Form Ogb - 17d - Monthly Report Of Gas Injected Withdrawn For Natural Gas Storage Facilities

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STATE OIL AND GAS BOARD OF ALABAMA
Form OGB - 17D
420 Hackberry Lane
5 / 00
P.O. Box 869999
Tuscaloosa, Alabama 35486-6999
(205) 349-2852
Fax (205)349-2861
Monthly Report of Gas Injected / Withdrawn
for Natural Gas Storage Facilities
(file in triplicate)
Name of operator
,
Month of
20
State
Address
Zip
City
County
Facility
Phone number
Person to contact
regarding this
Fax number
form
E-Mail address
Monthly gas
Monthly gas
Gas in
Average working
injected
pressure
withdrawn
storage
Well name and number
Permit number
(Mcf)
(Mcf)
(Mcf)
(psia)
Total
Remarks:
, 20
Executed this the
day of
Signature
Before me, the undersigned authority, on this day personally appeared
known to me to be the person
whose name is subscribed to the above instrument, who being by me duly sworn on oath states that he/she is duly authorized to make the above report and that he/she
has knowledge of the facts stated therein, and that said report is true and correct.
day of
, 20
Subscribed and sworn to before me this
SEAL
Notary Public in and for
County,
My commission expires

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