FORM 1014R – POST-LAND APPLICATION REPORT

FORM 1014R – POST-LAND APPLICATION REPORT This presentation will assist you in the completion of the Form 1014R. The post-land application report. Date of Last Revision: 2009 Rule Requirement: 10-7-19(h)(12); 10-7-26(h)(12) Explanation of Form: A post land application report shall be submitted by the operator or the operator’s agent to the Manager of Field Operations within ninety (90) days of the completion of land application. [Reference 165:10-7-19 and 165:10-7-26] Question concerning this Form: For more information contact Pollution Abatement at (405) 522-2763

FORM 1014R – POST-LAND APPLICATION REPORT OCC LOG-IN NUMBER: Do not write in this space. The number used in this box must be the same as used on Form 1014S.

FORM 1014R – POST-LAND APPLICATION REPORT WELL NAME (include the Section, Township and Range with Quarter Calls).

FORM 1014R – POST-LAND APPLICATION REPORT OPERATOR NAME

FORM 1014R – POST-LAND APPLICATION REPORT PHONE NUMBER OF THE OPERATOR

FORM 1014R – POST-LAND APPLICATION REPORT MAILING ADDRESS, CITY, STATE, AND ZIP CODE

FORM 1014R – POST-LAND APPLICATION REPORT CONTRACTOR OR AGENT’S NAME

FORM 1014R – POST-LAND APPLICATION REPORT PHONE NUMBER

FORM 1014R – POST-LAND APPLICATION REPORT LAND APPLICATION PERMIT NUMBER (The Land Application Permit Number must be the same of the OCC Log In Number)

FORM 1014R – POST-LAND APPLICATION REPORT ANY EXCEPTIONS TO THE RULES NEED TO BE NOTED HERE

FORM 1014R – POST-LAND APPLICATION REPORT LAND APPLICATION OF WATER-BASED DRILLING FLUIDS AND/OR CUTTINGS

FORM 1014R – POST-LAND APPLICATION REPORT LAND APPLICATION OF PETROLEUM HYDROCARBON-BASED DRILL CUTTINGS

FORM 1014R – POST-LAND APPLICATION REPORT LAND APPLICATION OF SOIL CONTAMINATED BY SALT OR CRUDE OIL

FORM 1014R – POST-LAND APPLICATION REPORT NUMBER OF ACRES OF LAND APPLICATION

FORM 1014R – POST-LAND APPLICATION REPORT TOTAL NUMBER OF ACRES PERMITTED

FORM 1014R – POST-LAND APPLICATION REPORT NUMBER OF ACRES NOT USED

FORM 1014R – POST-LAND APPLICATION REPORT TOTAL VOLUME OF LIQUIDS APPLIED (IN BARRELS)

FORM 1014R – POST-LAND APPLICATION REPORT TOTAL VOLUME OF SOLIDS APPLIED (IN BARRELS OR CUBIC FEET)

FORM 1014R – POST-LAND APPLICATION REPORT METHOD OF APPLICATION

FORM 1014R – POST-LAND APPLICATION REPORT BE SURE TO ATTACH AERIAL PHOTOGRAPH.

FORM 1014R – POST-LAND APPLICATION REPORT ATTACH TEST RESULTS AND LOADING CALCULATIONS

FORM 1014R – POST-LAND APPLICATION REPORT SIGNATURE BLOCK