FIR 1 - INSPECTION REPORT

Permit Holder: Quanico Oil & Gas, Inc Well Name/No: Kelly Permit: 31064
Lease Name: Kelly 5 Sec: 9 Twp: 17S Range 14W
GPS Well Location: Latitude: 33.25508 Longitude: -92.55426 Field: CHAMPAGNOLLE  
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 present with casing only. Concrete slab has been pushed away from the well. No identification is present at the well. Excess vegetation is present around the well.

Inspected by: ERIC FERRELL   Date:  6/21/2018 4:10:00 PM
Review for NNC or NOV:
If yes, check one
Ref #: Date: __________
ADEQ referral:
Date of referral:  __________