Document BRBYb4NBKXB1yBQGLq0X1mneo
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 3 2
Year-Month-Day: 2 0 2 3 - 0 3 - 3 0
EPA Permit # (or RA): N O N E
Page 1 Of 2
Carol Chen
Start Time: 10:35 am
End Time: 10:45 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 & #:
McDavid Lands #33-1
Well Type (see table):
Enhanced Oil Recovery (EOR)
Latitude (N):
30.98459855
Longitude (W):
API No. 0911320016 PA No. 311578
State Permit:
OG_480
--87.16683943
Elevation (ft):
Injection Method (check applicable): Casing Injector; X Tubing & Packer; Cemented Injection Tubing
PBTD: 15518' Total Depth (ft): 15621'
Other:
surface casing 10" @ 3634'
Inner Casing Size (in):
Tubing Size (in):
Gravity Perma-Pak Packer with Viton
@15114'
Packer Depth (ft):
Inj. Zone: Open Hole; X Perforated; Top(ft) 15302' Bottom(ft): 15465'
4400 psi PW Max. Injection Pressure (psig):
Latitude (N):
30.98456
Longitude (W): --87.16686
Elevation (ft):
EPA GPS ID: SX8123 Well Status (see table):
If not Active, Reported Date Last Active:
Nature of Injected Fluid(s) if any: Produced fluids
General Condition of the Well Site:
Well Data from File
Field Measurements and Observations
Notes & Comments (include discrepancies from database values):
Perforations (Smackover Formation):
Maximum injection pressures: Nitrogen (N) 7500 psi Produced Water (PW) 4400 psi
15302' to 15312' (4SPF) 3/12/1974
15407' to 15467' (2SPF) 10/31/1971
Tubing gauge:
1500 psi
15292' to 15312' (6SPF) 15346 to 15380' (6SPF)
5/27/2019 5/27/2019
Production gauge Surface gauge:
0 psi 0 psi
15411' to 15465' (6SPF) 5/27/2019 Injection well passed a mechanical integrity test on 5/11/2021
See reverse for additional observations, comments and photo log
UIC Inspector
UIC Inspector
Name: Signature:
Carl E. Weller
Digitally signed by CARL WELLER
CARL WELLER (Affiliate) (Affiliate)
Date: 2023.05.23 15:09:14 -04'00'
Name:
Carol Chen
CAROL CHEN Digitally signed by CAROL CHEN Date: 2023.05.17 14:38:15 -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 3 2 Year-Month-Day: 2 0 2 3 - 0 3 - 3 0
EPA Permit # (or RA): N O N E
Page 2 Of 2
Field Measurements and Observations (Cont.)
Photo Log
Photographer: Photo ID: Description: Photo ID: Description:
Carl E. Weller
EPA Camera ID:
SX8123
196
Time: 10:35 am Lat (N): 30.98456
Long (W)
close-up photo of injection well, closest GPS location
197
Time: 10:35 am Lat (N): 30.98458
Long (W)
photo of injection well, several feet back
--87.16686 --87.16690
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 15:09:54 -04'00'
UIC Inspector
Name: Carol Chen
CAROL CHEN Date: 2023.05.17 14:38:44 -04'00' Digitally signed by CAROL CHEN
Signature:
Version 2018-04-18