1. FORM 1014P – ANNUAL REPORT FOR SURFACE DISCHARGE

2. This presentation will assist you in the completion of the Form 1014P. The annual report for surface discharge. Date of Last Revision: 2001 Rule Requirement: 10-7-17 Explanation of Form: An annual report is required to be submitted to the Commission by April 1 of each year on Form 1014P concerning surface discharges of produced water. Current (within three month) analyses of the produced water and soil from the discharge plot must be attached to the annual report. [Reference 165:10-7-17] Question concerning this Form: For more information contact Pollution Abatement at (405) 522-2763

3. FORM 1014P – ANNUAL REPORT FOR SURFACE DISCHARGE PERMIT NUMBER

4. FORM 1014P – ANNUAL REPORT FOR SURFACE DISCHARGE OPERATOR’S NAME

5. FORM 1014P – ANNUAL REPORT FOR SURFACE DISCHARGE OTC/OCC OPERATOR’S NUMBER

6. FORM 1014P – ANNUAL REPORT FOR SURFACE DISCHARGE ADDRESS, PHONE NUMBER, CITY, STATE, ZIP CODE AND FAX NUMBER

7. FORM 1014P – ANNUAL REPORT FOR SURFACE DISCHARGE WELL NAME AND NUMBER

8. FORM 1014P – ANNUAL REPORT FOR SURFACE DISCHARGE API NUMBER

9. FORM 1014P – ANNUAL REPORT FOR SURFACE DISCHARGE LEGAL LOCATION: be sure to include quarter section calls along with the section, township, range and the county

10. FORM 1014P – ANNUAL REPORT FOR SURFACE DISCHARGE LAND APPLICATION AREA: provide the quarter section calls along with the section, township, range and the county

11. FORM 1014P – ANNUAL REPORT FOR SURFACE DISCHARGE YEARLY DISCHARGED AMOUNT OF PRODUCED WATER FOR THE YEAR (in barrels)

12. FORM 1014P – ANNUAL REPORT FOR SURFACE DISCHARGE ATTACH A COPY OF THE ANNUAL SOIL SAMPLE ANALYSIS

13. FORM 1014P – ANNUAL REPORT FOR SURFACE DISCHARGE ATTACH THE ANNUAL FLUID SAMPLE ANALYSIS OF THE DISCHARGED FLUIDS

14. FORM 1014P – ANNUAL REPORT FOR SURFACE DISCHARGE PERCENT OF MAXIMUM APPLICATION RATE OF TSS

15. FORM 1014P – ANNUAL REPORT FOR SURFACE DISCHARGE PERCENT OF MAXIMUM APPLICATION RATE OF OIL AND GREASE

16. FORM 1014P – ANNUAL REPORT FOR SURFACE DISCHARGE EXCHANGEABLE SODIUM PERCENTAGE (ESP)

17. FORM 1014P – ANNUAL REPORT FOR SURFACE DISCHARGE TOTAL DISSOLVED SOLIDS OF PRODUCED WATER

18. FORM 1014P – ANNUAL REPORT FOR SURFACE DISCHARGE OIL AND GREASE OF PRODUCED WATER

19. FORM 1014P – ANNUAL REPORT FOR SURFACE DISCHARGE SIGNATURE BLOCK FOR OPERATOR

20. FORM 1014P – ANNUAL REPORT FOR SURFACE DISCHARGE NOTARY SIGNATURE BLOCK