Document 71x3YaB3xL1664BZyZxaQ0rkV
Inspection ID
Facility Contact Information
Well Data from File
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
Inspector(s): Carl E. Weller
_ (lead),
,
EPA Well ID#: F L S 1 1 3 0 0 7 0
Year-Month-Day: 2 0 2 3 - 0 3 - 3 0
EPA Permit # (or RA): F L I 0 0 3 5
Page 1 Of 2
Carol Chen
Start Time: 10:00 am
End Time:10:07 am
Facility Name: Maverick Natural Resources, LLC (Breitburn Operating LP)
Street Address: 5415 Oil Plant Rd
City: Jay
County: Santa Rosa
State: FL Zip: 32565
Nature of Business: oil and gas production
Facility Owner/Operator: Maverick Natural Resources, LLC
Phone: 850-675-1702
Email:
Facility Contact (if different): Al Jones, Plant Superintendent
O/O Mailing Address: 5415 Oil Plant Rd
City:
Jay
County: Santa Rosa
Phone: 251-227-3319 State: FL Zip: 32565
Well Name & #:
E. G. Jeffreys #6-5
Well Type (see table): Enhanced Oil Recovery (EOR)
Latitude (N):
30.96827777
Longitude (W):
API No. 0911320228
PA No. 311644
State Permit:
-87.15710968
OG_1179
Elevation (ft):
Injection Method (check applicable): Casing Injector; X Tubing & Packer; Cemented Injection Tubing Baker FB-1 @15343'
PBTD: 15683'
Other:
surface casing 10" @3714'
Upper packer Baker FB-1
Total Depth (ft): 15815' Inner Casing Size (in):
Tubing Size (in):
Packer Depth (ft): @15255'
Inj. Zone: Open Hole; X Perforated; Top(ft) 15404' Bottom(ft): 15641'
7500 psi N Max. Injection Pressure (psig):
Latitude (N):
30.96829
Longitude (W):
-87.15711
Elevation (ft):
EPA GPS ID: SX8123 Well Status (see table): AC If not Active, Reported Date Last Active:
Nature of Injected Fluid(s) if any:
Nitrogen (N) injection
General Condition of the Well Site:
Notes & Comments: Maximum injection pressures are 7500 psi Nitrogen (N), 4400 psi Produced Water (PW)
Notes & Comments (include discrepancies from database values): This well passed a mechanical integrity test on 6/28/2022 Perforations:
15404' to 15436' (4SPF) 02/21/1990 15476' to 15510' (4SPF) 02/20/1990 15510' to 15577' (4SPF) 11/17/2012 15577' to 15641' (4SPF) 02/04/1986
Tubing gauge: Production gauge Surface gauge:
5400 psi 0 psi
0 psi
Field Measurements and Observations
Name: Signature:
See reverse for additional observations, comments and photo log
UIC Inspector
UIC Inspector
Carl E. Weller
Digitally signed by CARL WELLER
CARL WELLER (Affiliate) (Affiliate)
Date: 2023.05.23 15:17:15 -04'00'
Name:
Carol Chen
CAROL CHEN Digitally signed by CAROL CHEN Date: 2023.05.22 14:56:01 -04'00'
Signature:
Version 2018-04-18
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
(Cont)
EPA Well ID#: F L S 1 1 3 0 0 7 0 Year-Month-Day: 2 0 2 3 - 0 3 - 3 0
EPA Permit # (or RA): F L I 0 0 3 5
Page 2 Of 2
Field Measurements and Observations (Cont.)
Photo Log
Photographer: Photo ID: Description: Photo ID: Description:
Carl E. Weller
EPA Camera ID:
190
Time: 10:02 am Lat (N): 30.96829
SX8123
Long (W)
close-up photo of sign posted on the injection well
191
Time: 10:03 am Lat (N):
30.96831 Long (W)
photo of the injection well, several feet away
-87.15711 -87.15708
Photo ID:
Time:
Lat (N):
Long (W)
Description:
Photo ID:
Time:
Lat (N):
Long (W)
Description:
Photo ID:
Time:
Lat (N):
Long (W)
Description:
Photo ID:
Time:
Lat (N):
Long (W)
Description:
UIC Inspector
Name: Signature:
Carl E. Weller
Digitally signed by CARL WELLER
CARL WELLER (Affiliate) (Affiliate)
Date: 2023.05.23 15:17:53 -04'00'
UIC Inspector
Name: Carol Chen
CAROL CHEN Date: 2023.05.22 14:56:33 -04'00' Digitally signed by CAROL CHEN
Signature:
Version 2018-04-18