Document J2yo7pZ0eJmQq3pMEL2YX37a
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
Year-Month-Day: 2 0 2
EPA Permit # (or RA):
Carol Chen
1 1 3 0
3- 0 3
N O N E
Page 1
Start Time: End Time:
01 2 -3 0
Of 2 9:47 am 9:52 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 & #: W. W. Johnson #5-5A
Well Type (see table): Enhanced Oil Recovery (EOR)
Latitude (N):
30.97011389
Longitude (W):
API No. 091132018101 PA No. 311639
State Permit:
-87.15378056
OG_973A
Elevation (ft):
Injection Method (check applicable): Casing Injector; X Tubing & Packer; Cemented Injection Tubing additional packers...
PBTD: 15731'
Other:
surface casing 10" @3765'
Baker Packer @13996'
Total Depth (ft): 15780' Inner Casing Size (in):
Upper BHA Halliburton BWD @ 13994'
Tubing Size (in):
Packer Depth (ft):
Inj. Zone: Open Hole; X Perforated; Top(ft) 15510' Bottom(ft): 15729'
4400 psi PW Max. Injection Pressure (psig):
Latitude (N):
30.97012
Longitude (W):
-87.15378
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:
Produced fluids
General Condition of the Well Site:
Well Data from File
Field Measurements and Observations
Notes & Comments (include discrepancies from database values): Well passed a mechanical integrity test on 3/09/23.
Perforations (Smackover Formation):
Maximum injection pressures: Nitrogen (N) 7500 psi
15510' to 15634' (2PF) 7/07/1995 15596' to 15617' (4PF) 8/18/1979 15620' to 15624' (4PF) 8/18/1979 15628' to 15634' (4PF) 8/18/1979 15681' to 15697 (4PF) 8/07/1979
Produced Water (PW) 4400 psi
Tubing gauge:
3000 psi
Production gauge
100 psi
Surface gauge:
0 psi
15716' to 15729' (4PF) 8/07/1979
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 15:04:57 -04'00'
Name:
Carol Chen
CAROL CHEN Digitally signed by CAROL CHEN Date: 2023.05.16 16:24:33 -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 1 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
188
Time: 9:47 am Lat (N): 30.97012
Long (W)
sign posted directly on the injection well, close-up photo
189
Time: 9:47 am Lat (N): 30.97015
Long (W)
photo of injection well, seen a few feet away
-87.15378 -87.15376
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 15:05:30 -04'00'
UIC Inspector
Name: Carol Chen
CAROL CHEN Date: 2023.05.16 16:25:01 -04'00' Digitally signed by CAROL CHEN
Signature:
Version 2018-04-18