State of Colorado

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					  FORM

   10                                                              State of Colorado
 Rev 8/04
                                                         Oil and Gas Conservation Commission
                                              1120 Lincoln Street, Suite 801, Denver, Colorado 80203 (303)894-2100 Fax:(303)894-2109

                                          GAS FACILITY REGISTRATION/CHANGE OF OPERATOR
OGCC Operator Number:___________________                            Total Number of Wells Submitted:______________                                         Page ___ of ___
Name of Operator:_________________________                          Total Number of Wells This Page:______________                                         Date:__________

                  API Number                                         Well Name                                  Well No.                        Location
            (Cty, Sequence, Side Track)                                                                                                (QtrQtr, Sec, Twp, Rng, Mer)

				
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