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Maximum civil penalty shall not exceed $500,000 as provided in 49 USC 60122 Report Date ACCIDENT REPORT HAZARDOUS LIQUID PIPELINE SYSTEMS U.S. Department of Transportation Pipeline and Hazardous Materials Safety Administration Form Approved OMB No. 2137-0047 No. (DOT Use Only) INSTRUCTIONS Important: Please read the separate instructions for completing this form before you begin. They clarify the information requested and provide specific examples. If you do not have a copy of the in.

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