Document dGQLBBQ4aM17G1Z9ZOJRezLG
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
Inspector(s): Carl E. Weller
_ (lead),
,
EPA Well ID#: F L S 1 1 3 0 0 3 5
Year-Month-Day: 2 0 2 3 - 0 3 - 3 0
EPA Permit # (or RA): N O N E
Page 1 Of 2
Carol Chen
Start Time: 11:00 am
End Time: 11:13 am
Facility Contact Information
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 Data from File
Well Name & #: McDavid Lands #34-2
Well Type (see table): Enhanced Oil Recovery (EOR)
Latitude (N):
30.99152505
Longitude (W):
API No. 0911320027
PA No. 311582
State Permit:
-87.1631495
OG_498
Elevation (ft):
Injection Method (check applicable): Casing Injector; X Tubing & Packer; Cemented Injection Tubing
PBTD: 15564'
Other:
surface casing 10" at 3562'
Otis WB Packer
Total Depth (ft): 15677' Inner Casing Size (in):
Tubing Size (in):
Packer Depth (ft): @15060'
Inj. Zone: Open Hole; X Perforated; Top(ft) 15217' Bottom(ft): 15300' Max. Injection Pressure (psig):
Field Measurements and Observations
Latitude (N):
30.99153
Longitude (W): -87.16319
Elevation (ft):
EPA GPS ID: SX8123 Well Status (see table): SI If not Active, Reported Date Last Active:
Nature of Injected Fluid(s) if any:
General Condition of the Well Site: Notes & Comments: Maximum injection pressures: 7500 psi Nitrogen (N), 4400 psi Produced Water (PW)
Notes & Comments (include discrepancies from database values): T-disks were installed on both flowlines, N and PW, blocking all injection. Flowlines were also hand-checked for temperature. The gas line was not cold as usual during
injection. The PW flowline was not warm as usual during injection.
Perforations: 15217' to 15253' (4SPF) 11/15/1972 15264' to 15272' (4SPF) 01/28/1976 15282' to 15288' (4SPF) 01/28/1976 15288' to 15300' (4SPF) 11/15/1972
Tubing gauge:
1800 psi
Production gauge
0 psi
Surface gauge:
0 psi
This well passed a mechanical integrity test on 3/09/2023.
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: 2023.05.23 15:14:39 -04'00'
Name:
Carol Chen
CAROL CHEN Digitally signed by CAROL CHEN Date: 2023.05.22 11:44:43 -04'00'
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 5 Year-Month-Day: 2 0 2 3 - 0 3 - 3 0
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
198
Time: 11:00 am Lat (N): 30.99153
Long (W) -87.16319
close-up photo of the information sign posted on the injection well
199
Time: 11:00 am Lat (N): 30.99156
Long (W) -87.16322
photo of the injection well, several feet away
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: 2023.05.23 15:15:06 -04'00'
UIC Inspector
Name: Carol Chen
CAROL CHEN Date: 2023.05.22 11:45:14 -04'00' Digitally signed by CAROL CHEN
Signature:
Version 2018-04-18