NOTIFICATION
Mining Act 1971 and Mining Regulations 2011
PROGRAM NOTIFICATION – EXPLORATION PROGRAM FOR
ENVIRONMENT PROTECTION AND REHABILITATION (PEPR)
USE THIS FORM TO:
Provide notification of exploration programs conducted in accordance with a PEPR approved for an ongoing
period.
Refer to the determination for exploration PEPRs (Ministerial Determination 013) when completing this notification. Further
information on exploration requirements in South Australia is available on the Department of State Development (DSD) Minerals
website <www.minerals.statedevelopment.sa.gov.au>.
A program notification must be provided to DSD 21 days prior to the start date of each new program of works using this PEPR
program notification template.
All rehabilitation is to be completed within 3 months after the expiry of this program notification.
Please note that a program notification incorporates and takes the place of a park access notification which is required for proposals
located within parks and reserves.
In accordance with DSD policy, this document is not considered to be in the public interest and will not be released to the public
without the consent of the tenement holder.
SECTION A – GENERAL DETAILS
DSD PEPR reference number
<Provide the DSD PEPR reference number that the notification has been submitted against.>
Field stints
Single stint
Tenement details
<Provide EL, RL or MC tenement number(s) here.>
Tenement holder(s) (for each tenement)
<Include company name, address and contact details.>
Operating company
<Include company name, address and contact details of the exploration company that will
conduct the program.>
Project supervisor/contact person(s)
<Indicate the contact person(s) for the proposed program and the person in charge of field
supervision and implementing compliance monitoring requirements (including details of
relevant experience and qualifications).>
☐
Multiple stint
☐
Project/prospect name
Location details
<Provide general location details.>
Proposed project schedule (maximum
12 months)
Start date
End date
DECLARATION
In accordance with regulation 65(8) the information contained in this notification is to the best of my knowledge true and
accurate, and the proposed exploration activities will be conducted in accordance with the approved PEPR.
Name
Position
Company
Email
Phone
Date
I agree
☐
Exploration PEPR program notification template | June 2015
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Exploration PEPR program notification
SECTION B – ACCESS TO LAND
Landowner details and consultation (r. 65(1)(c))
Using the table below, provide relevant landowner and stakeholder details, including occupier and land manager details, and summarise the results of consultation that has been undertaken
on the proposed operation. Landowners include freehold landowners, Aboriginal land, Defence managed land (except the WPA), council, perpetual and pastoral lease holders, lessees or
sub-lessees and government departments.
Tenement
Stakeholder,
landowner and station
name
Land tenure
Land use
Date notice
of entry
(Form 21)
served
Date use of
declared
equipment
(Form 22)
served
Type of
Date waiver of
exempt land exemption
(Forms 23A,
23B) obtained
Date
Landowner concerns raised and how
consultation/access addressed
agreement and/or
permits
signed/authorised
<Tab to add rows.>
Additional information
List any other supporting information and/or documents submitted with the application, including land access approvals/permits required to conduct the proposed exploration program.
<Include text here.>
Woomera Prohibited Area (WPA)
Yes ☐
Will activities be conducted within the WPA? If yes, indicate if you have an access permit in place.
No ☐
<If yes, include text here.>
What is the expiry date of the access permit?
<Include date here.>
Identify closure periods that may impact on the exploration program
<Include text here.>
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Exploration PEPR program notification
SECTION C – ENVIRONMENT DETAILS
Land use and tenure
Using the table below, select the land tenure and land use that the proposed exploration activities will occur in. Include
additional information where prompted.
Land tenure
Applicable
Land use
Applicable
Freehold
☐
Grazing
☐
Pastoral lease
☐
Cereal/cropping
☐
Perpetual lease
☐
Residential
☐
Crown land
☐
Township
☐
Mining reserve
☐
Industrial
☐
Aboriginal freehold and leasehold (Anangu Pitjantjatjara
Yankunytjatjara and Maralinga Tjarutja lands)
☐
Tourism
☐
Forestry reserve
☐
Marine reserve
☐
National parks, conservation parks, conservation reserves,
regional reserves*
☐
Conservation
<If national parks is selected, please provide the name of the park here.>
Other*
☐
<If other is selected, describe the land tenure here.>
Defence – Woomera Prohibited Area (WPA)
☐
☐
Defence – Cultana
☐
Road reserve
☐
Native vegetation heritage agreements*
☐
<Provide the name of the area here.>
Orchard/vineyard
☐
European heritage sites
☐
<Provide the name of the site here.>
Sites of scientific significance (geological
monuments, fossil reserves etc.)
☐
<Provide the name of the site here.>
☐
Other (e.g. historic mining)
<Provide the name of the site here.>
* Indicates more information required in field immediately below.
Hydrology
Yes ☐
No ☐
Is the program area located within any prescribed watercourses or prescribed surface water areas under the Natural Yes ☐
Resources Management Act 2004 (NRM Act)? If yes, provide the name(s).
No ☐
Is the program area located within water protection areas defined under the River Murray Act 2003? If yes, provide
the name(s).
<If yes, provide the name(s) here.>
<If yes, provide the name(s) here.>
Groundwater
Is the proposed program located within a prescribed wells area or prescribed water resource area? If yes, provide
the name of the area.
Yes ☐
No ☐
<Insert the name of the area here.>
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Exploration PEPR program notification
Environmentally sensitive locations
Is this specific program located within or close to any environmentally sensitive locations identified in the approved
PEPR?
Yes ☐
No ☐
Yes ☐
No ☐
<If yes, include text here.>
