Document OJJv0B86ep77boE4BXkQ1JyVK
Inspector Operator Info
Location Latitude
Well Inspection Osage DNR / Environmental Protection Agency
1201 Elm Street, Suite 500 Dallas, Texas 75270
Matthew Allen
Inspection Date 10/02/2024
Time 09:15
Operator Representative Performance Energy Resources, LLC
Performance Energy
Inventory ID OS4530000
Resources, LLC P.O. Box 628 Barnsdall, OK 74002 Phone: 918-847-2531
API Well No Lease Name
Well ID
JACKSON 12
SE 03 24N 11E
Status Inactive
Well Type Disposal
36.582553
Longitude -96.107735
Inspection Reason
Inspect No.
Plugging Witnessed
Casing 4.5
Responsible Company at Time of Inspection
Date Last MIT 01/23/2018
Tubing
Performance Energy Resources
Last Test Fail Result USDW
Monitoring N Device Elected
Monitoring Device
FLM Canister Pressure
Lease Status
Barrel Monitor N Hooked Up?
Barrel Fluid Level (%)
Flowline Hooked N Up?
Tubings Annulus
Fittings N
N
Actual Pressure
AUTHORIZED Max Pressure 542 Max Volume
Determined? Static Fluid Level
Determined? Injection Rate
(bpd)
Max Inj Units Barrels Per Month
Injecting N
Inspection Comments
Inspector observed surface restoration was completed at the well location.
Inspector Signature
MATTHEW ALLEN Date: 2024.10.03 15:44:03 -05'00' Digitally signed by MATTHEW ALLEN
Supervisor Signature
JEANNE ECKHART Date: 2024.10.07 11:39:29 -05'00' Digitally signed by JEANNE ECKHART
Performance Energy Resources, LLC/Jackson Lease (OS4530000) Inspection Date: 10/02/2024
Appendix 1 Photograph Log
1 Photo
UNITED STATES ENVIRONMENTAL PROTECTION AGENCY
Photograph Log
Location: 36.582553, -96.107735 City: Barnsdall
Photo No. 1 County/Parish: Osage
State: Oklahoma
Photo File Name: R0010516 Orientation: NNE Date of Photo: 10/02/2024 Time of Photo: 9:18 AM Latitude: 36.582553 Longitude: -96.107735 Photographer: Matthew Allen Description: This was the well location for well OS4530000 after surface restoration had been completed.