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Get KCC U3C 2014-2023

Ted on a per well basis Complete all blanks - add pages if needed. Copy to be retained for five (5) years after filing date. OPERATOR: License # Permit Number: (E) (D) - Name: API No.: Address 1: Reporting Period: Address 2: January 1, 20 City: State: Zip: + 15- - to December 31, 20 - (Q/Q/Q/Q) - Sec. Contact Person: Phone: ( Twp. S. R. E W feet from S Line of Section feet from ) N / E / W Line of Section Legal Description of Lease or Unit: Lease Nam.

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