TO BE COMPLETED BY OPERATOR TYPE OR PRINT ALL ENTRIES ... 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the 'OPERATOR NAME' in the designated field. This is crucial as it identifies the generator of E&P Waste.
3. Next, input the 'OPERATOR CODE' assigned by the Office of Conservation. This code is essential for tracking purposes.
4. Fill in your complete 'MAILING ADDRESS', ensuring to include city, state, and zip code for accurate correspondence.
5. Provide a 'CONTACT PERSON' name along with their 'TELEPHONE NUMBER' for any inquiries related to this request.
6. If applicable, enter your 'BILLING ADDRESS' and ensure that you provide an 'EMAIL ADDRESS' where invoices will be sent.
7. Complete sections regarding waste source details, including well serial number and facility information as required.
8. Finally, review all entries for accuracy before submitting your form via email or fax as instructed at the top of the document.

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