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SURFACE MINING COMMISSION APPLICATION FOR COAL EXPLORATION PERMIT TO REMOVE MORE THAN 250 TONS OF COAL OR DISTURB MORE THAN ONE-HALF ACRE EXPLORATION FEE: $2000 ACREAGE FEE: $35 .00 PER ACRE 1. SUBMIT 3 COMPLETE COPIES OF APPLICATION: 3 CORRECT MAPS 2. Legal name of applicant: __________________________________________________ 3. Business address of applicant: ___________________________________Zip________ 4. Business telephone number of applicant:_______________________ 5. Describe the land upon which applicant proposes to conduct exploration operations. BE SPECIFIC. Give legal description to nearest quarter-quarter section, Section, Township, Range and County. 6. Give the name(s) and current mailing address(es) of the legal owner(s) and lessee of record of the surface and mineral (coal) interests of the lands to be affected. NAME ADDRESS WHAT INTEREST OWNED Surface Mineral PAGE 2 7. Describe in detail the legal right(s) held by the applicant to conduct exploration operations in the area. Give the specific source of such rights, the date such rights were acquired, and the nature of such rights. (e.q, deed, lease, etc. If by deed, state where recorded; if by lease, describe from whom to whom, and date executed.) LEASE FROM LEASE TO DATE SIGNED Surface Mineral 8. Is the land to be permitted properly zoned, or is zoning required by law? Yes No ( ) Zoning Not Required ( ) If yes, indicate the zoning classification . 9. Provide information given in public notification of intended exploration. 10. Describe access to the proposed exploration site from a commonly known point on nearest public highway; Be Specific. 11. What is the proposed number of tons of coal to be removed by this exploration operation and how will the amount be determined? 12. Provide written justification for the need to remove more than 250 tons of coal or disturb more than ½ acre. Be Specific. Include the name, address and phone number of the person responsible for the testing or evaluation of the coal to be removed. PAGE 3 13. What is the proposed term of this exploration operation? 14. Describe the topography of the permit area: 15. Describe the local geology of the permit area including lithology of the overburden and name and thickness of coal seams being investigated. 16. Describe the surface water drainage for the proposed permit area. (Detailed information for this part may be provided in the plane for the sedimentation control ponds). 17. Describe the existing vegetative cover in the permit area. 18. Describe any important habitats for fish, wildlife or plants, including any endangered or threatened species. 19. Does the proposed permit area contain any prime farmland soils? Yes ( ) No ( ) 20. List and identify any objects within the proposed permitted area found on the National Register of Historic Places and known significant archeological resources found within the proposed permit area. PAGE 4 21. In narrative form, describe the methods of coal exploration including the location where disturbance will commence, the orientation of “cuts” and direction of advancement. Describe the major equipment to be used in the exploration. Describe how roads and other access route construction will be accomplished. 22. Will exploration drilling be a part of the exploration operations? Yes ( ) No ( ) If Yes, describe the steps to be taken to manage the holes when no longer needed. 23. Are access roads proposed to be constructed as a part of the exploration operations? Yes ( ) No ( ) If Yes, describe their construction and removal; show the location of such roads on the permit map. 24. Provide detailed design plans for sediment ponds which conforms to the requirements of Section 880-X-8F-.11. PAGE 5 25. Is blasting proposed to be a part of the exploration operation? YES ( ) NO ( ) If YES, provide the information asked for the following blasting plan: BLASTING PLANS (880-X-8F-.07, 880-X-10C-.30 TO .35) (1) Ground vibration and air-blast control. (a) Check which of the following procedures will be used to limit ground vibration. ( )Maximum Peak Particle Velocity ( ) Scaled Distance Formula ( ) Modified Scaled Distance Factor, approval from the Commission is required before this method can be used. ( ) Blasting-level chart, approval from the Commission is required before this method can be used. (b)Check which of the following maximum levels’ and corresponding microphone lower frequency limitations will be used: ( ) 105 dB peak -c-weighted -slow response** ( ) 129 dB peak- 6Hz or lower ( ) 133 dB peak -2Hz or lower ( ) 134 dB peak -p. 1Hz or lower** *Identify the structure used for measuring-the scale distance. **Only with approval of the Commission (2) Describe what variations will be made in the blasting operation to control and correct adverse effects due to blasting. (3) Blast Monitoring: (a) Describe the blast monitoring equipment to be used (make and model, and sensitivity). Will it monitor ground vibrations, air blasts or both? (b) How will monitoring equipment be installed and activated? (c) Show the location of blast monitoring stations on the permit map or on a separate map with a scale of 1:24000 or smaller. PAGE 6 25.(continued) (4) Is blasting proposed to be conducted within 500 feet of an active underground mine? ( ) YES ( ) NO If YES, concurrence from MSHA is required. (5) Will blasting be conducted within 500 feet of an abandoned underground mine or within 1,000 feet of an occupied dwelling, church, school, community, or institutional building? ( ) YES ( ) NO If YES, provide the following information, either as a part of the permit application or at a later date, but before reaching the distance given above: (a) A sketch showing the drill patterns to be used; (b) Critical dimensions, i.e., burden, spacing, stemming, drill hole diameter, etc.; (c) Delay periods; (d) Amount of decking ; (e) Type and amount of explosives to be used, including the loading weight (lbs. per foot of drill hole); (f) Location and general description of the structures to be protected; (g) Discuss the measures to be used in the blasting operations to protect the public from the adverse effects of blasting; and (h) The plans are to be prepared by a Certified Blaster. (6) At what time will blasting operations be conducted? (7) Will blasting operations be conducted within 300’ of an occupied dwelling: (YES ( )NO If YES, give minimum distance to the houses to be affected. 26. Describe the reclamation measures to be implemented in this exploration operation including: a timetable for re-grading and re-vegetation; steps to be taken to stabilize the re-graded surface; types and amount of vegetation to be planted per acre; and soil tests to be performed to determine types and amount of soil amendments to be added and husbandry practices to be used. PAGE 7 27. Describe the steps to be taken in removing, stockpiling and redistribution of topsoils. 28. Minimum requirements for the permit map: (a) Scale 1:24,000 or smaller; (b) Show area to be disturbed by the exploration operation; (c) Existing roads; (d) Occupied dwellings; (e) Pipelines; (f) Proposed location of trenches, roads, and other access routes, and any structures to be constructed; (g) Location of land excavations to be conducted; (h) Water or coal exploration holes and wells to be drilled or altered; (i) Earth or debris disposal areas; (j) Existing bodies of surface water; (k) Topographic contour interval 20’ or less and drainage features; (l) Historic or cultural features; and (m) Habitats of any endangered or threatened species. PAGE 8 VERIFICATION OF PERMIT APPLICATION I, the undersigned operator do hereby submit this as my application for Coal Exploration and certify that all of the information contained herein is true and correct. I further certify that I have the legal right to enter and surface explore for coal, and further the area disturbed will be reclaimed as recorded in narrative report. I further certify that I will comply with the rules of this Commission and the laws of Alabama, and I will keep the Commission advised of any change of facts in this permit to explore for coal. ___________________________________________ (Type in Applicant’s Name) By:__________________________________________ (Signature) _________________________________________ (Title) STATE OF ALABAMA _________________County Before me, the undersigned authority, personally appeared_______________________ who, being first duly sworn upon oath, deposed and said, that he has read the foregoing application, that he is the person described therein and who executed same, that the facts and matters alleged therein are true and correct to the best of his knowledge, information, belief, and that he executed the same for the purpose therein expressed. Sworn to and subscribed before me, this the . _____day of _______________ ,20___ ___________________________________ NOTARY PUBLIC My Commission Expires:___________________