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Inspection ID Class I and II Well Inspection Form US Environmental Protection Agency - Region 4 Underground Injection Control Program 61 Forsyth Street SW, MC 9T25, Atlanta, Georgia, 30303 Phone: (404)562-9424 EPA Well ID#: F L S 1 1 3 0 0 0 3 Year-Month-Day: 2 0 2 2 - 0 9 - 1 3 EPA Permit # (or RA): 8 1 5 Page 1 Of 2 Inspector(s): Jason Rose ___________________ (lead), Page Cirillo_____________________________ Start Time: 8:20 AM ____ ____________________________________, ____________________________________ End Time: 8:40 AM_____ Facility Contact Information Facility Name: Blackjack Plant ____________________________________________________________________________ Street Address: 4940 Blackjack Plant Road _________________________________________________________________ City: Jay ____________________________ County: Santa Rosa _____________________ State: FL _____ Zip: 32535 ___ Nature of Business: Oil and gas production__________________________________________________________________ Facility Owner/Operator: Black Creek Energy, LLC ____________________________ Phone: (601) 431-5386 __________ Email: harris.butler@butlerroyals.com ______________________________________________________________________ Facility Contact (if different): Michael Wetzel ___________________________________ Phone: (850) 324-6271 __________ O/O Mailing Address: 140 Virginia Street, Suite 402 __________________________________________________________ City: Richmond ______________________ County: NA_____________________________ State: VA _____ Zip: 23209 ___ Well Data from File Well Name & #: St. Regis Paper Co (SRPC) #15W Well Type (see table): Enhanced Recovery (EOR) ________________________ State Permit: API # 0911320147 _________ Latitude (N): 30.858246N______________ Longitude (W): -87.135445W ___________ Elevation (ft): 178' _______ Injection Method (check applicable): Casing Injector; Tubing & Packer; Cemented Injection Tubing PBTD 16,146' Other: __________________________________________________________________ Total Depth (ft): 16,250' ___ Inner Casing Size (in): 7" ______ Tubing Size (in):3.5" ______ Packer Depth (ft): 14,505' _ Inj. Zone: Open Hole; Perforated; Top(ft): 15,818'_ Bottom(ft): 15,891' ____ Max. Injection Pressure (psig): 2,500 psi Field Measurements and Observations Latitude (N): 30.858188 N _____________ Longitude (W): -87.135390W ___________ Elevation (ft): NA _________ EPA GPS ID: PG No. Well Status (see table): AC 3358766066 ________ If not Active, Reported Date Last Active: ______ ____________ Nature of Injected Fluid(s) if any: __________________________________________________________________________ General Condition of the Well Site: The site is clean and well maintained. There was no evidence of leaks or excessive ___ Corrosion. _____________________________________________________________________________________________ Notes & Comments (include discrepancies from database values): At the time of inspection, the well was injecting at 1,680 psi. ___ DEP indicated this well was formerly equipped with a nitrogen release to release pressure back to the plant, instead of bursting the well. DEP indicated that the connection has been disconnected and sealed off. The operator confirmed this statement. The EPA Inspection Team's visual inspection confirmed that it appears to be disconnected and sealed off. The site was clean and well-maintained. There was no evidence of leaks or excessive corrosion. Perfs (see well schematics): Initial perfs (GRN & sonic): 16601- 16099' 2SPF July-76 Added perfs (GRN & sonic): 16100-16144' 4 SPF Oct-83 _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ See reverse for additional observations, comments and photo log Owner/Operator Representative (Optional) UIC Inspector Name: Cliff Emmons ___________________________________ Name: Jason Rose ____________________________________ Signature & Date: see attached field notes ________________ Signature & Date:__________________________1_0_/_2_6__/_2_2___ Version 2018-04-18 Inspection ID Field Measurements and Observations (Cont.) Class I and II Well Inspection Form US Environmental Protection Agency - Region 4 Underground Injection Control Program 61 Forsyth Street SW, MC 9T25, Atlanta, Georgia, 30303 Phone: (404)562-9424 EPA Well ID#: F L S 1 1 3 0 0 0 3 Year-Month-Day: 2 0 2 2 - 0 9 - 1 3 EPA Permit # (or RA): 8 1 5 Page 2 Of 2 (Cont) ________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ Photo Log Photographer: Jason Rose ____________________________EPA Camera ID: PG camera ID no. 14 S/N:31029537 _______ Photo ID: 1 _______________Time: 8:25 AM ____ Lat (N): NA __________________ Long (W) NA ___________________ Description: Looking south, St. Regis Paper Company #15-W sign alongside access road. _________________________ Photo ID: 2 _______________Time: 8:28 AM ____ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking west, closeup view of surface pressure gauge reading 0 psi. _______________________________ Photo ID: 3 _______________Time: 8:28 AM ____ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking west, closeup view of production casing pressure gauge reading 0 psi. ______________________ Photo ID: 4 _______________Time: 8:29 AM ____ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking west, closeup view of internal pressure gauge reading 1,680 psi. ___________________________ Photo ID: 5 _______________Time: 8:30 AM ____ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking north, site overview including well head, pressure gauges, valves, and access stairs. __________ Photo ID: 6 _______________Time: 8:31 AM ____ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking east, view of pressure relief system formerly attached to well, which used to convey unused nitrogen back to the Black Creek gas plant. It is disconnected and sealed off. __________________________________ Owner/Operator Representative (Optional) UIC Inspector Name: Cliff Emmons ___________________________________ Name: Jason Rose ____________________________________ Signature & Date: see attached field notes ________________ Signature & Date:__________________________1_0__/_2_6_/_2_2___ Version 2018-04-18 Site Photographs St. Regis Paper Company #15-W September 13, 2022 Photograph 1: Looking south, St. Regis Paper Company #15-W sign alongside access road. Page 1 of 6 Photograph 2: Looking west, closeup view of surface pressure gauge reading 0 psi. Page 2 of 6 Photograph 3: Looking west, closeup view of production casing pressure gauge reading 0 psi. Page 3 of 6 Photograph 4: Looking west, closeup view of internal pressure gauge reading 1,680 psi. Page 4 of 6 Photograph 5: Looking north, site overview including well head, pressure gauges, valves, and access stairs. Page 5 of 6 Photograph 6: Looking east, view of pressure relief system formerly attached to well, which used to convey unused nitrogen back to the Black Creek gas plant. It is disconnected and sealed off. Page 6 of 6