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INSPECTIONS Section 8: Oil Well Inspection Lease: al Well No.: Location: Date Completed: ed BAKERSFIELD FIRE DEPT, Prevention Services 21 b 1 H Street Bakersfield, CA 933,01 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page I of I �N I �_ l u(??2 C = Compliance V = Violation SPECIAL CONDITIONS: Dr I COMMENTS: Inspector: Well Site Responsible Party Questions regarding this inspection? Please call us at (661) 326-3979 White — Prevention Services I Pink -'Business Copy FD 2161 (Rev. 03119) OIL WELL SAFETY PROGRAM OIL WELL INSPECTION FIELD NOTES BAKERSFIELD FIRE DEPT. Prevention Services 2101 H Street Bakersfield, CA 93301 Tel.: (661) 326 -3979 Fes: (661) 852 -2171 N 1 t I o12Z-?- White - Prevention Services Pink - Business Copy Page of FD 2080 (Rev. 03/19) LEASE /SIT INFORMATION: AL .DATE COMPLETED INSPECTION: LEASE: ,-- WELL #: OCATION: ADDRESS: CITY: ZIP CODE: CONTACT PERSON(s): NAME: PHONE N`7 -6 310 0 CELL NO.: NAME: PHONE NO.: CELL NO.: NAME: PHONE NO.: CELL NO.: WELL NAME(s): PUMPING NOT PUMPING (v� One) (CAPABLE) FEE (� One) 1 CJ1U� YES ❑ YES � FEE t 2 Ve� CA-41-V �O� YES YES e�c FEE 3 YES ❑ YES ❑ FEE 4 YES ❑ YES ❑ FEE 5 YES ❑ YES ❑ FEE 6 YES ❑ YES ❑ FEE 7 YES ❑ YES ❑ FEE $ YES ❑ YES ❑ FEE 9 YES ❑ YES ❑ FEE 10 YES ❑ YES ❑ FEE 11 YES ❑ YES ❑ FEE 12 YES ❑ YES ❑ FEE TOTAL # OF WELLS White - Prevention Services Pink - Business Copy Page of FD 2080 (Rev. 03/19) OIL WELL SAFETY PROGRAM OIL WELL INSPECTION FIELD NOTES BAKERSFIELD FIRE DEPT Prevention Services 2101 H Street Bakersfield, CA 93301 ... Tel.: (661) 326 -3979 Fes: (661) 852 -2171 �`-T � 3 White — Prevention Services Pink - Business Copy Page of FD 2080 (Rev. 03/19) LEASE / SITE INFORMATION: .DATE COMPLETED INSPECTION: r. r Ja ?CLS)d LEASE: WELL #: LOCATION: ADDRESS- '"` f CITY: ZIP CODE: C NTACT PERSON s : NNW- - NAME: ;PHONE NO.: �. �- � - 6.36 CELL NO.: NAME: PHONE NO.: CELL NO.: NAME: PHONE NO.: CELL NO.: WELL NAME(s): PUMPING NOT PUMPING a6iL (�l One) (CAPABLE) FEE AN (� One) YES ❑ YES ❑ � .4 - F E E r or YES ❑ YES ❑ t FEE 3 YES ❑ YES ❑ FEE 4 YES ❑ YES ❑ FEE 5 YES ❑ YES ❑ FEE 6 YES ❑ YES ❑ FEE 7 YES ❑ YES ❑ FEE 8 YES ❑ YES ❑ FEE 9 YES ❑ YES ❑ FEE 10 YES ❑ YES ❑ FEE 11 YES ❑ YES ❑ FEE 12 YES ❑ YES ❑ FEE TOTAL # OF WELLS White — Prevention Services Pink - Business Copy Page of FD 2080 (Rev. 03/19)