be made in accordance with the land use
plan and /or the regulatory provisions for such changes. (For guidance on the
use of this stipulation, see BLM Manual 1624 and 3101 or FS Manual 1950 and
2820.)
be a true and comparative copy
of the official records on file
Crq
BuRE/ a A
ANAL.
a Nov 15 to Apr 30;
b. Feb 1 to Jul 31;
TIMING LIMITATION STIPULATION TLS
No surface use is allowed during the following time period(s). This
stipulation does not apply to operation and maintenance of production
facilities.
On the lands described below:
a. Sec 18: Lots 10 -13, 16, 17, SESW;
b. entire lease;
For the purpose of (reasons):
a. protecting crucial big game winter range.
b. protecting raptor nesting habitat.
WYW128179
000358
Any changes to this stipulation will be made in accordance with the land use
plan and /or the regulatory provisions for such changes. (For guidance on the
use of this stipulation, see BLM Manual 1624 and 3101 or FS Manual 1950 and
2820.)
co:::_ 1 11" I L.)
to be a true and comparative copy
of the official records on file
vi
BUREAU OF LANWMA vAG
Form 3109 -1
(December 1972)
(formerly 3103 1)
The lessee agrees to maintain, if required by the lessor during
the period of this lease, including any extension thereof, an
additional bond with qualified sureties in such sum as the
lessor, if it considers that the bond required under Section 2(a)
is insufficient, may at any time require:
(a) to pay for damages sustained by any reclamation
homestead entryman to his crops or improvements caused by
drilling or other operations of the lessee, such damages to
include the reimbursement of the entryman by the lessee, when
he uses or occupies the land of any homestead entryman, for
all construction and operation and maintenance charges be-
coming due during such use or occupation upon any portion of
the land so used and occupied;
(b) to pay any damage caused to any reclamation project
or water supply thereof by the lessee's failure to comply fully
with the requirements of this lease; and
(c) to recompense any nonmineral applicant, entryman,
purchaser under the Act of May 16, 1930 (46 Stat. 367), or
patentee for all damages to crops or to tangible improvements
caused by drilling or other prospecting operations, where any
of the lands covered by this lease are embraced in any non
mineral application, entry, or patent under rights initiated
prior to the date of this lease, with a reservation of the oil
deposits, to the United .States pursuant to the Act of
July 17, 1914 (38 Stat. 509).
As to any lands covered by this lease within the area of any
Government reclamation project, or in proximity thereto, the
lessee shall take such precautions as required by the
Secretary to prevent any injury to the lands susceptible to
irrigation under such project Or to the water supply thereof;
provided that drilling is prohibited on any constructed works
or right -of -way of the Bureau of Reclamation, and provided,
further, that there is reserved to the lessor, its successors
and assigns, the superior and prior right at all times to con-
struct, operate, and maintain dams, dikes, reservoirs, canals,
wasteways, laterals, ditches, ,telephone and telegraph lines,
electric transmission lines, roadways, appurtenant irrigation
structures, and reclamation works, in which construction,
operation, and maintenance, the lessor, its successors and
assigns, shall have the right to use any or all of the lands
herein described without making compensation therefor, and
shall not be responsible for any damage from the presence of
water thereon or on account of ordinary, extraordinary, unex-
pected, or unprecedented floods. That nothing shall be done
under this lease to increase the cost of, or interfere in any
manner with, the construction, operation, and maintenance of
such works. It is agreed by the lessee that, if the construc-
tion of any or all of said dams, dikes, reservoirs, canals,
wasteways, laterals, ditches, telephone or telegraph lines,
electric transmission lines, roadways, appurtenant irrigation
structures or reclamation works across, over, or upon said
lands should be made more expensive by reason of the
existence of the improvements and workings of the lessee
thereon, said additional expense is to be estimated by the
CER f DIED,
to be a true and corilp:,rtative cony
of the official record:; on filE.
C� lX�f.J h
9 (k a'0
ICJ r uJ
UNITED STATES
DEPARTMENT OF THE INTERIOR
BUREAU OF LAND MANAGEMENT
LEASE STIPULATIONS
BUREAU OF RECLAMATION
Secretary of the Interior, whose estimate is to be final and
binding upon the parties hereto, and that within thirty (30)
days after demand is made upon the lessee for payment of any
such sums, the lessee will make payment thereof to the
United States, or its successors, constructing such dams,
dikes, reservoirs, canals, wasteways, laterals, ditches,
telephone and telegraph lines, electric transmission lines,
roadways, appurtenant irrigation structures, or reclamation
works, across, over, or upon said lands; provided, however,
that subject to advance written approval by the United States,
the location and course of any improvements or works and
appurtenances may be changed by the lessee; provided,
further, that the reservations, agreements, and conditions
contained in the within lease shall be and remain applicable
notwithstanding any change in the location or course of said
improvements or works of lessee. The lessee further agrees
that the United States, its officers, agents, and employees,
and its successors and assigns shall not be held liable for
any damage to the improvements or workings of the lessee
resulting from the construction, operation, and maintenance of
any of the works hereinabove enumerated. Nothing in this
paragraph shall be construed as in any manner limiting other
reservations in favor of the United States contained in
this lease.
