Oil And Gas Form 9 - Well Completion Report Page 2
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OPERATOR’S STATEMENT
State: _________________________________
County: ________________________________
I, _____________________________________________________, am the ___________________________________________________
(Name)
(Title)
of ________________________________________________________ and attest that all information contained herein is true and correct.
(Name of Company)
Date: ___________________________________________________
Signature: ________________________________________________
DEP No. 51-005(16)
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