1. FORM 1014CA – COMPLIANCE AGREEMENT / ONE-TIME LAND APPLICATION

2. This presentation will assist you in the completion of the Form 1014CA. The compliance agreement / one-time land application. Date of Last Revision: 2010 Rule Requirement: 10-7-19(h)2, 10-7- 26(h)2 Explanation of Form: Any person responsible for supervision of land application must submit a compliance agreement to the Commission. [Reference 165:10-7-19 and 165:10-7- 26] Question concerning this Form: For more information contact Pollution Abatement at (405) 522-5799.

3. FORM 1014CA – COMPLIANCE AGREEMENT / ONE-TIME LAND APPLICATION NAME OF PERSON OR COMPANY DOING WORK IN THE FIELD

4. FORM 1014CA – COMPLIANCE AGREEMENT / ONE-TIME LAND APPLICATION TYPE OF ENTITY DOING THE WORK IN THE FIELD

5. FORM 1014CA – COMPLIANCE AGREEMENT / ONE-TIME LAND APPLICATION NAME OF THE OPERATOR

6. FORM 1014CA – COMPLIANCE AGREEMENT / ONE-TIME LAND APPLICATION CHECK BOX FOR THE RULE THAT APPLIES

7. FORM 1014CA – COMPLIANCE AGREEMENT / ONE-TIME LAND APPLICATION TELEPHONE NUMBER

8. FORM 1014CA – COMPLIANCE AGREEMENT / ONE-TIME LAND APPLICATION DAY, MONTH AND YEAR WITH SIGNATURE BLOCK

9. FORM 1014CA – COMPLIANCE AGREEMENT / ONE-TIME LAND APPLICATION NOTARY SIGNATURE BLOCK