FIR 1 - INSPECTION REPORT

Permit Holder: Max Extract Technologies, LLC Well Name/No: ES 12485 Permit: 28244
Lease Name: ES 12485 1-33 Sec: 33 Twp: 12N Range 26W
GPS Well Location: Latitude: 35.65716 Longitude: -93.75645 Field: ROCK CREEK  
Lease/Tank Battery: Latitude: 35.65713 Longitude: 93.75657 County: FRANKLIN  
Entrance from nearest 911 address, public street or highway Low Bridge Road (US Forestry Road)
Status:
Well equipment operational: Equipment plumbed properly: Excess equipment on lease:
Signs: At lease entrance:
At tank battery:
At well:
Signage compliance:

NoTypeConstructionSizeLeaksRemarks
1Fluids TankFiberglassOther Size 6' round x 8' h = 40 bbls
2SeparatorSteel Welded   

Tank Containment:
Dimensions: Length: 0 Width: 0 Diameter: 10 Height: 5 Capacity (bbls): 70
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:
Producing, containment is approx 1/2 full with storm water, clean location.

Inspected by: DAYMON BLOUNT   Date:  5/28/2019 9:41:00 AM
Review for NNC or NOV:
If yes, check one
Ref #: Date: __________
ADEQ referral:
Date of referral:  __________