Document QXNB6dXdeMLboMjZ5G6nKjL7o

DownloadSearchable PDFRandom document
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 EPA Well ID#: Year-Month-Day: 2 0 2 1 - 1 1 - 1 8 EPA Permit # (or RA): Phone: (404)562-9424 Page 1 Of 2 Inspector(s): ______A_n_t_h_o_n_y_S_h__e_lt_o_n______________ (lead),______C_a__rl_W__e_ll_e_r___________________ Start Time: _1_2_:_5_0__p_m__ Carol Chen ____________________________________, ____________________________________ End Time: _1_2_:_5_9__p_m__ Facility Contact Information Facility Name:______P_E_T_R__O_H__A_R_V_E_S_T_E_R__O_P_E__R_A_T_IN__G_C__O_M_P__A_N_Y_,_L_L_C_____________________________________________ Street Address:_____1_1__0_7_W___6_th__S_t__(o_f_f_ic_e__a_d_d_re_s_s_)__________________________________________________________ City: ________L_a_u_r_e_l__________________ County: ____________J_o_n_e_s_______________ State:___M_S____ Zip: _3_9_4__4_0___ Nature of Business: ____O_i_l _a_n_d_g_a_s__e_x_tr_a_c_t_io_n__in_d_u__st_r_y________________________________________________________ Facility Owner/Operator: __P_E_T_R_O__H_A_R__V_E_S_T_E_R__O_P_E_R_A__T_IN_G__C_O__M_P_A_N__Y_, _L_L_C________ Phone: ____6_0_1_-_6_5_1_-_2_1_0_0_________ Email: _______k_e_r_ry_._a_ll_e_n_@_r_o_c_k_a_ll_e_n_e_r_g_y_.c_o_m_________________________________________________________________ Facility Contact (if different): __K__e_rr_y_A__lle_n__, _S_r._O__p_e_ra__ti_o_n_s_M__a_n_a_g_e_r________________ Phone: ____6_0_1_-_6_5_1_-_2_1_0_5_________ O/O Mailing Address: _____1_1_0_7__W__6_t_h__S_t_(_o_f_fi_c_e_a_d_d_r_e_s_s_)_____________________________________________________ City: _______L_a_u_r_e_l___________________ County: ___________J_o_n_e_s________________ MS State:________ Zip: _3_9_4_4__0___ Well Data from File Well Name & #: _______C_i_t_y_o_f_L_a_u_r_e_l_(C__O_L_)_6_-_3_#__3___________________________________________________________ Well Type (see table): ____P_ro_d_u__ce__d_F_l_u_id__D_is_p__o_sa__l,_U_I_C_C__la_s_s_I_I____________ State Permit: _A_P_I_#_2_3_0_6__7_2_0_4_4_9__-0_0_-_0_0_____ Latitude (N): ______3_1__.6_9__6_3_7____________ Longitude (W): ________-8_9_._1_4_1_3__3________ Elevation (ft): ___2_8_1_'(_G_r_)___ Injection Method (check applicable): Casing Injector; X Tubing & Packer; Cemented Injection Tubing PBDT CIBP 3,595, 10' cement Other: __________________________________________________________________ Total Depth (ft): _4_,_6_1_6_'____ Inner Casing Size (in): ____7_"___ Tubing Size (in):___3___"____ 3,202' Packer Depth (ft): ________ Inj. Zone: Open Hole; X Perforated; Top(ft) _3_,_2_4_7_'__ Bottom(ft): __3_,5__3_6_'____ Max. Injection Pressure (psig): _7_4__6_p_s_i_ Field Measurements and Observations 31.69636 Latitude (N): __________________________ Longitude (W): ______-_8_9_._1_4_1_3_3__________ Elevation (ft): ____________ EPA GPS ID: __S_X_8_1_2_3__ Well Status (see table): ____A_C____ If not Active, Reported Date Last Active: __________________ Nature of Injected Fluid(s) if any: ___P_r_o_d_u_c_e_d__fl_u_id__s__________________________________________________________ General Condition of the Well Site: ___________N_A_____________________________________________________________ _____________________________________________________________________________________________________ Notes & Comments (include discrepancies from database values): __T_u_b_in_g__g_a_u_g_e__re_a_d_s_:_4__2_5_p__si_,_A_n_n_u_l_u_s_g_a_u_g_e__r_e_a_d_s_: _4_2_5__p_s_i __ _P_e_rf_o_r_a_ti_o_n_s_p_r_o_v_id_e_d__b_y_f_ie_l_d_h__a_n_d_o_n_-_s_it_e_:___T_e_a_m__'s__o_b_s_e_rv_a_t_io_n_s_:_____________________________________________ ____________3_,2__4_7_' _to__3_,_2_6_5_'______________W_e_l_l,_C__it_y_o_f_L_a_u_r_e_l_6_-_3_#__3_w__a_s_i_n_je_c_t_in_g__a_t _4_2_5__P_S_I_a_n_d__w_e__n_o_t_ic_e_d__th_a_t__th_e 3,315' to 3,325' Annulus was also at 425 PSI (which could show a Mechanical Failure), so _____________________________________________________________________________________________________ 3,368' to 3,400' we asked if the Annulus could be bleed off, to watch for a pressurization _____________________________________________________________________________________________________ ____________3_,5_2__3_' _to__3_,_5_3_6_'______________o_f_t_h_e_A__n_n_u_lu_s_._T_h_e__A_n_n_u_l_u_s_d_i_d_n_o__t _p_re_s_s_u_r_iz_e__in__t_h_e_t_im__e_w__e_w__e_re__a_t____ that location. _____________________________________________________________________________________________________ See reverse for additional observations, comments and photo log Owner/Operator Representative (Optional) UIC Inspector Anthony Shelton Name:_______________________________________________ Name: ______________________________________________ Signature: ___________________________________________ Signature: _A_N__T_H_O__N_Y__S__H_E__L_T_O__N__D_a_te_: 2_0_22_.0_1._14_1_0:_41_:3_6_-0_5'_00_' ____ Digitally signed by ANTHONY SHELTON Version 2018-04-18 CAROL CHEN Digitally signed by CAROL CHEN Date: 2022.01.13 17:53:52 -05'00' Inspector Carl Weller's signature: _________________________ Inspector Carol Chen's signature: _________________________ Inspection ID Field Measurements and Observations (Cont.) Class I and II Well Inspection Form US Environmental Protection Agency - Region 4 Underground Injection Control Program EPA Well ID#: Year-Month-Day: 2 0 2 1 - 1 1 - 1 8 61 Forsyth Street SW, MC 9T25, Atlanta, Georgia, 30303 EPA Permit # (or RA): Phone: (404)562-9424 Page 2 Of 2 (Cont) __C_i_ty__o_f_L_a_u__re__l _(C__O_L_)_6__-3__#_3_______________________________________________________________________ _____________________________________________________________________________________________________ _T_e_a__m_'_s_c_o__m_m__e_n_t_s__o_n__P_e_t_ro__H__a_rv_e__s_te_r_'_s_o_n__-s_i_te__o_p_e_r_a_t_i_o_n_s_:______________________________________________ _W__e__In__s_p_e_c_t_e_d__8_w__e_l_ls__th__a_t_d_a_y_,_w__it_h__a_t_o_t_a_l_o_f__9_p__e_o_p_l_e_. _4__fr_o_m___P_e_t_ro__H__a_rv_e__s_te_r_,_2__f_r_o_m__M__S_O_G__B__a_n_d__3__E_P_A_.__ __A_ll_t_h_e__lo__c_a_ti_o_n_s__w_e__w_e__re__o_n__d_u_r_i_n_g_I_n_s_p_e__c_ti_o_n_,_w__e_r_e_f_e_n_c_e_s__a_n_d__g_a_t_e_d__w_i_t_h_C__h_a_i_n_l_in_k__, _ta__ll_p_l_a_n_k__o_r_v_e_r_y_____ __s_t_y_li_s_h__b_ri_c_k__fe_n__c_in_g_.__A_ll_t_h_e__P_u_m__p_i_n_g__U_n_i_ts__a_n_d__I_n_je__c_ti_o_n__P_u_m__p_s__w_e_r_e__o_f_h_i_g_h__q_u_a_l_it_y_a_n__d_o__p_e_r_a_te__d_a__lm__o_s_t__ _s_i_le_n__tl_y_. _T_h_e__E_m__p_lo__y_e_e_s_w__e_r_e_p__o_li_t_e_. _L_o_c_a_t_io__n_s_s_e_e__m_e__d_t_o__b_e__k_e_p_t_c_l_e_a_n__a_n_d__o_r_g_a_n_i_z_e_d_.____________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ (TA status: inactive 2 years or more. IN status: inactive less than 2 years. PBTD: Plug back total depth - not total well depth) _____________________________________________________________________________________________________ Photo Log Photographer: ___________C_a_r_l_W__e_ll_e_r __________________EPA Camera ID: SX8123 ______________________________________ Photo ID: _______1_1_1________Time: __1_2_:_5_8__p_m___ Lat (N): ______3_1_._6_9_6_3_6________ Long (W) ______-_8_9_._1_4_1_2_4________ At the well site, the annulus gauge reads 425 psi. Altitude 121 Description: ___________________________________________________________________________________________ Photo ID: _______1_1_2________Time: __1__2_:5_9__p_m___ Lat (N): ______3_1_._6_9_6_3_5________ Long (W) ______-_8_9_._1_4_1_2_7________ Description: ____T_h_e_t_u_b_i_n_g_g_a_u_g_e__re__a_d_s_4_2_5__p_s_i_s_h_o_w_i_n_g_i_n_je_c_t_io_n__p_r_e_s_su__re_.___________A_l_ti_tu_d__e_1_2_1__________________ 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: ___________________________________________________________________________________________ Owner/Operator Representative (Optional) UIC Inspector Name:_______________________________________________ Name: ______A_n__th_o_n_y__S_h_e_lt_o_n___________________________ Signature: ___________________________________________ Signature: _A_N__T_H_O__N__Y__S_H__E_L_T_O__N__D_a_te_: 2_0_22_.0_1_.14_1_0_:4_2:_10_-0_5_'0_0'____ Digitally signed by ANTHONY SHELTON Version 2018-04-18 CAROL CHEN Digitally signed by CAROL CHEN Date: 2022.01.13 17:54:28 -05'00' Inspector Carl Weller's signature: _________________________ Inspector Carol Chen's signature: _________________________