Document eBJx0qDMM0Nrxnvjp8KNO3d4

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 5 5 Year-Month-Day: 2 0 2 2 - 0 9 - 1 3 EPA Permit # (or RA): 5 2 3 A Page 1 Of 2 Inspector(s): Jason Rose ___________________ (lead), Page Cirillo_____________________________ Start Time: 9:39 AM ____ ____________________________________, ____________________________________ End Time: 9:57 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 & #: St. Regis Paper Company #13-3 Well Type (see table): Enhanced Recovery (EOR) ________________________ State Permit: API # 0911320041 _________ Latitude (N): 30.8545N ________________ Longitude (W): -87.102597W ___________ Elevation (ft): NA _________ Injection Method (check applicable): Casing Injector; Tubing & Packer; Cemented Injection Tubing PBTD 16,143' Other: __________________________________________________________________ Total Depth (ft): 16,325' ___ Inner Casing Size (in): 7" ______ Tubing Size (in): 3.5"______ Packer Depth (ft): 15,550' _ Inj. Zone: Open Hole; Perforated; Top(ft): 15,732'_ Bottom(ft): 15,823' ____ Max. Injection Pressure (psig): 2,500 psi Field Measurements and Observations Latitude (N): 30.854564 N______________ Longitude (W): -87.102568 W ___________ Elevation (ft): NA _________ EPA GPS ID: PG No. 3358766066 Well Status (see table): SI If not Active, Reported Date Last Active: 2017 Operator did not provide specific date. _________________________________________ Nature of Injected Fluid(s) if any: __________________________________________________________________________ General Condition of the Well Site: _________________________________________________________________________ _____________________________________________________________________________________________________ Notes & Comments (include discrepancies from database values): ______________________________________________________ DEP indicated that this well is inactive, after having failed an MIT test in 2017. The site was clean and well-maintained. There was no evidence of leaks or excessive corrosion. Perfs (see well schematics): 15732'-15789' GR (Added Mar-75) 15790'-15800' GR (Dec-71) 1_5_8_0_9_'_-_1_5_8_2__3_' _G_R__(A_d__d_e_d_M__a_r_-7_5_)________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ 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 5 5 Year-Month-Day: 2 0 2 2 - 0 9 - 1 3 EPA Permit # (or RA): 5 2 3 A Page 2 Of 2 (Cont) ________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ Photo Log Photographer: Jason Rose ____________________________EPA Camera ID: PG camera ID no. 14 S/N:31029537 _______ Photo ID: 1 _______________Time: 9:40 AM ____ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking south, St. Regis Paper Company #13-3 sign alongside access road.__________________________ Photo ID: 2 _______________Time: 9:41 AM ____ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking southwest, site overview showing well head, pressure gauges, valves, and access stairs._______ Photo ID: 3 _______________Time: 9:42 AM ____ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking west, closeup view of surface pressure gauge reading 0 psi. _______________________________ Photo ID: 4 _______________Time: 9:43 AM ____ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking east, closeup view of production casing pressure gauge reading 0 psi._______________________ Photo ID: 5 _______________Time: 9:43 AM ____ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking down, closeup view of line pressure gauge reading 0 psi. __________________________________ Photo ID: 6 _______________Time: 9:43 AM ____ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking south, closeup view of internal pressure gauge reading 0 psi. ______________________________ 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: St. Regis Paper Company #13-3: September 13, 2022 Photograph 1: Looking south, St. Regis Paper Company #13-3 sign alongside access road. Page 1 of 6 Photograph 2: Looking southwest, site overview showing well head, pressure gauges, valves, and access stairs. Page 2 of 6 Photograph 3: Looking west, closeup view of surface pressure gauge reading 0 psi. Page 3 of 6 Photograph 4: Looking east, closeup view of production casing pressure gauge reading 0 psi. Page 4 of 6 Photograph 5: Looking down, closeup view of line pressure gauge reading 0 psi. Page 5 of 6 Photograph 6: Looking south, closeup view of internal pressure gauge reading 0 psi. Page 6 of 6