Answer ALL questions. If certain questions are not applicable to your activity, please indicate NONE or NOT APPLICABLE. If you are a tenant and do not use any fuel, omit items 1 and 2, BUT complete the rest of the form. If you are a tenant, so indicate under remarks, ITEM 7.

for heat,

1.

none

2.

coal

3.

(A38-2)

(A35-3)

power, or

electrical

generation

last year.

DO NOT

include fuel

used as

row

material.

B. If COAL is used at all, check the principal source of COAL:

1. IL 2. E. Ky. 3. W. Ky. 4. Ind. 5. Ohio 6. W. Va. 7. Penno.

1. No. 1 oil 2. No. 2 oil 3. No. 3 oil 4. No. 4 oil 5. No. 5 oil 6. No. 6 oil

F. If OIL is checked in question E, indicate the principal grade of OIL:
1. No. 1 oil 2. No. 2 oil 3. No. 3 oil 4. No. 4 oil 5. No. 5 oil 6. No. 6 oil

ITEM 1. continued

FIGURE 1 (Sheet 2 of 4)

H. If COAL is checked in A or E indicate the principal type of coal burning unit. (check one)