FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
This presentation will assist you in the
completion of the Form 1014HD. The
notice of surface discharge of
hydrostatic test water.
Date of Last Revision: 2001
Rule Requirement: 10-7-17
Explanation of Form: Companies
wishing to discharge water as required
by OAC 165:10-7-17, used to test a
pipeline, tank, etc. must submit a Form
1014HD to the appropriate
Conservation Division District Office
and the Pollution Abatement
Department for prior approval.
[Reference 165:10-7-17]
Question concerning this Form: For
more information contact Pollution
Abatement at (405) 522-2763
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
OCC LOG-IN NUMBER: DO NOT WRITE
IN THIS SPACE
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
NAME OF OPERATOR
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
OTC/OCC OPERATOR NUMBER
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
MAILING ADDRESS, PHONE NUMBER,
CITY, STATE, ZIP CODE AND FAX
NUMBER OF THE OPERATOR
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
TYPE OF FACILITY
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
LOCATION OF WHERE DISCHARGE
WILL OCCUR: PROVIDE THE QUARTER
SECTION CALLS, SECTION, TOWNSHIP
AND RANGE PLUS THE COUNTY
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
METHOD OF RELEASE
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
WHICH DISTRICT OFFICE OF THE OCC
WAS SENT A COPY OF THIS REPORT
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
MAXIMUM VOLUME TO BE
DISCHARGE AT ANY ONE TIME (IN
BARRELLS)
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
NUMBER OF ACRES IN PROPOSED
DISCHARGE AREA
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
SOURCE OF WATER TO BE USED FOR
THE TEST
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
DOES THE OIL AND GREASE CONTENT
EXCEED 15 MG/L
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
DOES THE WATER CONTAIN A SHEEN
OR DISCOLORATION
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
DOES THE TOTAL SUSPENDED SOLIDS
EXCEED 45 MG/L
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
THE PH IS NOT LESS THAN 6.5 OR
GREATER THAN 9.0 S.U.
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
THE DISCHARGE IS FREE FROM
FOREIGN MATERIAL
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
THE DISCHARGE IS DESIGNED TO
PREVENT EROSION
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
IF THE DISCHARGE WATER IS TO BE
LAND APPLIED, A COPY OF THIS
NOTICE WAS SENT AND APPROVAL
WAS OBTAINED FROM THE SURFACE
OWNER
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
SIGNATURE BLOCK OF THE OPERATOR
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
NOTICE SIGNATURE BLOCK
FORM 1014HD – NOTICE OF
SURFACE DISCHARGE OF
HYDROSTATIC TEST WATER
INSTRUCTIONS FOR COMPLETING THIS
FORM