FIR 1 - INSPECTION REPORT

Permit Holder: Delone, M S Well Name/No: Clark Permit: 17780
Lease Name: Clark 1 Sec: 24 Twp: 17S Range 12W
GPS Well Location: Latitude: 33.21655 Longitude: -92.28763 Field: BENJAMIN LAKE  
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:
All equipment needed to produce fluids was present and in working order. All equipment was secured and no leaks or spills were present at the time of my inspection. No field related issues were noted at the time of my inspection. The well was not producing at the time of my inspection.

Inspected by: BILLY HANEY   Date:  11/30/2023 5:07:00 PM
Review for NNC or NOV:
If yes, check one
Ref #: Date: __________
ADEQ referral:
Date of referral:  __________