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HomeMy WebLinkAboutSJFM_OIL WELL ENFORCEMENT 2019_2020010610551664• B A K E R S F I E L D Development Services Department Jacquelyn R. Kitchen, Development Services Director Phil Burns, Building Director Kevin F. Coyle, Planning Director Building Division "Facilitating the Future of Bakersfield" Planning Division Phone: (661) 326 -3720 Phone: (661) 326 -3681 October 29, 2018 San Joaquin Facilities Management Inc. Attn: Kenneth S. Gregg, Production engineer 4520 California Ave. Suite 300 Bakersfield Ca. 93309 RE: City of Bakersfield - Drilling, Re- Drilling and Recovery of Oil, Gas and other Hydrocarbons Dear Mr. Gregg: Bakersfield Municipal Code (BMC) Chapter 15.66 (Drilling for and Production of Petroleum) provides local regulations for petroleum drilling and production. The intent and purpose is so these activities may be conducted in a manner that: (A) protects public health, safety and welfare; (8) conforms with established codes and regulations; (C) minimizes the potential impact to property and mineral rights owners; (D) encourages drill site consolidation; and (E) protects the quality of the environment. Pursuant to BMC Section 15.66.030, no person shall drill, operate or maintain any well or well site for petroleum, natural gas, or related drilling, nor operate or maintain any production operation without first obtaining a permit. Applications for drilling /production permits shall be made in writing to the director of prevention services, or designee, on such forms as provided by the director. Permits are classified as follows: Class 1. The well site and /or production operation is: 1. Within an area zoned for residential development; or 2. Located less than five hundred feet from a dwelling except those for use by a caretaker or night security on the same parcel, or public assembly as defined in BMC Section 15.66. Class 2. The well site and /or production operation is: 1. Within an area zoned for commercial, light manufacturing or open space; or 2. Located between five hundred and one thousand feet from a dwelling unit except those for use by a caretaker or night security on the same parcel, or public assembly as defined in BMC Section 15.66, provided no well or related structure for production is located less than five hundred feet from said uses. Class 3. The well site and /or production operation is: 1. Within an area zoned for general manufacturing, heavy manufacturing, or agricultural, or is within the primary floodplain pursuant to the restrictions in subsection (B)(1) of BMC Section 15.66, or the secondary floodplain, provided no well or related structure for production is located less than five Building I Inspection I Code Enforcement Planning I Economic and Community Development City of Bakersfield • 1715 Chester Avenue • Bakersfield, California • 93301 Page 12 of 2 hundred feet from a dwelling except those for use by a caretaker or night security on the same parcel, or public assembly as defined in BMC Section 15.66; or 2. Located within the state approved boundaries of the following state designated oil fields as defined by the state Division of Oil, Gas and Geothermal Resources ( "D.O.G.G.R. "), regardless of the zone district or distance from dwellings or public assembly uses as defined in BMC Section 15.66: I. Kern River Oil Field (D.O.G.G.R. Map 457), ii. Kern Bluff Oil Field ( D.O.G.G.R. Map 439), ill. Portion of the Fruitvale Oil Field encompassing Sections 14 (west of State Highway 99), 21 (south of Meany Avenue), 22 (except Tracts 6003 and 6042), 23 (west of State Highway 99), 26 (north of the Cross Valley Canal and west of State Highway 99), 27 (north of the Cross Valley Canal), and 28 (east of the Friant -Kern Canal), all within T29S, R27E (D.O.G.G.R. Map 435); 3. An area zoned DI (drilling island district) zone or PE (petroleum extraction combining district) zone. Class 1 permits shall not be issued until a conditional use permit is granted by the board of zoning adjustment ( "B.Z.A. ") pursuant to BMC Chapter 17.64 (Modif /cations, Conditional Use Permits, Amendments and Appeals), except that a conditional use permit shall not be required for any well on a lot within an approved tentative or recorded subdivision map that is specifically identified as a drill site for the extraction