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Inspector Name:AXELSON, JOHN <br /> Spills/Releases: <br /> Type of Spill: Description: Estimated Spill Volume: <br /> Comment: <br /> Corrective Action: Date: <br /> Reportable: GPS: Lat Long <br /> Proximity to Surface Water: Depth to Ground Water: <br /> Water Well: Lat Long <br /> DWR Receipt Num: Owner Name: GPS : <br /> Field Parameters: <br /> Sample Location: <br /> Emission Control Burner(ECB): <br /> Comment: <br /> Pilot: Wildlife Protection Devices(fired vessels): <br /> Reclamation-Storm Water-Pit <br /> Interim Reclamation: <br /> Date Interim Reclamation Started: Date Interim Reclamation Completed: <br /> Land Use: <br /> Comment: <br /> 1003a. Debris removed? CM <br /> CA CA Date <br /> Waste Material Onsite? CM <br /> CA CA Date <br /> Unused or unneeded equipment onsite? CM <br /> CA CA Date <br /> Pit,cellars, rat holes and other bores closed? CM <br /> CA CA Date <br /> Guy line anchors removed? CM <br /> CA CA Date <br /> Guy line anchors marked? CM <br /> CA CA Date <br /> 1003b. Area no longer in use? Production areas stabilized? <br /> 1003c. Compacted areas have been cross ripped? <br /> 1003d. Drilling pit closed? Subsidence over on drill pit? <br /> Cuttings management: <br /> 1003e. Areas no longer needed for drilling or subsequent operations for have been re-vegetated to 80%of pre-existing? <br /> Production areas have been stabilized? Segregated soils have been replaced? <br /> RESTORATION AND REVEGETATION <br /> Date Run: 711412014 Doc[#667500270] Page 3 of 5 <br />