FIR 1 - INSPECTION REPORT

Permit Holder: Smith, Roger G Well Name/No: Troy Tokio Unit Permit: 27976
Lease Name: Troy Tokio Unit 23 Sec: 4 Twp: 14S Range 20W
GPS Well Location: Latitude: 33.54871 Longitude: -93.17823 Field: TROY  
Lease/Tank Battery: Latitude: 0 Longitude: 0 County: NEVADA  
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
No Vessels Found For This Inspection

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:
Well presents with casing, tubing and rods. Flow line is connected with no leaks. There is no concrete slab or pumping unit on site. Casing and tubing is secured with valves. Rods are secured with clamp bolt. Well is inactive and shut in.

Inspected by: RONNIE KENNEDY   Date:  11/7/2017 9:33:00 AM
Review for NNC or NOV:
If yes, check one
Ref #: Date: __________
ADEQ referral:
Date of referral:  __________