of petroleum, gas, and /or other hydrocarbons. Any conditions required under the conditional use permit shall be in addition to those imposed by BMC Section 15.66 for a Class 1 permit. The B.Z.A. may modify any condition set forth in the development standards and conditions if it determines that there will be no material detriment to the public welfare or safety of persons and property located within a reasonable distance of such a well. Attainment of permits pursuant to BMC Chapter 15.66 does not relieve the applicant of the responsibility in obtaining permits as required by law from other local, state or federal agencies. All required federal, state, county, and city rules and regulations shall be complied with at all times including, but not limited to, the rules and regulations of the following agencies: 1. Division of 011, Gas and Geothermal Resources; 2. City of Bakersfield fire department; 3. Kern County health department; 4. Regional Water Quality Control Board; S. San Joaquin Valley Unified Air Pollution Control District. The director of prevention services, or designee, may, in writing, suspend or revoke a permit issued under the provisions of BMC Chapter 15.66 whenever the permit is issued in error based on incorrect information supplied by the applicant, which results in there being a violation of any ordinance, or regulation or any of the provisions of said chapter. In summary, Bakersfield Fire Department Drilling Permits are for drilling new holes, including but not limited to going into an existing well, and then whipstocking a sidetrack or horizontal well from what was originally a vertical well. It should be noted that "workovers and stimulation" conducted after the well is completed are deemed maintenance; no Bakersfield Fire Department Drilling Permit is required for maintenance work. Sincerely, PaulJOhnson Principal Planner Attachment: FD2075 (0312018) s. \counter opemuwsVwrr, oMinance and Interptealions \OII Drill Permits \WM Lenar.doa City of Bakersfield • 1715 Chester Avenue • Bakersfield, California • 93301 Gavin Newsom, Governor California Da.id awn, Director Department of Conservation 801 K Sacramento, A 5814 Savemento, CA 95814 Division of Oil, Gas, and Geothermal Resources T: (916) 445 -9686 8/30/2019 API: 0403066737 Permit No.: 7010766 Kenneth Gregg San Joaquin Facilities Management, Inc. 4520 California Avenue, Suite 300 Bakersfield, CA 93309 -1190 Dear San Joaquin Facilities Management, Inc., The Division has received your Notice of Intention to New Drill dated 08116/2019 for Red Ribbon Ranch 72A, 1301284 bond, Fruitvale field, Sec. 27, T. 29S, R. 27E, MD BBM, Kern County. Your Notice of Intention has been reviewed by our division in conjunction with records currently held by our office. Please review all categories below as statuses may have changed since submission. Form ID 60440 Approved by Matt Stikes Senior Oil R Gas Engineer for Cameron D. Campbell District Deputy Engineer: Tho Tu Direct: (661) 334 3678 Office: (661) 322 4031 DECISION: THE NOTICE OF INTENTION IS APPROVED PROVIDED THAT: 1. Hole fluid of a quality and in sufficient quantity to control all subsurface conditions in order to prevent blowouts shall be used. 2. Blowout prevention equipment, as defined by this Division's publication No. M07, shall be installed and maintained in operating condition and meet the following minimum requirements: a. Class IIA 2M, with hydraulic controls, on the 9 5/8" casing. b. Class II 2M, with hydraulic controls, on the 5 1/2" casing. c. A 2M lubricator for wireline operations. 3. The 16 ", 9 5/8 ", and 5 1/2" casings are cemented with sufficient cement to fill behind the casing from the shoe to the surface (5 1/2" from cp to surface). 4. A directional survey shall be made and fled with this division within 60 days of completion of drilling. 5. No program changes are made without prior Division approval. Gavin Newsom, Governor California David Bunn, Director DeDepartment of Conservation 901 KStreet, P Sacramento, CA A 955914 814 Division of Oil, Gas, and Geothermal Resources T: (916) 445 -9686 NOTE: 1. Hole fluid disposal must comply with Regional Water Quality Control Board regulations. 