Bonus Bid (Tender) Submission for Surface Materials Exploration Operations Division PLEASE PRINT OR TYPE FOR DEPARTMENTAL USE ONLY Operations Division Provincial Programs Branch 5th floor, South Petroleum Plaza 9915 – 108 Street Edmonton, Alberta, T5K 2G8 Fax: 780-427-1029 aep.alberta.ca/lands-forests/ Department File Number: SME Client ID No.: FNC No.: Applicant's name: Applicant's authorized representative name: Address: Address: Phone: Fax: Phone: Fax: Are you an employee of the Alberta Government or member of the Legislative Assembly of the Province of Alberta? Yes Dept. No Are you a Canadian Citizen? Have you attained the age of 18 years? Yes No Yes No SURFACE MATERIALS REQUIRED: Non-Manufacturing Clay Sand Sand & Gravel Marl - Type of equipment to be used: including testing, line cutting and access equipment: - SME proposed commencement day/month/year SME proposed completion including testing and reclamation day/month/year A. PLAN REQUIREMENTS: Surface Materials Exploration Boundary as provided by the Department. In addition to the sketch requirements the sketch must also indicate the proposed test hole locations, new and existing access to be used, creek crossings, etc. For specific requirements check: Manufacturing Clay MUNICIPALITIES ONLY: Is this a public work project? Yes No aep.alberta.ca/lands-forests/land-management/disposition-plan-requirements.aspx LAND BEING APPLIED FOR (Attach Schedule if insufficient space) QTR/LSD B. MONIES: Yes Yes Yes Yes SEC No No No No TWP RGE MER QTR/LSD SEC TWP RGE MER Applicant fee ($525) attached. GST ($26.25) or GST Registrant No. Security Deposit attached $7,000 upto 320 acres ($1,500 per 80 acres or thereof) non-transferable. Mapping fee ($125) attached Information you provide to Alberta Environment and Parks (AEP) is collected under the authority of Section 33(c) of the Freedom of Information and Protection of Privacy (FOIP) Act and is managed in accordance with Part 2 of the FOIP Act. The personal information you provide will be used by AEP for the purpose of administering the Public Lands Act and its associated regulations. Your personal information will not be used for any other purpose by AEP without your consent; however, it may be publicly disclosed to anyone requesting access of the record in accordance with Sections 166-167 of the Public Lands Administration Regulation. Aug 27, 2015 Bonus Bid (Tender) Application for Surface Materials Exploration Page 1 of 2 (LD 19) © 2015 Government of Alberta -2- C. ACCESS OR TESTING PROCEDURE: Yes No Testing is to occur along existing lines only. If no, complete Sections E & F - If no, all new lines to be constructed are to be shown on an attached map along with spacing and access routes. - Right of Way widths for new cut lines are metres. - Length of new cut lines is metres. - Describe disposal of woody debris: Activity on the land during adverse ground conditions must be suspended if the activity is likely to cause unacceptable damage to vegetation and soil. TESTING REQUIREMENTS: - The holder shall provide the department with a detailed report of every log or survey taken on each hole within 60 days of completion of program. - If the proponent wishes to pursue a surface materials lease on a specific location within the exploration area, further testing may be required to determine the quality and confirm the quantity of materials. - All excavated test holes are to be back filled (horizons replaced in order found if backhoe used) compacted and capped. The topsoil/ surface soil layer is to be salvaged and replaced on the surface of the back filled excavation. D. EVALUATION OF IMPACTS ON WATERCOURSES/WATER BODIES Yes No The Exploration Program includes watercourse/water body crossings. If Yes, section "G" must be completed. For exploration and access roads which cross a watercourse or water body, the Water Act Code of Practice for Watercourse Crossings must be followed, except in those situations where a watercourse crossing is identified as being exempt from requiring an approval under Schedules 1 & 2 of the Water Act Ministerial Regulation. The applicable Code of Practice Management Area Map is to be consulted to determine the crossing “types” that would be applicable to any activity potentially impacting water bodies. The code and maps outline where certain types of crossings may be used and identify certain locations where new crossings are not permitted. The code and maps are available through Queen's Printer or at website: aep.alberta.ca/water/legislation-guidelines/codes-of-practice-pipelines-telecommunications-lines-crossing-a-water-bodywater-course-crossings.aspx It is expected that the proposed watercourse crossings have been evaluated and positioned to minimize environmental impact and meet the applicable Code of Practice requirements. Each water crossing, where mechanical equipment will cross, must be identified on the map. Each location must be given a number and the proposed crossing method identified with the appropriate symbol, as shown below (enclosed in a circle), Examples SF Snow SF and/ or ice fills IF Strapped or cabled log fills LF Ford type crossings F Log Fill LgF Portable free span bridge PB Existing bridge B Culvert C Other (specify): The holder shall not deposit or push debris, soil or other deleterious materials into or through any watercourse or water body or on the ice of any watercourse/body. The capacity of any culvert and bridges in a watercourse crossing must ensure that any increase in back flooding does not result in flood damage to public land or property. E. RECLAMATION - Progressive reclamation work is to be carried out concurrently with exploration. - Reclamation includes debris disposal, slope stabilization, re-contouring, restoration of natural drainage(s), replacement of surface soil and revegetation. - Woody debris, including leaning trees, must be disposed of in accordance with the Forest & Prairie Protection Regulations, Part II, unless otherwise directed by a departmental officer. - Seed mixture must be determined in consultation with the departmental officer. The holder shall provide, upon request of a departmental officer, a certificate of analysis for each seed lot used in the reclamation of these lands. - A Letter of Closure is required to Release the Holder of the Exploration Approval of any further reclamation responsibilities ________________________________________ Date Aug 27, 2015 ______________________________________________ Signature of Applicant or Representative Bonus Bid (Tender) Application for Surface Materials Exploration (LD 19) © 2015 Government of Alberta Page 2 of 2