Document pewp982aZjbOKD9D2rNDqe9kD
Inspection ID
Facility Contact Information
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 2 2 Year-Month-Day: 2 0 2 3 - 0 3 - 2 9
EPA Permit # (or RA): N O N E
Page 1 Of 2
Carol Chen
Start Time: 11:06 am
End Time: 11:10 am
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 Name & #: Well Type (see table): Latitude (N):
J. F. Shell #20-1
Enhanced Oil Recovery (EOR)
30.9518512
Longitude (W):
API No. 0911320019 PA No. 311579
State Permit:
-87.17535298
OG_483
Elevation (ft):
Injection Method (check applicable): Casing Injector; X Tubing & Packer; Cemented Injection Tubing
PBTD: 15902'
Other:
surface casing 10" @ 3748'
Lower BHA Baker: 15419'
Total Depth (ft): 15993' Inner Casing Size (in):
Tubing Size (in):
Upper BHA Arrowdrill B: Packer Depth (ft): 15354'
Inj. Zone: Open Hole; X Perforated; Top(ft) 15600' Bottom(ft): 15750' Max. Injection Pressure (psig):
Latitude (N):
30.95185189
Longitude (W):
-87.1753538
Elevation (ft):
EPA GPS ID: SX8123 Well Status (see table): SI
If not Active, Reported Date Last Active: 1/25/22
Nature of Injected Fluid(s) if any:
General Condition of the Well Site:
Well Data from File
Field Measurements and Observations
Notes & Comments (include discrepancies from database values): Maximum Injection Pressure: 7500 psi N, 4400 psi PW
This well failed a mechanical integrity test on 1/25/22.
Perforations (Smackover Formation):
15600' to 15646' (4SPF) , 9/08/2012
Tubing gauge:
0 psi
15675' to 15707' (4SPF), 9/07/2012 15707' to 15717' (4SPF), 6/28/1974 15740' to 15750 (4SPF), 6/28/1974
Production gauge Surface gauge:
0 psi 0 psi
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: 2023.05.17 10:11:46 -04'00'
Name:
Carol Chen
CAROL CHEN Digitally signed by CAROL CHEN Date: 2023.05.15 12:54:14 -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 2 2 Year-Month-Day: 2 0 2 3 - 0 3 - 2 9
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
174
Time: 11:07 am
EPA Camera ID:
Lat (N): 30.95185189
SX8123
Long (W)
-87.1753538
photo of sign, posted directly on the well, shows closest GPS location
175
Time: 11:07 am Lat (N): 30.95185185
Long (W) -87.1753542
second photo of the well
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: 2023.05.17 10:12:15 -04'00'
UIC Inspector
Name: Carol Chen
Signature: CAROL CHEN Date: 2023.05.15 12:54:44 -04'00' Digitally signed by CAROL CHEN
Version 2018-04-18