2. This permit is for an oil or gas activity within the scope of the analysis set forth in the final environmental document(s) prepared and approved by the California Division of Oil, Gas, and Geothermal Resources (Division) as Lead Agency. The Division has considered the environmental document(s) and the analysis therein, made findings regarding the proposed oil or gas activity to any extent necessary, and issues this permit in the capacity as a Lead Agency with expertise in the activity(ies) authorized by this permit. The environmental document(s) and notice(s) filed with the State Clearinghouse can be found on the Division's website at http: / /www.consemation.ca.gov/ dog /CEQA /Pages /CEQANotices.aspx/ If you have any supplemental questions, please contact your nearest DOGGR office or visit us at www.consewation.c-a.gov/dog. Sincerely, Cameron D. Campbell District Deputy CC People: CC Organizations: A copy of this permit and the proposal must be posted at the well site prior to commencing operations. Records for work done under this permit are due within 60 days after the work has been completed or the operations have been suspended. California Department of Conservation At,, Division of Oil, Gas, and Geothermal Resources 9/25/2019 API: 0403066875 Permit No.: 7011343 Kenneth Gregg San Joaquin Facilities Management, Inc. 4520 California Avenue, Suite 300 Bakersfield, CA 93309 -1190 Dear San Joaquin Facilities Management, Inc., Gavin Newsom, Governor David Bunn, Director 801 KStreei. MS 18-05 Sacramento. CA 95814 T: (916) 445.9686 The Division has received your Notice of Intention to New Drill dated 08/26/2019 for Red Ribbon Ranch 37B, 1301284 bond, Fruitvale field, Sec. 27, T. 29S, R. 27E, MD B &M, Kern County. Your Notice of Intention has been reviewed by our division in conjunction with records currently held by our office. Please review all categories below as statuses may have changed since submission. CRITICAL WELL Form ID 61710 Approved by Matt Stikes Senior Oil & Gas Engineer for Cameron D. Campbell District Deputy Engineer: Tho Tu Direct: (661) 334 3678 Office: (661) 322 4031 DECISION: THE NOTICE OF INTENTION IS APPROVED PROVIDED THAT: * ** —NOTE: THIS PERMIT CONTAINS SIGNIFICANT VARIATIONS ON YOUR PROPOSAL. PLEASE READ CAREFULLY BEFORE PROCEEDING WITH WORK. ** 1. This well is designated a CRITICAL WELL and as such, it must comply with section 1724.3 of the California Code of Regulations. 2. Hole fluid of a quality and in sufficient quantity to control all subsurface conditions in order to prevent blowouts shall be used. 3. Blowout prevention equipment, as defined by this Division's publication No. M07, shall be installed and maintained in operating condition and meet the following minimum requirements: a. Class 1116 3M, with hydraulic controls, on the 9 5/8" casing. b. A 3M lubricator for wireline operations. Gavin Newsom, Governor California David Bunn, Director Department of Conservation Sa ment street. MS 18 14 p Sacramento, CA 95814 Division of Oil, Gas, and Geothermal Resources T: (916) 445 -9686 4. The 14" and 9 5/8" casings are cemented with sufficient cement to fill behind the casing from the shoe to the surface. 5. A directional survey shall be made and filed with this division within 60 days of completion of drilling. 6. Zone isolation cement plugs shall use cement that has a minimum compressive strength of 1000 psi and a maximum liquid permeability of 0.1 md. 7. The placement of a cement plug in offset well "Red Ribbon Ranch" 37 -A (API No. 029 - 08134) will be executed from intercept well "Red Ribbon Ranch" 37B. 8. For isolation of the the Base of Freshwater and the lower portion of the offset well, sufficient cement shall be squeezed into the cavity shot at 3100'- 3090' True Vertical Depth (TVD) to fill to 3870' (TVD), and the well is plugged with cement from 3100' to 2500' (TVD). 9. THIS DIVISION SHALL BE NOTIFIED TO: a. Witness a test of the installed blowout prevention equipment prior to drilling out the shoe of the 9 5/8" casing. b. Witness the clean -out depth at 3100' (TVD) executed in offset well "Red Ribbon Ranch" 37 -A. c. Witness the cavity shot at 3100' -3090' (TVD). d. Witness the cement squeeze below 3100 -3090' (TVD) into offset well "Red Ribbon Ranch" 37 -A. e. Witness the location and hardness of the cement plug at 2500' to verify isolation of the base of Freshwater and the lower portion of the offset well. 10. No program changes are made without prior Division approval. NOTE: 1. Hole fluid disposal must comply with Regional Water Quality Control Board regulations. 