Marine Conservation and Enforcement Team, Marine Management Organisation, Lancaster House, Hampshire Court, Newcastle upon Tyne, NE4 7YH Tel: 0191 376 2629/2677 Fax: 0191 376 2681 Email: conservation@marinemanagement.org.uk Filling out this form You can either: - print this form and fill out the relevant fields using block capitals and in black ink or - fill out the relevant fields on screen, then print out the form. You may add sheets for additional information - please cross-reference these. The form must then be signed and returned to the above email address. Voluntary notification of intent to carry out geophysical (including seismic) surveys This form allows developers to receive comments about the impacts of proposed geophyical (including seismic) surveys from stakeholders and interested parties. Natural England (within the 12 nautical mile boundary) and the Joint Nature Conservation Committee will consider the environmental aspects. It will also help to facilitate the wider monitoring of noisy activities in the marine environment. The Marine Management Organisation (MMO) will circulate and compile any feedback received. The developer can consider the feedback when planning surveys. We recommend that you submit the form at least 28 days before the survey starts. We also encourage developers to put in place a notice to mariners and submit details of the survey to the fortnightly Kingfisher Bulletin, currently maintained by SeaFish. European protected species A European protected species (EPS) stage 1 risk assessment is required to show that the proposal does not carry a risk of disturbance or injury to any EPS. This assessment should not be demanding but should acknowledge that there could be a risk of an effect on a EPS and provide an audit trail that the activity has been assessed. This form does not remove the duty of the developer to get other relevant consents. Data Protection Act 1998 The Marine Management Organisation (MMO) complies with these principles in all matters relating to the processing and storing of personal information. The MMO is the data controller in respect of any personal data that you provide when you complete this form. The MMO may have to release information, including personal and commercial information, on request under the Freedom of Information Act 2000 or the Environmental Information Regulations 2004, but we will not allow an unwarranted breach of confidentiality or will we act in contravention of our obligations under the Data Protection Act 1998. We may use your personal details to contact you in connection with similar services or customer research aimed at improving the service that we provide. (Revised 1 April 2013) Page 1 of 9 1. Contact details Name Organisation/Company name Full postal address (including post code) Telephone number (including area code) Email address 2. Purpose or background to survey 3. Survey dates Earliest start date Latest end date Estimated number of working days 4. Survey location A map (A4 size) should be provided, showing the survey and greater working area and, if appropriate, the survey sail (transect) lines. Location (such as Southern North Sea) Minimum distance from nearest coastline Approximate geographical co-ordinates and datum for corners of survey area (Revised 1 April 2013) Page 2 of 9 Survey area (square kilometres) Approximate geographical co-ordinates and datum for corners of greater work area (if different) Greater work area (square kilometres) Total sail (transect) line length (km) - if appropriate Sail (transect) line spacing (metres) - if appropriate 5. Type of survey Type Multi-beam and side scan sonar Sub-bottom profiling (pingers, boomers, sparkers and chirp) Reservoir Regional Site OBC or OBS Multi-component 4C (shear wave measurement) Marine vibroseis Refraction Vertical seismic profile (VSP) or borehole seismic Gravity surveys Magnetic surveys Shallow drilling operations Other geographical seabed seismic surveys not covered by the above (Revised 1 April 2013) Page 3 of 9 Details 6. Details of survey equipment Seismic surveys Energy source type Energy source volume (cubic inches) Estimated sound level at 1 metre over Sound exposure level (SEL) frequency band 10 Hz to 10 kHz Sound pressure level dB re1µPa2s dB re1µPapeak Shot interval (seconds) Number of cables Length of towed equipment, including tail buoys (metres) Width of towed equipment (metres) Depth of towed equipment (metres) Other surveys or operations Survey type Estimated sound level at 1 metre over Sound exposure level (SEL) the dominant frequency band Sound pressure level Specify dominant frequency band Brief description of equipment 7. Details of vessel(s) Number of vessels involved Name(s) Tonnage(s) Registrations(s) Call sign(s) Vessel's role (source, guard) (Revised 1 April 2013) Page 4 of 9 dB re1µPa2s dB re1µPapeak 8. Environmental information Will surveys be carried out in or adjacent to marine protected areas? If yes, identify site, provide a brief description and state distance to project. Does the survey area and timing coincide with any fish or shellfish spawning or nursery sensitivities? If yes, please provide details. 9. European protected species stage 1 risk assessment A European protected species (EPS) stage 1 risk assessment is required to show that the proposal does not carry a risk of distrubance or injury to any EPS. If an assessment has been carried out in a separate report or is included in the environmental impact assessment, please provide this with this form. If not, please complete the information below.The level of detail required depends on the potential risk. The Joint Nature Conservation Committee (JNCC) have produced guidance in relation to the EPS stage 1 risk assessment and the likely risk of different types of geophysical surveys can be found in the draft guidance 'The protection of marine European protected species from injury and disturbance - Guidance for the marine area in England and Wales and the UK offshore marine area'. Please contact us if you require a copy of this document. Please select this box if you have attached any extra information a) Intensity and frequency of sound Intensity and frequency Extent of area where injury or disturbance thresholds could be exceeded (see JNCC's guidance) (Revised 1 April 2013) Page 5 of 9 Explain how potential injury or disturbance will be mitigated b) In-combination effects Interaction with known concurrent, preceding or subsequent noise producing activities (Revised 1 April 2013) Page 6 of 9 c) Likelihood of exposure Known cetacean populations and likely densities (Revised 1 April 2013) Page 7 of 9 10. Mitigation or liaison (see JNCC's guidance) Have discussions taken place with other licencees if survey overlaps, or extends into, an area licensed by any third party, including renewable licences? Please provide details and whether permission was granted by those licencees. Have discussion taken place with relevant statutory nature conservation bodies? Please state which bodies were involved and when discussions took place. Have you made arrangements for a marine mammal observer or observers? If yes, please state which organisation will provide them and how many will be provided. Have you made arrangements for passive acoustic monitoring (PAM)? If yes, please state which organisation will provide this and how many operators will be provided. Have discussions taken place with fisheries organisations? If yes, please provide details including which organisations were involved and when discussions took place. Have you arranged a fisheries liaison? If yes, please state which organisation will provide this and how many staff will be provided. (Revised 1 April 2013) Page 8 of 9 11. Declaration I have read and understand the guidance provided with this application form. I declare to the best of my knowledge and belief that the information given in this form and related papers is correct. Signature ____________________________________________ Name (in capital letters) (Revised 1 April 2013) Page 9 of 9 Date __________________