FORM 1014P – ANNUAL
REPORT FOR SURFACE
DISCHARGE
FORM 1014P – ANNUAL
REPORT FOR SURFACE
DISCHARGE
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
FORM 1014P – ANNUAL
REPORT FOR SURFACE
DISCHARGE
PERMIT NUMBER
FORM 1014P – ANNUAL
REPORT FOR SURFACE
DISCHARGE
OPERATOR’S NAME
FORM 1014P – ANNUAL
REPORT FOR SURFACE
DISCHARGE
OTC/OCC OPERATOR’S NUMBER
FORM 1014P – ANNUAL
REPORT FOR SURFACE
DISCHARGE
ADDRESS, PHONE NUMBER, CITY,
STATE, ZIP CODE AND FAX NUMBER
FORM 1014P – ANNUAL
REPORT FOR SURFACE
DISCHARGE
WELL NAME AND NUMBER
FORM 1014P – ANNUAL
REPORT FOR SURFACE
DISCHARGE
API NUMBER
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
FORM 1014P – ANNUAL
REPORT FOR SURFACE
DISCHARGE
LAND APPLICATION AREA: provide the
quarter section calls along with the
section, township, range and the
county
FORM 1014P – ANNUAL
REPORT FOR SURFACE
DISCHARGE
YEARLY DISCHARGED AMOUNT OF
PRODUCED WATER FOR THE YEAR (in
barrels)
FORM 1014P – ANNUAL
REPORT FOR SURFACE
DISCHARGE
ATTACH A COPY OF THE ANNUAL SOIL
SAMPLE ANALYSIS
FORM 1014P – ANNUAL
REPORT FOR SURFACE
DISCHARGE
ATTACH THE ANNUAL FLUID SAMPLE
ANALYSIS OF THE DISCHARGED FLUIDS
FORM 1014P – ANNUAL
REPORT FOR SURFACE
DISCHARGE
PERCENT OF MAXIMUM APPLICATION
RATE OF TSS
FORM 1014P – ANNUAL
REPORT FOR SURFACE
DISCHARGE
PERCENT OF MAXIMUM APPLICATION
RATE OF OIL AND GREASE
FORM 1014P – ANNUAL
REPORT FOR SURFACE
DISCHARGE
EXCHANGEABLE SODIUM PERCENTAGE
(ESP)
FORM 1014P – ANNUAL
REPORT FOR SURFACE
DISCHARGE
TOTAL DISSOLVED SOLIDS OF
PRODUCED WATER
FORM 1014P – ANNUAL
REPORT FOR SURFACE
DISCHARGE
OIL AND GREASE OF PRODUCED
WATER
FORM 1014P – ANNUAL
REPORT FOR SURFACE
DISCHARGE
SIGNATURE BLOCK FOR OPERATOR
FORM 1014P – ANNUAL
REPORT FOR SURFACE
DISCHARGE
NOTARY SIGNATURE BLOCK