2. This permit is for an oil or gas activity within the scope of the analysis set forth in the final environmental document(s) prepared and approved by the California Division of Oil, Gas, and Geothermal Resources (Division) as Lead Agency. The Division has considered the environmental document(s) and the analysis therein, made findings regarding the proposed oil or gas activity to any extent necessary, and issues this permit in the capacity as a Lead Agency with expertise in the activity(ies) authorized by this permit. The environmental document(s) and notice(s) filed with the State Clearinghouse can be found on the Division's websfte at http: / /www.consemation.ca.gov/ dog /CEQA /Pages /CEQANotices.aspxl 3. This permit does not grant approval from this office to sidetrack this well. A separate notice to sidetrack must be submitted and approval received prior to any sidetracking operations. 4. Geologic marker depth: Base of Freshwater 3050' (TVD). Gavin Newsom, Governor California David Bunn, to.CA 5814 Department of Conservation 501 Kstrain. MS 18 -05 Sacramento, CA 95814 Division of Oil, Grp I Geothermal Resources T: (916) 445 -9656 If you have any supplemental questions, please contact your nearest DOGGR office or visit us at www.conservation.ca.gov/dog. Sincerely, Cameron D. Campbell District Deputy CC People: CC Organizations: A copy of this permit and the proposal must be posted at the well site prior to commencing operations. Records for work done under this permit are due within 60 days after the work has been completed or the operations have been suspended. Gavin Newsom, Governor California David Shabazian Director 801 K Streel, MS 18 -05 Department of Conservation Sacramento, GA 95814 Division of 011, Gas, and Geothermal Resources T: (916) 445 -9686 PERMIT TO CONDUCT WELL OPERATIONS Old New FIELD CODE 256 256 AREA CODE 9 9 POOL CODE - 0 Dec 12, 2019 API No.: 0403066875 -01 Permit No.: 7012808 Kenneth Gregg San Joaquin Facilities Management, Inc. 4520 California Avenue, Suite 300 Bakersfield, CA 93309 -1190 The Division has received your Notice of Intention to Sidetrack dated 12112/2019 for well "Red Ribbon Ranch" 37B, API No. 0403066875 -, 1301284 bond, Fruitvale field, Sec. 27, T. 29S, R. 27E, MD B &M, Kem County. Your Notice of Intention has been reviewed in conjunction with records currently held by the Division. CRITICAL WELL Convert to Oil & Gas Form ID 83486 Approved by Matt Stikes Senior Oil & Gas Engineer for Cameron D. Campbell District Deputy Engineer: Tho Tu Direct: (661) 334 3678 Office: (661) 322 4031 DECISION: THE NOTICE OF INTENTION IS APPROVED PROVIDED THAT: 1. Blowout prevention equipment, as defined by this Division's publication No. M07, shall be installed and maintained in operating condition and meet the following minimum requirements: a. Class IIIB 3M, with hydraulic controls, on the 9 5/8" casing. b. Class II 3M, with hydraulic controls, on the 5 1/2" casing (if applicable). c. A 3M lubricator for wireline operations. 2. The 5 1/2" casing is cemented with sufficient cement to fill behind the casing from the casing port collar at 3600' to the surface. 3. THIS DIVISION SHALL BE NOTIFIED TO: Gavin Newsom, Gowerncr California David Shabazian. Director 801 K Street, MS 18-05 Department of Conservation Sacramento, CA 95814 Division of Oil, Gas, and Geothermal Resources 7; (916) 445-9686 a. Inspect the installed blowout prevention equipment prior to commencing completion operations. 4. In all other respects, the operations are to be conducted in accordance with provisions outlined in Permit No. 7011343, dated 9125/2019. 