FIR 1 - INSPECTION REPORT

Permit Holder: First Ascent Operating, LLC Well Name/No: Forshee, W H Permit: 13521
Lease Name: Forshee, W H 1 Sec: 32 Twp: 18S Range 14W
GPS Well Location: Latitude: 33.11354 Longitude: -92.56342 Field: HIBANK  
Lease/Tank Battery: Latitude: 0 Longitude: 0 County: UNION  
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 is in operational condition at the time of inspection. Flowline is ran on top of the ground from the well to the tank which is all on location.

Inspected by: ERIC FERRELL   Date:  6/19/2018 10:40:00 AM
Review for NNC or NOV:
If yes, check one
Ref #: Date: __________
ADEQ referral:
Date of referral:  __________