Document qmd0Dz0mjd93R3wNeG1QXvj1j
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 Year-Month-Day: 2 0 2
EPA Permit # (or RA):
Carol Chen
1 1 30 05 5
3 - 0 3 - 28 F L I 0 029
Page 1 Of 2
Start Time:10:46 am End Time:10:52 am
Facility Name: Street Address: City:
Black Creek Energy, LLC
4940 Blackjack Plant Rd.
Jay
County:
Santa Rosa
Nature of Business:
Oil and gas production
Facility Owner/Operator:
Black Creek Energy, LLC
Email:
Mike Wetzel <mikew2859@gmail.com>
Facility Contact (if different):
Michael Wetzel
O/O Mailing Address: 140 Virginia Street, Suite 302
City:
Richmond
County:
N/A
State: FL
Zip:32565-9260
Phone: 601-431-5386 Phone: 850-324-6271
State: VA Zip: 23219
Well Name & #: St. Regis Paper Company (SRPC) #13-3
API No. 0911320041 PA No. 302383
Well Type (see table):
Enhanced Oil Recovery (EOR)
State Permit:
OG_ 523
Latitude (N):
30.85450534
Longitude (W):
-87.10260216
Elevation (ft):
Injection Method (check applicable): Casing Injector; X Tubing & Packer; Cemented Injection Tubing
PBTD: 16143'
Total Depth (ft):
16235'
Other: srfc csg 10" @ 4242'
Inner Casing Size (in):
Tubing Size (in):
Otis WB packer at 15550' Packer Depth (ft): Otis WB 15477'
Inj. Zone: Open Hole; X Perforated; Top(ft) 15732' Bottom(ft): 15823' Max. Injection Pressure (psig): 2500 psi
Latitude (N):
30.85457
Longitude (W):
-87.10264
Elevation (ft):
EPA GPS ID: SX8123 Well Status (see table): TA If not Active, Reported Date Last Active: 8/24/2017
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): This well is planned to be plugged and abandoned, final closure.
Perfs 15732' to 15789' (Mar-75)
Perfs 15790' to 15800' (Dec-71)
Tubing gauge:
25 psi
Perfs 15809 to 15823' (Mar-75)
Production gauge:
0 psi
Surface gauge:
0 psi
Injection well failed a mechanical integrity test on 8/24/2017.
Injection well passed a mechanical integrity test on 8/20/2015.
See reverse for additional observations, comments and photo log
UIC Inspector
UIC Inspector
Name: Signature:
Carl E. Weller
Digitally signed by CARL WELLER
CARL WELLER (Affiliate) (Affiliate)
Date: 2023.05.11 13:34:40 -04'00'
Name: Carol Chen
CAROL CHEN Date: 2023.05.10 19:47:43 -04'00' Digitally signed by CAROL CHEN
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 5 5 Year-Month-Day: 2 0 2 3 - 0 3 - 2 8
EPA Permit # (or RA): F L I 0 0 2 9
Page 2 Of 2
Field Measurements and Observations (Cont.)
Photo Log
Photographer: Photo ID: Description: Photo ID: Description:
Carl E. Weller
143
Time: 10:47 am
144
Time: 10:50 am
EPA Camera ID:
Lat (N):
30.85599
sign posted
Lat (N):
30.85457
photo of injection well
SX8123 Long (W) -87.10240
Long (W)
-87.10264
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:
Carl E. Weller
CARL WELLER
Signature: (Affiliate)
Digitally signed by CARL WELLER (Affiliate) Date: 2023.05.11 13:37:07 -04'00'
UIC Inspector
Name: Carol Chen
CAROL CHEN Date: 2023.05.10 19:48:12 -04'00' Digitally signed by CAROL CHEN
Signature:
Version 2018-04-18