5. No program changes are made without prior Division approval. If you have any questions, please contact the appropriate Division office or visit us at www.conseNation.ca.gov/dog. Sincerely, Cameron D. Campbell District Deputy CC People: CC Organizations: A copy of this permit and the proposal must be posted at the well site prior to commencing operations. Records for work done under this permit are due within 60 days after the work has been completed or the operations have been suspended. California ft Department of Co u ervation on cee a feomermel aesnurc 1 NATURAL RESOURCES AGENCY OF CALIFORNIA DEPARTMENT OF CONSERVATION DIVISION OF OIL, GAS, AND GEOTHERMAL RESOURCES CALIFORNIA ENVIRONMENTAL QUALITY ACT CEQA OPERATOR CHECKLIST The purpose of this form is to assist the Division of Oil, Gas, and Geothermal Resources ( "DOGGR ") in determining its Agency Role and the type of environmental review that DOGGR must conduct for a proposed project under the California Environmental Quality Act ('CEQA"). This form also serves to assist Operators in understanding the CEQA review process for proposed projects, including the information and documents DOGGR typically needs, along with the NO] or Application, to comply with CEQA. To expedite the CEQA review process, please submit this forth, answering all questions as completely as possible, and the documents identified in this form, FOR DOGGR USE ONLv to the extent applicable, when submitting the NOI or Application. Proposed projects received NONAPPLIOAMNJ PROJECTM: by DOGGR without this form completed will require longer time periods for processing as DOGGR seeks the information referred to by this Checklist through other means. Instructions on how to complete this form are located at the end of the document. For additional information, you may access the CEQA Webpage at http.Aw . conservation.ca.gov /dog/CEQA. I. APPLICANT INFORMATION OPERATOR CONSULTANT DATE: M12=19 COUNTY: Kem CITY: Bakemfeld DOGGR DISTRICT: Company: San Joaquin Facilllies Management ,Inc. Company: Address: 4520 California Ave. Suite 300 Atltlress: Bakersfield, CA 93309 ❑ Development Contact: Ken Gregg Context ❑ NORTHERN ❑ COASTAL INLAND ❑ $ODTHERN Title: Engineer Title: Phone: 661 -371 -2688 Phone:❑ Email: kgregg@sfmmac,r cam Email: INFORMATION ❑O Oil & Gas ❑ WST ❑ Geothermal ❑ Exploratory ❑ Development ❑ UGS ❑ UIC ❑New Drill ❑ Rework/Deepen /Sidetrack ❑ Abandon /Re- Abandon ❑ Supplementary Notice ❑ New Drill ❑ Rework/Supplementary ❑ Abandon ❑ New Project ❑ Modify Existing ❑ Merge Two Projects ➢ Approved Project #s: SURFACE OWNERSHIP' MINERAL OWNERSHIP' Private O State ❑ Federal ❑ Agency Name: Private 0 State ❑ Federal ❑ Agency Name: 'N ' DOGGR ODES NOT 00 A TITLE SEARCH', THIS INFORMATION ONLY HELPS IDENTIFY THETYPE OF CEQA REVIEW TO BE CONDUCTED. Revined4.8.2019 CEQA Operator Checklist 1 III, DOCUMENTATION of CEQA COMPLIANCE LEAD AGENCY INFORMATION: Did the Local Agency prepare an Environmental Document for this Project? YES (DOGGR maybe the Responsible Agency) ❑ Permit was Issued, and an environmental document (ND, MND, EIR) was prepared for this project; or ❑ Permit was issued, and the project is within the scope of a prior environmental document © NO (DOGGR maybe the Lead Agency). The Local Agency found this activity to be ... ❑ Exempt; and/or ❑ Permit was issued, but no environmental document was prepared; or 0 No permit was issued i Permit is not required Y If NO permit or NOE available, provide evidence of communication with the local agency below • Contact Name: Paul Johnson Phone #: 661 - 852 -7509 • Date of Conversation: Standing letter for projects within the City of E and/or Email: pjohnson @bakersfieldeity.us provide Local or State CEQA Lead Agency and Federal NEPA Lead Agency mJormaoon below, as appucome: D CEQA Lead Agency ❑ NEPA Lead Agency Local or State Division of Oil, Gas & Geothermal Resources Agency Name: Federal Agency Name: Address: 801 K Street, MS 18 -05 Address: Sacramento, CA 95814 -3530 Contact Name: Department of Conservation Headquarters Contact Name: Title: CEQA Unit Title: Phone: 91 &322 -0732 Phone: Email: DOGGR _Headquartem@wnsewaffon.cagov Email: ENVIRONMENTAL REVIEW DOCUMENTATION: If o Local Agency (or another State Agency) is the CEQA LEAD AGENCY, complete the information below: ❑ CEQA Project: Project Title: ❑ ND ❑ MIND ❑ EIR CEQA Documentation: Subsequent ❑ Supplement ❑ Addendum ❑ Substitute Document ❑ State Clearinghouse (SCH) #: Date EIR Certified a, NDNND Adopted: Novemberg,2015 Type of CEQA Notice: ❑ NOD j ❑ Exempt: ❑ NOE or ❑ Resolution If a Federal Agency is the NEPA LEAD AGENCY, complete the information below: NEPA Project #: ❑ Project: NEPA Project Title: ❑ CX ❑ DNA ❑ EA/FONSI Date of Decision Record: NEPA Documentation: Federal Register Notice #: ❑ EIS Publication Date: _Date_ of Record of Decision (ROD): _ ❑ Review Documentation: There is no documentation available to verify that a CEQA or No Environmental NEPA environmental