Instructions for Form 5600-PM-BMP0020 "Environmental Good Samaritan Project Proposal" - Pennsylvania

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5600-PM-BMP0020
Rev. 7/2019
COMMONWEALTH OF PENNSYLVANIA
Instructions
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF MINING PROGRAMS
INSTRUCTIONS FOR COMPLETING
ENVIRONMENTAL GOOD SAMARITAN
PROJECT PROPOSAL
GENERAL INFORMATION
4. List of Project Participants: Identify the persons
or organizations that will be working on the project
1.
Eligible Projects are:
on Attachment B. It is not necessary, but it is a good
Projects that reclaim lands that have been
idea, to identify individual members of participating
adversely affected by mining, oil or gas
organizations.
The project applicant can add
extraction or exploration for these resources.
persons to this list as the project progresses.
Persons not on the list are not prohibited from
Projects that treat or abate water pollution
working on the project.
caused by mining or oil or gas extraction.
5. List of Adjacent and Riparian Landowners:
2.
This information is provided to assist the applicant
Provide the names and addresses of property
in obtaining DEP approval for reclamation and
owners adjacent to the property(ies) on which the
water pollution abatement projects under the
project will take place on Attachment C.
Also
Environmental Good Samaritan Act.
include counties, municipalities and parcel numbers
3.
Complete the application by typing or printing
for these property owners, if available.
clearly. If additional space is required to provide
If the project is adjacent to a stream or involves a
information
in
this
application,
attach
an
discharge to a stream, provide the names and
8½ x 11 inch sheet of paper appropriately labeled.
addresses of persons who own property along the
4.
One original of this application must be completed
stream downstream of the project area.
and submitted to the appropriate DEP District
SECTION B. LOCATION
Mining Office.
1. Location:
Give the name of the county and
GROWING GREENER PROJECTS
municipality, for each site.
Also include latitude,
If a project is approved for a grant under the
longitude and USGS quadrangle, if possible.
Pennsylvania Growing Greener program, the applicant
2. Project
boundaries:
Provide
a
narrative
may apply for coverage under the Environmental Good
describing the boundaries of the project or a map of
Samaritan Act by completing Attachments A, B, C and D
the project boundaries. Identify the properties and
and sending them along with one copy of the Growing
their owners within and adjacent to the project area.
Greener grant application to the appropriate District
Mining office.
3. Newspaper of general circulation published in
locality of proposed project:
List the name,
SECTION A. APPLICANT INFORMATION
address and telephone number of a newspaper of
1. Applicant:
Identify the person or organization
general circulation published in the locality of the
under which the application is filed, the applicant’s
proposed
project.
The
Department
will
be
legal mailing address, and the type of person or
responsible for project notices.
persons. The applicant is usually the person who
SECTION C. PROJECT DESCRIPTION
has overall responsibility and control of the project
activities.
1. Project Name: Give the name of the project and
check the box which identifies the type of project.
2. Project Coordinator:
Give the name of the
individual representing the applicant and having
2. Project area: Give the total area in acres to be
primary control of on-site activities; the daytime
affected by the project and indicate the expected
telephone number for the project coordinator; and
duration of the reclamation and abatement activities
the legal mailing address of the project coordinator.
that will be taking place on the project site.
3. List of Landowners: Identify all landowners within
3. Description of the problem to be addressed by
the project area on Attachment A. Include names
the project:
If the project is a land reclamation
and mailing addresses; if available, also include
project, describe the existing site conditions and
counties, municipalities and parcel numbers for
total acres to be reclaimed. If the project is a water
these landowners.
pollution
abatement
project,
describe
the
discharges, identifying the polluting substances and
their respective concentrations and flow rates.
Describe the general nature of the impacts of the
discharges on the receiving stream. If known,
- 1 -
5600-PM-BMP0020
Rev. 7/2019
COMMONWEALTH OF PENNSYLVANIA
Instructions
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF MINING PROGRAMS
INSTRUCTIONS FOR COMPLETING
ENVIRONMENTAL GOOD SAMARITAN
PROJECT PROPOSAL
GENERAL INFORMATION
4. List of Project Participants: Identify the persons
or organizations that will be working on the project
1.
Eligible Projects are:
on Attachment B. It is not necessary, but it is a good
Projects that reclaim lands that have been
idea, to identify individual members of participating
adversely affected by mining, oil or gas
organizations.
