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Get Tax Exempt Form R 1392 511

Annular Saltwater Disposal Well Permit Application Office of Conservation Injection Mining Division P. O. Box 94275 Baton Rouge LA 70804-9275 UIC-9 TYPE ONLY Initial Permit Repermit 1. Application to 2. Operator s Name and Address 3. Operator Code 4. Phone WELL INFORMATION 5. Well Name and Number 6. Serial No. 7. Status of Well ACTIVE used at least once a month STANDBY INACTIVE but useable with minor work or effort ABANDONED but not plugged. -.

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