review was conductedforthis project. aeviu :4.8.2019 CEOA Operator Checklist IV. SUPPORTING DOCUMENTS Revised: 4.8.2019 Ci operator Checklist Document PDF weblink URt Documents typically needed for CEQA review of A. each NOI / Application submittal, include: 1. CEQA Operator Checklist (completed)❑ N/A 2. Indemnity Agreement(signed) ❑ N/A 3. Project Description 0 N/A Documents typically needed for CEQA review B. if DOGGR is Responsible Agency, also include: 4. Approved Local Permit for Project ❑ ❑ $. CEQA Documents (approved ND /N0, or carol EIR) ❑ ❑ ➢ Operator to identify page Its in the CECA document that indicate proposed project is within its scope ... S. CEQA Notice (stamped copy filed with SCH) ♦ Notice of Determination (NOD) ❑ ❑ C. Additional Information (asappiicaaie>: 7. Exemption CEQA Notice of Exemption (NOE) ❑ ❑ (stamped copy) or 0 Local Resolution: Project and exemption approval ❑ ❑ by BOS or City Council ):.... _ 8. NEPA Documents (final EN'ONSI U : lOD) ❑ ❑ ➢ Operatorto identify specific page Ns in the CEQA Enter Page us here : document that indicate proposed project is within its scope ... 9. Toxicity Data (for WST projects) ❑ ❑ 10. CEC Substitute Document r- , . ... :........ ❑ ❑ ➢ Operatorto identify page Ms in the CEQA documentthat Enter Page us here: indicate proposed project Is within its scope ... 11. MMRP — Mitigation Monitoring & Reporting Program ❑ ❑ 12. CEQA Environmental Document Filing Fees NED or Fee required by CDFW (F &GC711.4) only when DOGGR is Lead Agency and files a NOD. Submitted to ❑ N/A DOGGR later & must accompany NOD when filed at SCH. ♦ No Effect Determination (NED) ... or ♦ Check for CEQA Filing Fee N/A N/A ( See CDFW webpage for further information at: hap // Idlfeca ov /Conservaton/CEOA/Fees) Revised: 4.8.2019 Ci operator Checklist V. PROJECT DESCRIPTION Project Name: Red Ribbon Ranch 37B and Red Ribbon Ranch 72A Applicant Name: San Joaquin Facilities Management, Inc. Project Proposal: Project is drilling two all and gas wells known as Red Ribbon Ranch 37B, and Red Ribbon Ranch 72A, using standard drilling practices, within the existing fully disturbed area of Fruitvale oil field. Red Ribbon Ranch 37B (New Drill) NO] Type: New Drill Field: Fruitvale Estimated Total Depth: 4500' Red Ribbon Ranch 72A (New Drill) NO[ Type: New Drill Field: Fruitvale Estimated Total Depth: 4550' Project Location: Fruitvale oil field - Red Ribbon Ranch 37B and Red Ribbon Ranch 72A City of Bakersfield Fruitvale Field, Section 27, T 29S, R 27E; Base Meridian: MD Environmental Setting: Incorporated City, Commercial, Established oil field Local Agency Requirements: City of Bakersfield - Development Services Dept. issued a standing letter from projects within the City of Bakersfield. Revised 4 &2019 CEOA operator Checklist Revised: 4.6.2019 CEO Operator ChecklIst API No. Well Name Date Filed. with DOGGR 1 RRR 37B 8/1212019 2 RRR 72A 811212019 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Revised: 4.6.2019 CEO Operator ChecklIst VII. CHECKLIST INSTRUCTIONS By completing & submitting this Checklist to DOGGR, you are declaring the information therein is accurate & true, to the best of yaurknowledge I. Applicant Information Date: Enter date submitted. County: Enter county where proposed project will be located and check the appropriate DOGGR District. City: Enter the city where the proposed project is located. Only add if the project is located in an incorporated area. Operator & Consultant: Enter name and contact information. rrogram: cnecx me nox(es) for me type of program under which the permit(s) is being applied for: ❑ Oil & Gas (O &G) ❑ Geothermal: Exploratory wells or ❑ UGS (Underground Gas Storage) ❑ Well Stimulation (WST) Development (in existing field) ❑ UIC (Underground Injection Control) Activity: Check the boxes) associated with each program for the type of activity the permit(s) is being applied for ❑ New Drill — drill new well for 08G production, observation /monitoring, injection, storage, or geothermal. ❑ Rework/Deepen/Sidet rack — modifcations/convereon of an existing well ❑ Abandon /Re abandon —Plug & Abandonment (P&A) of a company -owned well ❑ Supplementary — information added to already approved permits) ❑ Under UGS or UIC Activity: if project has been previously approved, enter project or PAL # after the space