Form C-133 "Authorization to Move Produced Water" - New Mexico

What Is Form C-133?

This is a legal form that was released by the New Mexico Energy, Minerals and Natural Resources Department - a government authority operating within New Mexico. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 1, 2013;
  • The latest edition provided by the New Mexico Energy, Minerals and Natural Resources Department;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form C-133 by clicking the link below or browse more documents and templates provided by the New Mexico Energy, Minerals and Natural Resources Department.

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Download Form C-133 "Authorization to Move Produced Water" - New Mexico

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Submit a single copy to
State of New Mexico
Form C-133
Santa Fe Office
Energy Minerals and Natural Resources
Revised August 1, 2013
Oil Conservation Division
1220 South St. Francis Dr.
Santa Fe, NM 87505
AUTHORIZATION TO MOVE PRODUCED WATER
Transporter Name:__________________________________________________________________________________
Business (Physical) Address in New Mexico:
Contact Mailing Address (If different):
________________________________________________
_____________________________________________
________________________________________________
_____________________________________________
Business Phone: _________________________________
Contact Phone: ________________________________
Business Fax: ____________________________________
Contact Fax: __________________________________
1.
Attach a copy of the applicant’s New Mexico Public Regulation Commission (PRC) Warrant for Transportation
Services.
2.
Identify the form of the applicant’s business entity: (Example: corporation, limited liability company [LLC],
limited partnership, limited liability partnership, partnership, sole proprietor): ________________________________
A.
If the applicant is a corporation or LLC, provide the Secretary of State corporation number:
_________________________________________________________________________________
B.
If the applicant is a limited partnership or limited liability partnership, provide the Secretary of State file
number: _________________________________________________________________________
C.
If the applicant is any other form of partnership, identify all partners:
___________________________________________________________________________________
D.
If the applicant is a sole proprietor, provide the name of the sole proprietor:
___________________________________________________________________________________
(Note: If the form of your business entity changes, the name of your business changes, or the business address changes,
you must re-apply for authorization.)
It is the responsibility of each holder of an approved Form C-133 to comply with 19.15.34 NMAC and familiarize its
personnel with that rule’s requirements. Failure to move or dispose of produced water in accordance with 19.15.34
NMAC may be cause for cancellation of the Form C-133.
“I hereby certify that the information above is true and complete to the best of my knowledge and belief.” (Application
must be signed by person who is authorized to obligate the company applying for the permit)
Signature:________________________________________
Date:_________________________________________
Printed Name:_____________________________________
Title:_________________________________________
E-mail Address:____________________________________
(This space for State use)
Approved by:_____________________________________
Title:_________________________________________
Date:____________________________________________
Submit a single copy to
State of New Mexico
Form C-133
Santa Fe Office
Energy Minerals and Natural Resources
Revised August 1, 2013
Oil Conservation Division
1220 South St. Francis Dr.
Santa Fe, NM 87505
AUTHORIZATION TO MOVE PRODUCED WATER
Transporter Name:__________________________________________________________________________________
Business (Physical) Address in New Mexico:
Contact Mailing Address (If different):
________________________________________________
_____________________________________________
________________________________________________
_____________________________________________
Business Phone: _________________________________
Contact Phone: ________________________________
Business Fax: ____________________________________
Contact Fax: __________________________________
1.
Attach a copy of the applicant’s New Mexico Public Regulation Commission (PRC) Warrant for Transportation
Services.
2.
Identify the form of the applicant’s business entity: (Example: corporation, limited liability company [LLC],
limited partnership, limited liability partnership, partnership, sole proprietor): ________________________________
A.
If the applicant is a corporation or LLC, provide the Secretary of State corporation number:
_________________________________________________________________________________
B.
If the applicant is a limited partnership or limited liability partnership, provide the Secretary of State file
number: _________________________________________________________________________
C.
If the applicant is any other form of partnership, identify all partners:
___________________________________________________________________________________
D.
If the applicant is a sole proprietor, provide the name of the sole proprietor:
___________________________________________________________________________________
(Note: If the form of your business entity changes, the name of your business changes, or the business address changes,
you must re-apply for authorization.)
It is the responsibility of each holder of an approved Form C-133 to comply with 19.15.34 NMAC and familiarize its
personnel with that rule’s requirements. Failure to move or dispose of produced water in accordance with 19.15.34
NMAC may be cause for cancellation of the Form C-133.
“I hereby certify that the information above is true and complete to the best of my knowledge and belief.” (Application
must be signed by person who is authorized to obligate the company applying for the permit)
Signature:________________________________________
Date:_________________________________________
Printed Name:_____________________________________
Title:_________________________________________
E-mail Address:____________________________________
(This space for State use)
Approved by:_____________________________________
Title:_________________________________________
Date:____________________________________________