Notice of Application for [Commercial] Oil & Gas Waste Disposal Well Permit

______________________________________________________________________________                                            
                                          (Company Name/Address) 
is applying to the Railroad Commission of Texas for a permit to dispose of produced salt water or other oil
and gas waste by well injection into a porous formation [productive (Rule 46)]  OR  [not productive (Rule 9)] of oil or gas.

The applicant proposes to dispose of oil and gas waste into the _________________________________,
                                                                                                                           (Formation Name)

____________________________Lease, Well Number _________________. The proposed 
                  (Lease Name)                                                       (Well Number)

disposal well is located ______miles __________of ________________________________,
                                                             (Direction)                       (Nearest Town)

in the ___________________________Field, in County. ____________________________________ 
                           (Field Name)                                                      (County Name)

The waste water will be injected into strata in the subsurface depth interval from________ to___________ feet.

LEGAL AUTHORITY: Chapter 27 of the Texas Water Code, as amended, Title 3 of the Texas 
Natural Resources Code, as amended, and the Statewide Rules of the Oil and Gas Division of the Railroad
Commission of Texas.

Requests for a public hearing from persons who can show they are adversely affected or requests for
further information concerning any aspect of the application should be submitted in writing, within fifteen days
of publication, to Technical Permitting, Oil and Gas Division, Railroad Commission of Texas,
P.O. Box 12967, Austin, Texas 78711 (Telephone 512/463-6792).



Commissioners