Follow the steps to fill out the LA UIC-23 form with ease.

1. Press the ‘Get Form’ button to access the form and open it in an editor.
2. Enter your company name in the first field. It’s important to provide the exact name as registered.
3. Fill in the contact name of a representative who can be reached for questions about the form.
4. Complete the company mailing address by including your city, state, and ZIP code.
5. Provide a contact email address where permit correspondence can be sent.
6. Include a telephone number where the contact person can be reached.
7. Enter a fax number if available, to receive quick communications.
8. If your billing address is different from the mailing address, fill this in as well.
9. Add the billing contact’s name, who will handle invoicing matters.
10. Provide the billing phone number for the billing contact.
11. Indicate the type of exploration and production waste you are transporting by selecting from the provided options.
12. Enter your purchase order number or any other billing number, as needed.
13. Specify the amount of waste you are transporting, measured in barrels.
14. If applicable, describe any waste types that fall under the category ‘99’ in detail.
15. Clearly explain how the waste was generated to provide context for the request.
16. Indicate the source of the waste generated, including relevant numbers such as DNR well serial number.
17. Complete the NORM screen measurements for the background and waste, with discretions on radioactivity levels.
18. Provide an estimated completion date for the operation related to the waste transport request.
19. List an emergency contact person along with their phone number in case of urgent communications.
20. Specify the name of the commercial facility or transfer station operator that will receive the waste.
21. Indicate the location of the commercial facility or transfer station for waste delivery.
22. Fill in the site code related to the facility handling the E&P waste.
23. Provide the name of the transporter responsible for transporting the E&P waste.
24. Enter the PSC code related to the transporter.
25. Certify the accuracy of the information provided by printing your name, including your title, and adding your signature and date.
26. Once all fields are complete, review the form to ensure accuracy before saving the changes.
27. Download, print, or share the completed form as required, ensuring a copy accompanies the original manifest.

Complete the LA UIC-23 document online now for efficient waste transport processing.