provided. Surface Ownership & Mineral Ownership: Check boxes to indicate ownership for the resource being extracted, both above and below ground. If the surface or mineral rights are owned by the State of California, check the State box and provide the State Agency or Department that has ownership. If the surface or mineral rights are owned by the federal government, check the Federal box, and provide the Federal Agency that has ownership [e.g., BLM, USFS, USFWS, NIPS, DOD, BOEM]. III. Documentation of CEQA Compliance LEAD AGENCY INFORMATION: Operator should contact the Local Agency (or State Agency other than DOGGR) to verify whether a CEGA environmental document (ND, MIND, EIR) was prepared for the project (may be written specifically for this project, or within the scope of a prior environmental document). This information is necessary for DOGGR to determine its CEQA Agency Role: Lead or Responsible. Based on this and other information provided on this form, answer the question in this box: "Did the Local Agency prepare an Environmental Document for this ProjectT' ❑ By marking 'YES', this means the Local Agency or another State Agency (other than DOGGR, such as SLC, DEC, CPUC) has prepared an environmental document, and DOGGR may conduct its CEQA review as the Responsible Agency. Provide name & contact information for the CEQA Lead Agency in box below. Continue to 'Environmental Review Documentation" in Section III of this form. ❑ By marking'NO', this means the Local Agency did not prepare an environmental document, and DOGGR may conduct its CEQA review as the Lead Agency. There may be situations when the Local Agency determines the proposed project is exempt and still issues a permit — if so, check both the "Exempt" and "Permit was issued, but no environmental document was prepared" boxes. If project was determined to be exempt, provide a copy of the date- stamped NOE, or local resolution approving the exemption if a NOE was NOT fled. To expedite DOGGR's CEQA review process, please provide information to verify communication with the Local Agency if no permit was issued — provide name, phone If and/or email of staff person contacted, and date of communication. Communication may also be demonstrated by providing a copy of the NOE or an approved local permit (or approvals by another name, such as "job card' or 'zoning clearance "). If activity requires federal permitting and compliance with NEPA (National Environmental Policy Act), identify & provide contact information for the NEPA Lead Agency in box below — this could be a Federal agency such as BUM, USFS, USFWS, NIPS, DOD, BOEM. ENVIRONMENTAL REVIEW DOCUMENTAION: CEQA documentation: Provide Project Title (name of CEQA document); type of CEQA documentation & Notice, and other information requested. If an EIR is submitted, include Responses to Comments, Findings, & Statement of Overriding Considerations. NEPA documentation: Provide Project Title (name of NEPA document) and NEPA Project #; type of NEPA documentation; and other information requested. For EIS only — Federal Register Notice #, publication date, and date of ROD. • CEQA Acronyms: Environmental Impact Report (EIR); Initial Study (IS), Midgated Negative Declaration (MIND), Negative Declaration (ND), Notice of Determination (NOD), Notice of Exemption (NOE), State Clearinghouse (SCH), Substitute Document (CA Energy Commission EIR equivalent); • NEPA Acronyms: Categodo d Exemption (CX), Environmental Assessment (EA), Environmental Impact Statement (EIS), Finding of No Significant Impact (FONSI), Federal Register (FR), and Record of Decision (ROD) • ARencv Acronyms: State Lands Commission (SLC); CA Energy Commission (CEC); CA Public Utilities Commission (PUC); Bureau of Law Management (BLM), US Forest Service (USFS), US Fish and Wildlife Service (PNS), National Park Service (NIPS), Department of Defense (DOD). Bureau of Ocean Energy Management (BOEM) No Environmental Review Documentation: Mark this box if the "No' box is marked at the tap of Section III, and there is no environmental document and no exemption notice or paperwork. Revised: 48.3019 CEQA Operator Checklist IIV. Supporting Documents Check the boxes for documents submitted with this Checklist for DOGGR's CEQA review. URL's maybe added in WeIISTAR under the Form Submit step, under comments. Please provide