FIR 1 - INSPECTION REPORT

Permit Holder: XOG Operating, LLC Well Name/No: Kersey Permit: 38178
Lease Name: Kersey 1 Sec: 32 Twp: 10N Range 24W
GPS Well Location: Latitude: 35.48495 Longitude: -93.56733 Field: UNION CITY  
Lease/Tank Battery: Latitude: 0 Longitude: 0 County: JOHNSON  
Entrance from nearest 911 address, public street or highway
Status:
Well equipment operational: Equipment plumbed properly: Excess equipment on lease:
Signs: At lease entrance:
At tank battery:
At well:
Signage compliance:

NoTypeConstructionSizeLeaksRemarks
1Fluids TankFiberglass50 7' x 7'
2Separator    
3Dehy Unit    
4Other Tanks    

Tank Containment:
Dimensions: Length: 20 Width: 20 Diameter: 0 Height: 1.8 Capacity (bbls): 128
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:
Site in compliance.

Inspected by: DEREK GOODMAN   Date:  11/29/2023 9:53:00 AM
Review for NNC or NOV:
If yes, check one
Ref #: Date: __________
ADEQ referral:
Date of referral:  __________