UPDATE: Ecology's new website will be live on Monday morning! Our official web address will be https://ecology.wa.gov

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Spills Program

Crude Oil Transmission Pipeline Report Form

Reference: WAC 173-185-080

This form will be submitted to Washington State Department of Ecology at: OilTransferNotifications@ecy.wa.gov

Report Period: January 1 - June 30 July 1 - December 31
Report Due: July 31 January 31

Please fill in the following information. Please check it for accuracy and then click the "Submit" button at the bottom of this form. You may be contacted for additional clarification.


Submitting Party Information
Company Name:
Contact Name:
Phone Number:
Street Address:
City:
State:
ZIP Code:

Report Information
Report Date:
Report Period Start Date:
Report Period End Date:

Crude Oil Information
Provide the total volume of crude oil by each state or province of origin of crude oil for the reporting period.
State/Province of Origin: Volume of Crude Oil (Bbls):
State/Province of Origin: Volume of Crude Oil (Bbls):
State/Province of Origin: Volume of Crude Oil (Bbls):
State/Province of Origin: Volume of Crude Oil (Bbls):
State/Province of Origin: Volume of Crude Oil (Bbls):

**To save your own record of the information entered above, please print this page before you hit the submit button below.**



Form #: ECY 070-562
December 2016

If you need this form in an alternate format, call the Spills Program at (360) 407-7455. Persons with hearing loss, call 711 for Washington Relay Service. Persons with a speech disability, call (877) 833-6341.