FIR 1 - INSPECTION REPORT

Permit Holder: Wel-Tes, Inc Well Name/No: Owens Permit: 26943
Lease Name: Owens 2 Sec: 18 Twp: 5N Range 30W
GPS Well Location: Latitude: 35.10488 Longitude: -94.23782 Field: WITCHERVILLE  
Lease/Tank Battery: Latitude: 0 Longitude: 0 County: SEBASTIAN  
Entrance from nearest 911 address, public street or highway HWY 252
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:
Property owned by Mr. Sparkman. His home is located in NE corner of property at the corner of HWY 252 and Top Fork Rd. Walk-in access to site only, Mr. Sparkman has gate locked with personal lock. Well is located 90' SW of second cross-fence gate. 1' tall 7 5/8" casing with welded cap is all that is present at site.

Inspected by: MICHAEL PASSMORE   Date:  3/23/2016 10:31:00 AM
Review for NNC or NOV:
If yes, check one
Ref #: Date: __________
ADEQ referral:
Date of referral:  __________