Chaparral Energy Aerial Investigation/Right-of-Way Inspection Report

• Facility/Line Segment

• Conducted on

  Date

• Prepared by

• Location
  Address

Type of Report

• Aerial Field Investigation

• Right-of-Way Inspection

• Line Segment

• Reported By

• Date Reported

  Date

• Survey/Section

• County

• State

Line Markers (check all that apply)

• Well Marked

• Picture(s)

  Media

• Markers Need Paint

• Picture(s)

  Media

• Needed on ROW

• Picture(s)

  Media

• Needed on Road Crossing

• Picture(s)

  Media

• Other

• If "Other" please explain

• Picture(s)

  Media

Exposed Line (check all that apply)

• N/A

• Free Span

• Picture(s)

  Media

• In Field

• Picture(s)

  Media

• In Water

• Picture(s)

  Media

• In Ditch

• Picture(s)

  Media

• Other

• If "Other" please explain

• Picture(s)

  Media

Line Condition (check all that apply)

• N/A

• Heavy Rust

• Picture(s)

  Media

• Heavy Pitting

• Picture(s)

  Media

• Good Coating

• Picture(s)

  Media

• Light Rust

• Picture(s)

  Media

• Moderate Pitting

• Picture(s)

  Media

• Poor Coating

• Picture(s)

  Media

• Painted

• Picture(s)

  Media

• Other

• If "Other" please explain

• Picture(s)

  Media

ROW Conditions

Field Investigation

• N/A

• Person Contacted

• Address/Location

• Phone Number

• Actual Activity

Comments and Recommendations

• Employee Signature

  Sign

• Supervisor Signature

  Sign

• Date Supervisor Reviewed/Signed Report

  Date