Document 9JEQjN79B8GM9yGvz5R1Rz66
Inspection ID
Facility Contact Information
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 8 1
Year-Month-Day: 2 0 2 3 - 0 3 - 2 9 EPA Permit # (or RA): F L I 0 0 5 3
Page 1 Of 2
Carol Chen
Start Time: 11:17 am
End Time: 11:26 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 & #: Braxton #21-1
Well Type (see table):
Enhanced Oil Recovery (EOR)
API No. 0911320033
State Permit:
PA No. 302989
OG_510
Latitude (N): 30.93770471
Longitude (W): -87.17526027
Elevation (ft):
Injection Method (check applicable): Casing Injector; X Tubing & Packer; Cemented Injection Tubing
PBTD: 16016'
Other:
surface casing 9" @3829'
Total Depth (ft): 16084' Inner Casing Size (in):
Tubing Size (in):
Packer Depth (ft):
15691'
15770'
7260 psi PW 7260 psi N
Inj. Zone: Open Hole; X Perforated; Top(ft)
Bottom(ft):
Max. Injection Pressure (psig):
Latitude (N):
30.93766
Longitude (W):
-87.17500
Elevation (ft):
EPA GPS ID: SX8123 Well Status (see table): SI
If not Active, Reported Date Last Active:
Nature of Injected Fluid(s) if any:
General Condition of the Well Site:
Well Data from File
Field Measurements and Observations
Notes & Comments (include discrepancies from database values): Maximum injection pressure: 7260 psi Produced Water (PW)
Injection well passed a mechanical integrity test on 5/11/2021.
7260 psi Nitrogen (N)
On 3/03/2022, during the State's oil and gas inspection, this well was reported shut-in, needing repair.
Perforations (Smackover Formation):
Tubing gauge:
0 psi
15691' to 15696' (4SPF - 5') 10/03/1972
Production gauge
0 psi
15711' to 15728' (4SPF - 17') 10/03/1972
Surface gauge:
0 psi
15729' to 15770' (4SPF - 41') 7/15/1982
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: 2023.05.17 10:23:41 -04'00'
Name:
Carol Chen
CAROL CHEN Date: 2023.05.16 12:01:51 -04'00' Digitally signed by CAROL CHEN
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
Year-Month-Day: 2 0 2 3 - 0 3
EPA Permit # (or RA): F L I 0
Page 2
08 1 - 29 0 5 3
Of 2
Field Measurements and Observations (Cont.)
Photo Log
Photographer: Carl E. Weller
EPA Camera ID:
Photo ID: 176
Time: 11:18 am Lat (N): 30.93794
Description:
sign posted directly on the injection well
Photo ID: 177
Time: 11:21 am Lat (N): 30.93766
Description:
photo of injection well, taken close-up
SX8123
Long (W)
Long (W)
-87.17489 -87.17500
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: 2023.05.17 10:24:07 -04'00'
UIC Inspector
Name: Carol Chen
CAROL CHEN Digitally signed by CAROL CHEN Date: 2023.05.16 12:02:17 -04'00'
Signature:
Version 2018-04-18