Document NedzYYaeemQZE52qo9Z5XBZkQ
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 6
Year-Month-Day: 2 0 2 3 - 0 3 - 2 9
EPA Permit # (or RA): N O N E
Page 1 Of 2
Carol Chen
Start Time: 1:11 pm
End Time: 1:16 pm
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 & #: St. Regis Paper Company (SRPC) #39-1
Well Type (see table): Enhanced Oil Recovery (EOR)
Latitude (N):
30.96358171
Longitude (W):
API No. 0911320051 PA No. 311589
State Permit:
-87.19219837
OG_541
Elevation (ft):
Injection Method (check applicable): Casing Injector; X Tubing & Packer; Cemented Injection Tubing
PBTD: 15721'
Other:
surface casing 10" @ 3678' BHA 6/02/1984 Otis WB Packer
Total Depth (ft): 15805' Inner Casing Size (in):
Tubing Size (in):
Packer Depth (ft): 15411'
Inj. Zone: Open Hole; X Perforated; Top(ft) 15473' Bottom(ft): 15618'
7500 psi N Max. Injection Pressure (psig):
Latitude (N):
30.96364
Longitude (W):
-87.19226
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)
General Condition of the Well Site:
Well Data from File
Field Measurements and Observations
Notes & Comments (include discrepancies from database values):
Maximum injection pressure: 7500 psi Nitrogen (N), 4400 psi Produced waters (PW).
Perforations (Smackover Formation): 15473' to 15538' (4SPF) 8/31/1972
Tubing gauge:
15564' to 15570' (4SPF) 6/28/1974
Production gauge
15610' to 15618' (4SPF) 6/28/1972
Surface gauge:
Injection well passed a mechanical integrity test on 3/09/2023.
5700 psi 0 psi 0 psi
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 10:13:11 -04'00'
Name:
Carol Chen
CAROL CHEN Date: 2023.05.15 14:31:32 -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 0 3 6 Year-Month-Day: 2 0 2 3 - 0 3 - 2 9
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:
180
Time: 1:11 pm Lat (N): 30.96354
sign is posted farther away from the injection well
181
Time: 1:11 pm Lat (N): 30.96364
photo of the injection well
SX8123
Long (W)
Long (W)
-87.19267 -87.19226
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 10:13:42 -04'00'
UIC Inspector
Name: Carol Chen
CAROL CHEN Date: 2023.05.15 14:32:01 -04'00' Digitally signed by CAROL CHEN
Signature:
Version 2018-04-18