FIR 1 - INSPECTION REPORT

Permit Holder: Cornerstone Energy, LLC Well Name/No: Williams Etal Permit: 27244
Lease Name: Williams Etal 2 Sec: 3 Twp: 17S Range 12W
GPS Well Location: Latitude: 33.27194 Longitude: -92.32169 Field: CAREYVILLE LANDING  
Lease/Tank Battery: Latitude: 0 Longitude: 0 County: BRADLEY  
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:
No identification. Rotary unit on well. Power off to motor.

Inspected by: JO COOK   Date:  11/27/2018 1:20:00 PM
Review for NNC or NOV:
If yes, check one
Ref #: Date: __________
ADEQ referral:
Date of referral:  __________