Document om1q4Mw3LkywaVykwwobDVky3

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 1 0 Year-Month-Day: 2 0 2 2 - 0 9 - 1 3 EPA Permit # (or RA): 7 2 8 Page 1 Of 2 Inspector(s): Jason Rose ___________________ (lead), Page Cirillo_____________________________ Start Time: 10:40 AM___ ____________________________________, ____________________________________ End Time: 10:52 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 & #: W.W. Foskett #25-N Well Type (see table): Enhanced Recovery (EOR) ________________________ State Permit: API # 0911320136 _________ Latitude (N): 30.833716N______________ Longitude (W): -87.0953W _____________ Elevation (ft): NA _________ Injection Method (check applicable): Casing Injector; Tubing & Packer; Cemented Injection Tubing PBTD 16,018' Other: __________________________________________________________________ Total Depth (ft): 16,120' ___ Inner Casing Size (in): 7" ______ Tubing Size (in): 3.5"______ Packer Depth (ft): 15,700' Inj. Zone: Open Hole; Perforated; Top(ft): 15,958'_ Bottom(ft): 15,992' ____ Max. Injection Pressure (psig): 2,500 psi Field Measurements and Observations Latitude (N): 30.833734 N______________ Longitude (W): -87.095360 W ___________ Elevation (ft): NA _________ EPA GPS ID: PG No. 3358766066 Well Status (see table): AC _______ If not Active, Reported Date Last Active: __________________ Nature of Injected Fluid(s) if any: __________________________________________________________________________ General Condition of the Well Site: The site is clean and well maintained. There was no evidence of leaks or excessive ___ corrosion. The access stairs are not stable, could use some repairs/upgrades to ensure safety of personnel. ___________ Notes & Comments (include discrepancies from database values): ______________________________________________________ The internal pressure gauge was reading 1,750 psi. The surface casing pressure gauge was reading 80 psi. The operator suggested that this is likely due to the thermal expansion of the fluids above the top of cement due to having been shut in for a long period, then being recently reactivated. The operator indicated this is not indicative of an MI issue, because the production casing pressure still reads 0 psi. Perfs (see well schematics): 4 SPF 15958-66' GRM (1974-08) & 15966-92' added (1976-07) _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ 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 1 0 Year-Month-Day: 2 0 2 2 - 0 9 - 1 3 EPA Permit # (or RA): 7 2 8 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: 10:41 AM ___ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking south, W.W. Foskett #25-N sign alongside access road. ___________________________________ Photo ID: 2 _______________Time: 10:48 AM ___ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking north, site overview, showing well head, pressure gauges, valves, and access stairs. __________ Photo ID: 3 _______________Time: 10:49 AM ___ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking west, closeup view of surface pressure gauge reading 0 psi. _______________________________ Photo ID: 4 _______________Time: 10:49 AM ___ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking north, closeup view of production casing pressure gauge reading 0 psi. _____________________ Photo ID: 5 _______________Time: 10:49 AM ___ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking south, view of incoming line pressure gauge reading 1,520 psi._____________________________ Photo ID: 6 _______________Time: 10:50 AM ___ Lat (N): NA __________________ Long (W): NA___________________ Description: Looking west, view of internal presure gauge reading 1,750 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 W.W. Foskett #25-N: September 13, 2022 Photograph 1: Looking south, W.W. Foskett #25-N sign alongside access road. Page 1 of 6 Photograph 2: Looking north, 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 80 psi. Page 3 of 6 Photograph 4: Looking north, closeup view of production casing pressure gauge reading 0 psi. Page 4 of 6 Photograph 5: Looking south, view of incoming line pressure gauge reading 1,520 psi. Page 5 of 6 Photograph 6: Looking west, view of internal presure gauge reading 1,750 psi. Page 6 of 6