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Get LA UIC-23 2015-2024

FFICE OF CONSERVATION ENVIRONMENTAL DIVISION 617 N. THIRD ST., 8TH FLOOR BATON ROUGE, LA 70802 E-Mail: Environmental-Div@la.gov Fax: Fee: 225-242-3505 $150 per request 1. COMPANY NAME 2. CONTACT NAME 3. COMPANY MAILING ADDRESS (including city, state & zip code) 4. CONTACT EMAIL ADDRESS 5. TELEPHONE NUMBER 6. FAX NUMBER 7. BILLING ADDRESS 8. EMAIL ADDRESS (Invoice and Approval or Denial will be sent to this address) 9. BILLING CONTACT 10. BILLING PHONE NUMBER 12. TYPE OF E&P WASTE.

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