Copies of applicable documents associated with the proposed project (PDF or weblink). A. Items ( #1 -3): Documents necessary for DOGGR to conduct its CEQA review — submit with every NOI or Application. B. hems (#4.6): Documents necessary for DOGGR to conduct its CEQA review — submit only when DOGGR is the Responsible Agency. C. Items (#7.12): Documents that may apply to your project, due to specific activity types or other circumstances — submit if applicable. V. Project Description The project description Is the stamng point for every project mat must unaergo a Gallmarma enwronmentai Uuallry Act (ULUA) environmental review at DOGGR. Its purpose is to provide basic information for DOGGR to: determine its CEQA agency role; identify potential environmental impacts resulting from the proposed activity; determine appropriate level of environmental analysis (exemption determination or type of environmental document to prepare); and identify any additional information that may be needed during the environmental review. It must be written in a narrative format that is clear and use simple language where practical. A full and complete project description may be required for environmental review. For examples, please visit the CEQA Project webpage to view project descriptions in past environmental documents prepared for projects approved by DOGGR. Example project descriptions for different activities are also available at the end of this document. To the extent applicable, include the following information on the proposed project. • Project Name • Applicant Name • Project Proposal: Provide a statement of objectives describing the purpose of the project, including description of project activity, project type, and DOGGR action(s) requested for the proposed project (e.g., issue new drill permit, WST permit, UIC project approval letter, or Combination thereof). Describe activities for each phase of the proposed project, including duration and equipment needed. Include descriptions of associated Construction, if any, for temporary and permanent facilities (e.g.; well pad, flowlines, new/widening of access road(s), power poles, etc.). Describe the area in acres that would be disturbed from project activity (temporary and permanent); proposed water use including quantity, source, and method of transportation (e.g.; truck, pipeline, etc.); transportation required (for water, chemicals, equipment, workers, and waste; number of vehicles trips required and vehicle miles); and disposition of all waste materials including the facility where waste would be properly managed (e.g.; reuse, recycle, disposal). Discuss whether the project would result in an increase in production, thereby requiring expansion of associated facilities (e.g., product processing capacity, addition or expansion of flowlines, addition of flares, steam generation capacity, etc.). Identify any BMPs proposed as part of the project intended to avoid or reduce any potential impacts) to the environment that may result from this project • Project Location: Identify city and /or county, latitude/longitude, section township /range, oil field name, well name(s), and the size of the project (in acres); and identify whether the proposed well(s) is located inside or outside of a designated oil field boundary established on or before April 5, 1973. • Environmental Setting: Describe the current physical environmental Conditions at the project location and the surrounding land use(s) (e.g., agricultural, residential, commercial, established oil field, or other industrial). • Local Agency Requirements: Discuss briefly the local zoning and presence or absence of permits required by the local agency for the proposed activity. • Aerial Photos /Maps: Include photos and/or maps of the project vicinity and project boundary that includes all activities related to the proposed project A. Project Well List List the API #, if applicable, Well Name, and date the NO1 or permit application was (or will be) filed with DOGGR. List only NOls or permit applications currently being submitted to DOGGR. Potential future projects should not be included. Addtonal pages can be added as necessary. This Checklist and other CEOA forms can be found on DOGGR's CEQA website at: http,//www.consemation.ca.gov/doq/CEQA Revised: 4S.2019 CEOA Operator Checklist