Document VjXQpKwejkrGajDLv8J7J9Gjo
Inspection ID
Facility Contact Information
Well Data from File
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#: N O N Year-Month-Day: 2 0 2
EPA Permit # (or RA):
Carol Chen
E 3 -03 NO N E
Page 1
Start Time:
End Time:
- 28
Of 2
11:13 am 11:17 am
Facility Name: Street Address: City:
Black Creek Energy, LLC
4940 Blackjack Plant Rd.
Jay
County:
Santa Rosa
Nature of Business:
Oil and gas production
Facility Owner/Operator:
Black Creek Energy, LLC
Email:
Mike Wetzel <mikew2859@gmail.com>
Facility Contact (if different):
Michael Wetzel
O/O Mailing Address: 140 Virginia Street, Suite 302
City:
Richmond
County:
N/A
State: FL
Zip:32565-9260
Phone: 601-431-5386 Phone: 850-324-6271
State: VA Zip: 23219
Well Name & #: St. Regis Paper Company (SRPC) #24-1B
Well Type (see table):
Producer
Latitude (N):
30.84666667
Longitude (W):
API No. 0911320071 PA No. 309820
State Permit:
30.84666667
OG_ 555B
Elevation (ft):
Injection Method (check applicable): Casing Injector; X Tubing & Packer; Cemented Injection Tubing
PBTD: 15920' Total Depth (ft): 16144'
Other: srfc csg 10" @ 4185'
Inner Casing Size (in):
Tubing Size (in):
Packer Depth (ft): cement packer 14880'
Inj. Zone: Open Hole; X Perforated; Top(ft) 15744' Bottom(ft): 15786' Max. Injection Pressure (psig):
Latitude (N):
30.84675
Longitude (W):
-87.09422
Elevation (ft):
EPA GPS ID: SX8123 Well Status (see table): NI If not Active, Reported Date Last Active:
Nature of Injected Fluid(s) if any:
General Condition of the Well Site:
Notes & Comments (include discrepancies from database values):
Temporarily Plugged and Abandoned (TPA) on 2/17/1998.
NI: Not an injection well
Tubing gauge:
0 psi
Production gauge:
0 psi
Surface gauge:
0 psi
Field Measurements and Observations
Mechanical integrity test passed on 9/20/2021, has cement plug at 14880'.
See reverse for additional observations, comments and photo log
UIC Inspector
UIC Inspector
Name: Signature:
Carl E. Weller
CARL WELLER (Affiliate)
Digitally signed by CARL WELLER (Affiliate) Date: 2023.05.11 14:51:57 -04'00'
Name: Carol Chen
CAROL CHEN Date: 2023.05.11 14:27:39 -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#: N O N E Year-Month-Day: 2 0 2 3 - 0 3 - 2 8
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
145
Time: 11:00 am Lat (N): 30.84718
Long (W)
-87.09395
sign posted (both signs for OG_555A and OG_555B)
147
Time: 11:14 am Lat (N):
30.84675
Long (W)
-87.09422
photo of producer
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
UIC Inspector
Name: Signature:
Carl E. Weller
Digitally signed by CARL WELLER
CARL WELLER (Affiliate) (Affiliate)
Date: 2023.05.11 14:52:23 -04'00'
Name: Carol Chen
CAROL CHEN Digitally signed by CAROL CHEN Date: 2023.05.11 14:28:14 -04'00'
Signature:
Version 2018-04-18