Identify the environmentally sensitive location(s) applicable to this program. Mark these areas on a locality plan.
<If yes, include text here.>
SECTION D – EXPLORATION ACTIVITIES
Exploration activities (scope)
Briefly describe the exploration activities to be conducted during the proposed program (including ancillary activities described
within the approved PEPR). Please note that activities proposed must be consistent with the activities described within the
approved PEPR.
<Include text here.>
Drilling activities
Using the table below summarise the maximum drilling requirements for the proposed program.
Tenement Drilling
type
Maximum Maximum
number drillhole
of
depth (m)
drillholes
Maximum
number of
sumps
required
at each
site
Maximum size Average size of each
of sumps
drill pad* (m2) (no
(length x
excavation required)
depth x width)
(m3)
Number of
Average volume (m3) of
sites
material to be excavated
requiring pad (excluding sumps)
excavation
Total
number of
drillholes
(add each
row to
calculate
the total).
Total
number of
sumps
(maximum
number of
sumps x
drillsites for
each row,
then add
each row to
calculate the
total).
Total volume of
sumps
(maximum size
of sumps x
number of sumps
for each row,
then add each
row to calculate
the total).
Total number of
pads requiring
excavation (add
each row to
calculate the
total).
TOTAL
Total metres
proposed
(maximum
number of
holes x
average depth
for each row,
then add each
row to
calculate the
total).
Total area of disturbance
(number of holes x
average size for each row,
then add each row to
calculate the total).
Total volume of material to be
excavated (number of sites
requiring excavation x average
volume for each row, then add
each row to calculate the total).
* The footprint includes all areas of disturbance associated with the drillsite.
Costeans and bulk sample disposal pits
Using the table below, outline costean/bulk sample disposal pit requirements (excludes drilling sumps) planned for the proposed
program.
Tenement Number of
Size of costean
costeans/pits (length x width)
(m2)
Average
depth (m)
Volume excavated
(m3)
Total volume excavated
(m3) (number of
costeans/pits x volume)
Total area of
disturbance* (length x
width) (m2)
<Tab to add rows.>
TOTAL
Total number of
costeans/pits
(add each row to
calculate the
total).
Total volume of material to be
excavated (add each row to
calculate the total)
Total area of disturbance
(number of costeans/pits x
area of disturbance for each
row, then add each row to
calculate the total).
*Includes storage of excavated material at the site (e.g. topsoil and subsoil segregation).
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Exploration PEPR program notification
Access to work areas
Will existing tracks require upgrading?
Yes ☐
No ☐
Will access off existing tracks be required?
Yes ☐
No ☐
Where access is required off existing tracks (includes drill traverses and seismic lines), include the number of new tracks and the total area of
disturbance (i.e. length (km) and width (m) of new tracks).
<Include text here.>
Campsites, storage and equipment laydown areas
Is a campsite required?
Yes ☐
No ☐
Is a storage and equipment laydown area required?
Yes ☐
No ☐
If a camp and or laydown area is required, briefly describe the camp and/or laydown area and include the locations on a map.
<Include text here.>
Groundwater drilling and investigation activities
Yes ☐
No ☐
Yes ☐
No ☐
Will any water wells be drilled to supply water for the program? If yes, attach a copy of the relevant licence/permit
required in accordance with the NRM Act.
Yes ☐
No ☐
Will mineral drillholes be used as a water supply well? If yes, attach a copy of the licence (where required) for the
extraction of water in accordance with the NRM Act (i.e. programs located within a prescribed wells area or
prescribed water resource area). Please note that mineral drillholes used to supply water that are not permitted
under the NRM Act (i.e. a permitted water bore) must be decommissioned in accordance with the approved PEPR
water supply wells.
Yes ☐
No ☐
Will water drilling and/or groundwater investigation activities be conducted during the program? If yes, attach
permits/licences required in accordance with the Natural Resources Management Act 2004 (NRM Act).
Water affecting activities
Will any water affecting activities be undertaken? If yes, attach a copy of the permit required in accordance with the
NRM Act.
Water supply management
Other exploration methods and/or ancillary activities
Describe any other exploration methods (e.g. seismic) and/or ancillary exploration activities (bag farms, core storage areas, bulk
sample disposal pits etc.) required for the proposed program.
<Include text here.>
Other relevant information
Provide any other relevant information.
<Include text here.>
SECTION E – MAPS
Provide a map showing the following information, where applicable:

tenement boundaries

exploration activities (including access tracks and other ancillary exploration activities such as camps and equipment
laydown areas)

any areas of environmental significance

any other requirements as agreed to in the approved ongoing/project PEPR.
All maps must conform to the standards outlined in the determination for exploration PEPRs (Ministerial Determination 013).
<Attach maps here.>
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Exploration PEPR program notification
SECTION F – SUBMISSION OF EXPLORATION PEPR PROGRAM NOTIFICATION
An electronic version (PDF preferred) is to be submitted to DSD. A hard copy of the exploration PEPR program notification
together with an electronic version can be submitted if the file size is too large to email. The information in both the hard copy
and electronic version must be identical.
Submissions should be marked ‘Attention: Exploration Regulation’ and forwarded by email, post or courier:
Email
DSD.Exploration@sa.gov.au
Post
Mineral Tenements and Exploration Branch
Resources and Energy
Department of State Development
GPO Box 320
Adelaide SA 5001
Courier
Mineral Tenements and Exploration Branch
Resources and Energy
Department of State Development
c/- Level 7, 101 Grenfell Street
Adelaide SA 5000
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