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ST0502A-CS150226Plugging Report. Tracking #:99958 STATE OF TEXAS PLUGGING REPORT for Tracking #99958 Page 1 of 2 Owner: Mary Twell Owner Well #: No Data Address: 288 South Freeport Pkwy. Grid #: 32-08-3 Total Depth of Borehole: Coppell , TX 75019 Date Well Plugged: 2/1212015 Well Location: 300 South Freeport PIKWY Latitude: 32' 58'01 " N Operation: Coppell , TX 75019 License Number of 2176 Well County: Dallas Longitude: 0970 00' 54" W Plugging Variance #: No Data GPS Brand Used: I phone Well Type: Water HISTORICAL DATA ON WELL TO BE PLUGGED Original Well Driller: Unknown Driller's License Number No Data of Original Well Driller: Date Well Drilled: No Data Well Report Tracking No Data Number: Diameter of Borehole: 4" inches Total Depth of Borehole: 285' feet Date Well Plugged: 2/1212015 Person Actually Jerry Browning Performing Plugging Operation: License Number of 2176 Plugging Operator: Plugging Method: Tremmie pipe bentonite from bottom to 2 feet from surface, cement top 2 feet. Plugging Variance #: No Data Casing Left Data: 1st Interval: 4 inches diameter, From 0 ft to 285 ft 2nd Interval: No Data 3rd Interval: No Data Cement/Bentonite Plugs 1 st Interval: From 0 ft to 10 ft; Sack(s)/type of cement used: 2 portland cement Placed in Well: 2nd Interval: From 10 ft to 285 ft; Sacks)/type of cement used: 15 Bentonite 3rd Interval: No Data 4th Interval: No Data 5th Interval: No Data Certification Data: The plug installer certified that the plug installer plugged this well (or the well was plugged under the plug installer's direct supervision) and that each and all of the statements herein are true and correct. The plug installer understood that failure to complete the required items will result in the logs) being returned for completion and resubmittal. Company Information: Millican Well Service LLC P.O. Box 820487 Fort Worth, TX 76182 Plug Installer License 2176 Number: bttps://texaswellreports.twdb.state.tx.us/drillers-new/pluggingreportprint.asp 2/1912015 Plugging Report: Tracking #:99958 Page 2 of 2 Licensed Plug Installer Jerry Browning Signature: Registered Plug Installer No Data Apprentice Signature: Apprentice Registration No Data Number: Plugging Method No Data Comments: Please include the plugging report's tracking number (Tracking #99958) on your written request. Texas Department of Licensing & Regulation P.O. Box 12157 Austin, TX 78711 (512) 463-7880 https:lltexaswellreports.twdb. state.tx.usldrillers-newlpluggingrreportprint_asp 2/19/2015