FIR 1 - INSPECTION REPORT

Permit Holder:	Dews, Dossie			Well Name/No:	Bank	Permit:	33720
Lease Name:	Bank 1	Sec:	19	Twp:	16S	Range	26W
GPS Well Location:		Latitude:	33.35436	Longitude:	-93.83991	Field:	CHRISTMAS
Lease/Tank Battery:		Latitude:	0	Longitude:	0	County:	MILLER
Entrance from nearest 911 address, public street or highway

Status:

Completing New not producing Operating Old not producing Not found

Single well pad Mutiple well pad NA

Well equipment operational:	Equipment plumbed properly:	Excess equipment on lease:
Yes No NA	Yes No NA	Yes No

Signs:

At lease entrance:

Yes No

At tank battery:

Yes No NA

At well:

Yes No NA

Signage compliance:

Yes No

Tank Containment:

Earthen Metal ring Tank in tank No Tanks Other

Dimensions:

Length:

0

Width:

0

Diameter:

0

Height:

0

Capacity (bbls):

0

Capacity compliance:		Breaches/Erosion:		Excessive vegetation present:			Compliance agreement:
Yes No NA		Yes No NA		Yes No NA			Yes No NA

Containment Conditions:

Fluids Present:

Yes No

Produced fluids Storm water Waste oil NA Other

Well Site Compressor:

Yes No

Is it in compliance?

Yes No NA

Trash/Debris:	Yes No	Use as storage area:	Yes No	Unusual equipment:	Yes No	Excessive erosion:	Yes No
If yes to any, explain:

Entry Gate Present:

Yes No

Gate locked on arrival:

Yes No

Gate locked on departure:

Yes No

Is spill or discharge of drilling, completion or produced fluids present:					Yes No
If yes, did spill or discharge of drilling, completion or produced fluids occur or travel off the well pad:								Yes No NA	(If yes, complete FIR 5)
Compliance Summary Remarks:
Well and pumping unit are present. Flow line is connected with no leaks. Motor is missing from unit. Power supply is in the off position. Well is inactive and shut in.

Inspected by:	RONNIE KENNEDY				Date:  2/14/2017 10:02:00 AM
Review for NNC or NOV:	Yes No	If yes, check one	NNC NOV DNI NA	Ref #:	Date: __________
ADEQ referral:	Yes No	Date of referral:  __________