HomeMy WebLinkAboutR. J. bellerve Inc._4.5.21Section 8: Oil We 11 Inspection
Lease:
Well No.:
Location:
Date Completed:
�to
BAKE RSFIELD FIRE DEPT,
:Prevention Services
21,101 H Street
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
Page I of I
OPERATION C V COMMENTS
Repbrtab1eH.az-Mat. on-Site (Business. Plan requirement)
Well location 26feet from Tanks or Sources
Well Location 75 Feet from Dedicated Public Street
Well Location 1.00, Feet from Miscellaneous Buildings
Well Location, 300 Feet from Public A I s.sernbly Building
No Well Discharge to Drainage Canals, etc.
On the ground within 25 feet of
No Combustible Waste Well Site or Tanks
Sumps, Less Than=12 Feet Wide and Fenced
Blowout Prevention in Place
Signs Properly Posted
Proper Fire Protection on Site
SPECIAL CONDITIONS:
COMMENTS.*
Ile- Ut U')V_'AV' Qck'e
L&4%z� 72 J 31 UL;o0T"_1z7U1
Inspector:
Q_
Questions regarding this. inspection? Please call us at (661) 326-3979
C = Compliance V = Violation
Well Site Responsible Party
White — Prevention Services Pink - Business Copy I'D 2161 (Rev. 03/19)
OIL WELL SAFETY PROGRAM
OIL WELL INSPECTION
FIELD NOTES
Qf P ARC
BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
P7
White — Prevention Services Pink - Business Copy
Page of
FD 2080 (Rev. 03/19)
LEASE SITE INFORMATION:
.DATE COMPLETED INSPECTION:
(� 1
LEASE:
_
WELL #:
LOCATION:
te, I
ADDRESS:
CITY:
ZIP CODE:
CONTAC PERSON s
NAME:
PHONE N09,7 � CELL NO.:
'i NAME:
PHONE NO.:
Corp .
CELL NO.:
60 )
--A�57
NAME:
PHONE NO.:
CELL NO.:
WELL NAME(s):
PUMPING
NOT PUMPING
(�I� One)
(CAPABLE)
FEE �
(� One)
YES
YES ❑
(.,F
Qs
EE
2
YES ❑
YES ❑
FEE
3
YES ❑
YES O
FEE
4
�^
YES ❑
YES ❑
FEE
5
l J�
YES ❑
YES 1:1
FEE
6
�j
T
1 JS
YES 1:1
YES E]
FEE
7
YES ❑
YES ❑
FEE
8
*
�
YES ❑
YES ❑
-e--:2LC\ \0�0
FEE
9
V V JV I
YES ❑
YES ❑
FEE
10
VVC� �YES
G
YES ❑
l5� �p'�
FEE
YES D
YES ❑
FEE
12
YES ❑
YES ❑
FEE
TOTAL # OF WELLS
4
White — Prevention Services Pink - Business Copy
Page of
FD 2080 (Rev. 03/19)