FIR 1 - INSPECTION REPORT

Permit Holder: Black Hills Energy Arkansas, Inc. Well Name/No: Crockett Permit: 35161
Lease Name: Crockett 2-21 Sec: 21 Twp: 10N Range 28W
GPS Well Location: Latitude: 35.52549 Longitude: -93.97596 Field: LONE ELM  
Lease/Tank Battery: Latitude: 35.52558 Longitude: 93.97626 County: FRANKLIN  
Entrance from nearest 911 address, public street or highway Lone Elm Road
Status:
Well equipment operational: Equipment plumbed properly: Excess equipment on lease:
Signs: At lease entrance:
At tank battery:
At well:
Signage compliance:

NoTypeConstructionSizeLeaksRemarks
1SeparatorSteel Welded   
2SeparatorSteel Welded   

Tank Containment:
Dimensions: Length: 0 Width: 0 Diameter: 0 Height: 0 Capacity (bbls): 0
Capacity compliance: Breaches/Erosion: Excessive vegetation present: Compliance agreement:
Containment Conditions: Fluids Present:
Well Site Compressor:
Is it in compliance?
Trash/Debris:
Use as storage area:
Unusual equipment:
Excessive erosion:
If yes to any, explain:
Entry Gate Present:
  Gate locked on arrival:
Gate locked on departure:
Is spill or discharge of drilling, completion or produced fluids present:
 
If yes, did spill or discharge of drilling, completion or produced fluids occur or travel off the well pad:
(If yes, complete FIR 5)
Compliance Summary Remarks:
Location is a storage well, ground work is being conducted on location, clean location shared with Limerock 3-21.

Inspected by: DAYMON BLOUNT   Date:  1/12/2021 1:16:00 PM
Review for NNC or NOV:
If yes, check one
Ref #: Date: __________
ADEQ referral:
Date of referral:  __________