5600-FM-BMP0086 11/2012 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF ENVIRONMENTAL PROTECTION BUREAU OF MINING PROGRAMS BLASTING PLAN FOR SMALL NONCOAL (INDUSTRIAL MINERAL) OPERATIONS 1. Permittee: Permit #: County: Township: 2. Dwelling and Structures: A. B. C. Indicate the distance between the blasting area and the nearest dwelling or structure, which is not owned nor leased by the operator. Feet Will blasting occur within 1000 feet of any public building or school? Yes No Maximum particle velocity Maximum airblast Determined by 25 Pa Code 133 dBL unless otherwise specified. Section211.151(c) Figure 1 unless otherwise specified. DEPARTMENT USE ONLY Alternative Maximum Allowable Peak Particle Velocity Alternative Maximum Allowable Airblast 3. Oil and Gas Wells and Underground Utility Lines: If any of the following are located within 200 feet of the area where blasting will occur, attach a copy of the notification sent to the owner(s). Oil or Gas Wells. 4. No Underground Utility Lines Yes Blast Loading Plan (Overburden, Development, or Other – Must Identify Other): Number of holes per pattern Number of rows (Burden) Diameter of holes 4(a). Yes Maximum Maximum Maximum Minimum Minimum Burden Minimum Maximum Spacing Minimum Maximum Depth Minimum Maximum Minimum Scaled Distance Other Length of stemming Type of stemming Maximum explosives weight per delay (8 MS or greater) Method of blast initiation Electric Non-Electric Explain Other Blast Loading Plan (Production): Will Detonating Cord be the primary type of explosives used? Number of holes per pattern Maximum Number of rows (Burden) Maximum Diameter of holes Maximum Minimum Length of stemming Minimum Type of stemming Method of covering Detonating Cord Maximum explosives weight per delay (8 MS or greater) -1- Yes No Burden Minimum Maximum Spacing Minimum Maximum Depth Minimum Maximum Minimum Scaled Distance No 5600-FM-BMP0086 11/2012 Method of blast initiation If other, explain 5. Electric Non-Electric Other Will blasting be conducted at a scaled distance of 70 or greater, as determined by the formula Ds=D/√w? Yes No If no, submit proof of public notice of blasting schedule, in accordance with 25 Pa Code Section 77.563 to the Department prior to conducting any blasting activities. Note: All blasting conducted at a scaled distance of 90 or less requires seismograph monitoring. 6(a). Additional Precautions taken when blasting within 1,000 feet of a dwelling or other occupied building. Describe additional precautions to be taken when blasting within 1,000 feet of a dwelling or other occupied building: 6(b). Procedures for notification of all persons who may be in or near the blast area. Describe the procedures for notification of all persons who may have access to the blast area: 7. Public Highways Will blasting occur within 800 feet of public road? Yes No If yes, describe what precautionary measures will be taken to safeguard the public as required by 25 Pa Code Section 77.564(g)(1). 8. Blast Area Describe how the blast area, as defined in 25 Pa. Code Section 211.101, will be determined, secured and safeguarded: 9. Proof of Insurance Submit proof of insurance covering the proposed blasting activities. 10. Application Fee There is a fee required under 25 PA Code Chapter 77.106 for each blast plan application. The fee is $475. Is the fee being submitted with the application? Yes No 11. Blast Plan Preparer The PA licensed blaster who prepared this application must sign below. BLSignature of Licensed Blaster, General or Surface Mining Authorization is required. DEPARTMENT USE ONLY DEP Blasting Inspector: Recommendation: Approval Disapproval Comments: -2-