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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 EPA Well ID#: F L S 1 1 3 0 0 0 2 Year-Month-Day: 2 0 2 2 - 0 9 - 1 3 EPA Permit # (or RA): 7 2 9 Page 1 Of 2 Inspector(s): Jason Rose ___________________ (lead), Page Cirillo_____________________________ Start Time: 8:50 AM ____ ____________________________________, ____________________________________ End Time: 9:05 AM_____ Facility Contact Information Facility Name: Blackjack Plant ____________________________________________________________________________ Street Address: 4940 Blackjack Plant Road _________________________________________________________________ City: Jay ____________________________ County: Santa Rosa _____________________ State: FL _____ Zip: 32535 ___ Nature of Business: Oil and gas production__________________________________________________________________ Facility Owner/Operator: Black Creek Energy, LLC ____________________________ Phone: (601) 431-5386 __________ Email: harris.butler@butlerroyals.com ______________________________________________________________________ Facility Contact (if different): Michael Wetzel ___________________________________ Phone: (850) 324-6271 __________ O/O Mailing Address: 140 Virginia Street, Suite 402 __________________________________________________________ City: Richmond ______________________ County: NA_____________________________ State: VA _____ Zip: 23209 ___ Well Data from File Well Name & #: D.M. Kirkland #11W Well Type (see table): Enhanced Recovery (EOR) ________________________ State Permit: API # 0911320135 _________ Latitude (N): 30.871768N______________ Longitude (W): -87.119786W ___________ Elevation (ft): NA _________ Injection Method (check applicable): Casing Injector; Tubing & Packer; Cemented Injection Tubing PBTD 15,890' Other: __________________________________________________________________ Total Depth (ft): 16,010' ___ Inner Casing Size (in): 7" ______ Tubing Size (in): 3.5"______ Packer Depth (ft): 15,690' _ Inj. Zone: Open Hole; Perforated; Top(ft): 15,847'_ Bottom(ft): 15,873' ____ Max. Injection Pressure (psig):2,500 psi Field Measurements and Observations Latitude (N): 30.871772 N _____________ Longitude (W): -87.119735 W __________ Elevation (ft): NA _________ EPA GPS ID: PG No. If not Active, Reported Date Last Active: 2017 Operator did notprovide (see table): SI 3358766066 Well Status specific day. _________________________________________ Nature of Injected Fluid(s) if any: __________________________________________________________________________ General Condition of the Well Site: ___ _____________________________________________________________________________________________________ Notes & Comments (include discrepancies from database values): DEP indicated that there was a known pressure communication between the tubing and production casing of this well and that the well hasn't been active since 2017. DEP indicated that the well was shut in and there are plans to plug and abandon the well. Internal pressure reading was 1,850 psi. Production casing pressure was 1,600 psi. The surface casing pressure was 0 psi. Perfs (see well schematics): 15847-15873' GR 4 SPF 8/12/74 _____________________________________________________________________________________________________________________________________________________________________ _ The site is clean and well maintained. There was no evidence of leaks or excessive corrosion. _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ See reverse for additional observations, comments and photo log Owner/Operator Representative (Optional) UIC Inspector Name: Cliff Emmons ___________________________________ Name: Jason Rose ____________________________________ Signature & Date: see attached field notes ________________ Signature & Date:__________________________1_0_/_2_6_/_2_2____ Version 2018-04-18 Inspection ID Field Measurements and Observations (Cont.) 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 EPA Well ID#: F L S 1 1 3 0 0 0 2 Year-Month-Day: 2 0 2 2 - 0 9 - 1 3 EPA Permit # (or RA): 7 2 9 Page 2 Of 2 (Cont) ________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ Photographer: Jason Rose ____________________________EPA Camera ID: PG camera ID no. 14 S/N:31029537 _______ Photo ID: 1 _______________Time: 8:50 AM ____ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking east, D.M. Kirkland #11-W sign alongside access road. ____________________________________ Photo ID: 2 _______________Time: 8:52 AM ____ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking south, closeup view of surface casing pressure gauge reading 0 psi. ________________________ Photo ID: 3 _______________Time: 8:53 AM ____ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking south, closeup view of production casing pressure gauge reading 1,600 psi. _________________ Photo ID: 4 _______________Time: 8:56 AM ____ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking south, closeup view of internal pressure gauge reading 1,850 psi. __________________________ Photo ID: 5 _______________Time: 8:58 AM ____ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking east, site overview, including well head, pressure gauges, valves, and access stairs. ___________ Photo Log Owner/Operator Representative (Optional) UIC Inspector Name: Cliff Emmons ___________________________________ Name: Jason Rose ____________________________________ Signature & Date: see attached field notes ________________ Signature & Date:__________________________1_0_/_2_6_/_2_2____ Version 2018-04-18 Site Photographs D. M. Kirkland #11-W: September 13, 2022 Photograph 1: Looking east, D.M. Kirkland #11-W sign alongside access road. Page 1 of 5 Photograph 2: Looking south, closeup view of surface casing pressure gauge reading 0 psi. Page 2 of 5 Photograph 3: Looking south, closeup view of production casing pressure gauge reading 1,600 psi. Page 3 of 5 Photograph 4: Looking south, closeup view of internal pressure gauge reading 1,850 psi. Page 4 of 5 Photograph 5: Looking east, site overview, including well head, pressure gauges, valves, and access stairs. Page 5 of 5