THE LESSEE FURTHER AGREES That there is reserved to
the lessor, its successors and assigns, the prior right to use
any of the lands herein leased, to construct, operate, and
maintain dams, dikes, reservoirs, canals, wasteways, laterals;
ditches, telephone and telegraph lines, electric transmission
lines, roadways, or appurtenant irrigation structures, and also
the right to remove construction materials therefrom, without
any payment made by the lessor or its successors for such
right, with the agreement on the part of the lessee that if the
construction of any or all of such dams, dikes, reservoirs,
canals, wasteways, laterals, ditches, telephone and telegraph
lines, electric transmission lines, roadways, or appurtenant
irrigation structures across, over, or upon said lands or the
removal of construction materials therefrom, should be made
more expensive by reason of the existence of improvements or
workings of the lessee thereon, such additional expense is to
be estimated by the Secretary of the Interior, whose estimate
is to be final and binding upon the parties hereto, and that
within thirty (30) days after demand is made upon the lessee
for payment of any such sums, the lessee will make payment
thereof to the United States or its successors constructing
such dams, dikes, reservoirs, canals, wasteways, laterals,
ditches, telephone and telegraph lines, electric transmission
lines, roadways, or appurtenant irrigation structures across,
over, or upon said lands or removing construction materials
therefrom. The lessee further agrees that the lessor, its
officers, agents, and employees and its successors and
assigns shall not be held liable for any damage to the im-
provements or workings of the lessee resulting from the
construction, operation, and maintenance of any of the works
herein above enumerated. Nothing contained in this paragraph
shall be construed as in any manner limiting other reservations
in favor of the lessor contained in this lease.
(Signature of Lessee)
BN LB ('A ale 281 i
000359
000360
To insure against the contamination of the waters of the Reservoir,
Project, State of the lessee agrees that
the following further conditions shall apply to all drilling and operations on lands covered by this lease, which lie
within the flowage or drainage area of the Reservoir, as such area
is defined by the Bureau of Reclamation:
1. The drilling sites for any and all wells shall be approved by the Superintendent, Bureau of
Reclamation,
Project, before
drilling begins. Sites for the construction of pipe -line rights -of -way or other authorized fac; shall
also be approved by the Superintendent before construction begins.
2. All drilling or operation methods or equipment shall, before their employment, be inspected
and approved by the Superintendent of the Project,
and by the Supervisor of the U. S. Geological Survey having jurisdiction
over the area.
U.S. Government tin ice: legion 8
Note: "X" means Stipulation applies.
000361
Lease No. WYW128179
BUREAU OF RECLAMATION
SPECIAL OIL AND GAS LEASE STIPULATIONS
X 1. Leasee agrees to provide written notice to the Bureau of Reclamation
15 days prior to any and all intended surface activities in con-
nection with exploration, drilling or any other activity associated
with, or leading to, oil and gas production (including seismic
activity) on any lands which the Bureau of Reclamation has juris-
diction as the Surface Managing Agency.
2. Leasee agrees that there will be no surface occupancy within 1,500
horizontal feet of Dam. This stipulation
is to ensure the integrity of the structure.
3. Leasee agrees that there will be no surface occupancy within 500
horizontal feet of the maximum water surface elevation of
Reservoir (maximum water surface elevation is
feet above mean sea level). This stipulation is to
minimize the possibility of pollution and interference with the
operation and maintenance of the Reservoir.
4. Leasee agrees that there will be no surface occupancy within 200
horizontal feet of the centerline of any constructed or proposed
Bureau of Reclamation tunnel, canal, aqueduct, pipeline, lateral,
drain, transmission lines, telephone lines, and roadways, under
the administration or jurisdiction of the Bureau of Reclamation.
Also, O&M roads will not be used for access without prior approval
of Bureau of Reclamation.
x 5. Leasee agrees that there will be no surface occupancy within 500
horizontal feet of any improved campground facility.
x 6. Leasee agrees to locate production facilities so that they will not
be seen by the general public using the Reservoir or campground areas.
CERTIFIED
to be a true and comparative copy
of the official records on file