FIR 1 - INSPECTION REPORT

Permit Holder: Faulconer, Vernon E, Inc Well Name/No: Hogrefe Permit: 24243
Lease Name: Hogrefe 1 Sec: 22 Twp: 9N Range 21W
GPS Well Location: Latitude: 35.41657 Longitude: -93.21865 Field: ROSS  
Lease/Tank Battery: Latitude: 0 Longitude: 0 County: POPE  
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
1Fluids TankFiberglass100  

Tank Containment:
Dimensions: Length: 25 Width: 21 Diameter: 0 Height: 2 Capacity (bbls): 187
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:
In compliance. No chart to show production, so reporting not producing.

Inspected by: JIMMY WIEDOWER   Date:  7/18/2016 11:40:00 AM
Review for NNC or NOV:
If yes, check one
Ref #: Date: __________
ADEQ referral:
Date of referral:  __________