Chesapeake Energy Location Inspection Sheet

• Pad Name:

• Date:

  Date

• Frac Crew:

• Rig Crew:

• Flowback Company:

• Rouster Company:

• Containment Company:

• Inspection Completed By:

Erosion and Sediment Control

• Is silt fence maintained (< 50% covered with silt, gaps)?

  Yes

  No

  N/A

• Culverts in working order?

  Yes

  No

  N/A

• Erosion concerns on location?

  Yes

  No

  N/A

• Is entire location bermed?

  Yes

  No

  N/A

• Is the berm a minimum of 30"? If not, denote lowest height.

  Yes

  No

  N/A

• Is the location entrance 30" above pad level?

  Yes

  No

  N/A

• Is there standing water in the ditch line?

  Yes

  No

  N/A

• Are slopes 70% vegetated or otherwise stabilized?

  Yes

  No

  N/A

Impoundments

• Safety fencing around impoundment(s)?

  Yes

  No

  N/A

• 24" freeboard in impoundment?

  Yes

  No

  N/A

• Impoundment construction and liner sound?

  Yes

  No

  N/A

• Do freshwater impoundments have required signage?

  Yes

  No

  N/A

• Are there two life rings (one on fence, one in water)?

  Yes

  No

  N/A

• Are there two life vests on fence?

  Yes

  No

  N/A

Tanks, Containments and Cleanliness

• Are all openings and valves on tanks plugged?

  Yes

  No

  N/A

• Are all containments free of fluid accumulations?

  Yes

  No

  N/A

• Are all containment berms and liners secured?

  Yes

  No

  N/A

• Are there any visible holes or suspected leaks?

  Yes

  No

  N/A

• Are tanks properly labeled?

  Yes

  No

  N/A

• Are all tanks bonded together?

  Yes

  No

  N/A

• Is the bonded tank system grounded?

  Yes

  No

  N/A

• Is location or access road exceptionally muddy?

  Yes

  No

  N/A

• Is county road clean?

  Yes

  No

  N/A

• Is Spill Cleanup Kit on location?

  Yes

  No

  N/A

• Are any spills or stains present?

  Yes

  No

  N/A

• If yes, is cleanup underway?

  Yes

  No

  N/A

• Cellar pumped out and properly covered?

  Yes

  No

  N/A

• Location and ditches clear of trash, debris?

  Yes

  No

  N/A

Documentation, Signage and Permitting

• Are all MSDS sheets necessary on location?

  Yes

  No

  N/A

• Is reclamation plan (or ESCGP-1) on location?

  Yes

  No

  N/A

• Is permit on location?

  Yes

  No

  N/A

• Is Preparedness, Prevention and Contingency Plan on location?

  Yes

  No

  N/A

• Is pad sign present?

  Yes

  No

  N/A

• Is muster sign present?

  Yes

  No

  N/A

• Is "No Trespassing/Smoking" sign present?

  Yes

  No

  N/A

• Is site safety book up to date? (PJSAs, Location Inspection Sheets, BOP/Frac Stac PT, Inspection Documents, Flange Up Sheets, Incident Reports)

  Yes

  No

  N/A

• Is well site secure (gate, guard or other)?

  Yes

  No

  N/A

• Are well heads properly labeled?

  Yes

  No

  N/A

Additional Information

• Field Construction Notified<br>(Name and Date)

  Yes

  No

  N/A

• Additional Comments

• Additional Photos

  Media

• EHS Contact

  Select Kevin Patterson - 304-641-0551 Matt Boggs - 304-406-2454 Kris Osecky - 724-886-8161

  • Kevin Patterson - 304-641-0551
  • Matt Boggs - 304-406-2454
  • Kris Osecky - 724-886-8161

• Chesapeake Consultant

• Shawn Jackson - 405-365-9974 - 304-517-1416 X- 86082
  Chesapeake Completion Superintendent

• Nathan Smarr - 304-997-0600
  Chesapeake Field Superintendent