THE UNDERSIGNED ATTESTS THAT THE INFORMATION PROVIDED UPON THIS REGISTRATION FORM, INCLUDING ALL ATTACHMENTS, IS TRUE AND CORRECT. ______________ SIGNATURE DATE RETURN THIS FORM and the REQUIRED ATTACHMENTS TO: Hulsey Used Tire Recycling Program Land Protection Division Oklahoma Department of Environmental Quality 707 N Robinson PO Box 1677 Oklahoma City, OK 73101 RECEIVED DATE _________________ COMMENTS___________________________ APPROVED DATE _________________ _______________________________________ _______________________________________ _______________________________________ _______________________________________
THE UNDERSIGNED ATTESTS THAT THE INFORMATION PROVIDED UPON THIS REGISTRATION FORM, INCLUDING ALL ATTACHMENTS, IS TRUE AND CORRECT. ______________ SIGNATURE DATE RETURN THIS FORM and the REQUIRED ATTACHMENTS TO: Hulsey Used Tire Recycling Program Land Protection Division Oklahoma Department of Environmental Quality 707 N Robinson PO Box 1677 Oklahoma City, OK 73101 RECEIVED DATE _________________ COMMENTS___________________________ APPROVED DATE _________________ _______________________________________ _______________________________________ _______________________________________ _______________________________________
BeneficialReuseApplication2016.docx