The project applicant can add
extraction or exploration for these resources.
persons to this list as the project progresses.
Persons not on the list are not prohibited from
Projects that treat or abate water pollution
working on the project.
caused by mining or oil or gas extraction.
5. List of Adjacent and Riparian Landowners:
2.
This information is provided to assist the applicant
Provide the names and addresses of property
in obtaining DEP approval for reclamation and
owners adjacent to the property(ies) on which the
water pollution abatement projects under the
project will take place on Attachment C.
Also
Environmental Good Samaritan Act.
include counties, municipalities and parcel numbers
3.
Complete the application by typing or printing
for these property owners, if available.
clearly. If additional space is required to provide
If the project is adjacent to a stream or involves a
information
in
this
application,
attach
an
discharge to a stream, provide the names and
8½ x 11 inch sheet of paper appropriately labeled.
addresses of persons who own property along the
4.
One original of this application must be completed
stream downstream of the project area.
and submitted to the appropriate DEP District
SECTION B. LOCATION
Mining Office.
1. Location:
Give the name of the county and
GROWING GREENER PROJECTS
municipality, for each site.
Also include latitude,
If a project is approved for a grant under the
longitude and USGS quadrangle, if possible.
Pennsylvania Growing Greener program, the applicant
2. Project
boundaries:
Provide
a
narrative
may apply for coverage under the Environmental Good
describing the boundaries of the project or a map of
Samaritan Act by completing Attachments A, B, C and D
the project boundaries. Identify the properties and
and sending them along with one copy of the Growing
their owners within and adjacent to the project area.
Greener grant application to the appropriate District
Mining office.
3. Newspaper of general circulation published in
locality of proposed project:
List the name,
SECTION A. APPLICANT INFORMATION
address and telephone number of a newspaper of
1. Applicant:
Identify the person or organization
general circulation published in the locality of the
under which the application is filed, the applicant’s
proposed
project.
The
Department
will
be
legal mailing address, and the type of person or
responsible for project notices.
persons. The applicant is usually the person who
SECTION C. PROJECT DESCRIPTION
has overall responsibility and control of the project
activities.
1. Project Name: Give the name of the project and
check the box which identifies the type of project.
2. Project Coordinator:
Give the name of the
individual representing the applicant and having
2. Project area: Give the total area in acres to be
primary control of on-site activities; the daytime
affected by the project and indicate the expected
telephone number for the project coordinator; and
duration of the reclamation and abatement activities
the legal mailing address of the project coordinator.
that will be taking place on the project site.
3. List of Landowners: Identify all landowners within
3. Description of the problem to be addressed by
the project area on Attachment A. Include names
the project:
If the project is a land reclamation
and mailing addresses; if available, also include
project, describe the existing site conditions and
counties, municipalities and parcel numbers for
total acres to be reclaimed. If the project is a water
these landowners.
pollution
abatement
project,
describe
the
discharges, identifying the polluting substances and
their respective concentrations and flow rates.
Describe the general nature of the impacts of the
discharges on the receiving stream. If known,
- 1 -
5600-PM-BMP0020
Rev. 7/2019
Instructions
include information about former operations at the
Knox District Mining Office
site, specifically, the name, operator’s permit
White Memorial Building, P.O. Box 669
number, and approximate dates of operation.
Knox, PA 16232-0669
Telephone: 814-797-1191
Describe the work to be done and the sequence and
Counties Serves: Beaver, Butler, Clarion, Crawford, Elk,
timing of activities.
Erie, Forest, Jefferson, Lawrence, McKean, Mercer,
a. For reclamation projects, include a description of
Venango and Warren.
the reclamation to be accomplished.
Cambria District Mining Office
b. For water pollution abatement projects, include a
286 Industrial Park Rd
description of the abatement or treatment
Ebensburg, PA 15931
measures planned.
Telephone: 814-472-1900
Counties Served:
Adams, Bedford, Blair, Cambria,
Include a table that identifies the major project
Cumberland, Franklin, Fulton, Huntingdon, Indiana,
milestones and the estimated date for completing
Juniata, Mifflin, Perry and Somerset.
each milestone.
New Stanton District Mining Office
4. Permission
to Enter
Project
Area:
Each
P.O. Box 133
landowner, whose property will be used for the
New Stanton, PA 15672
proposed project or used to provide access to the
Phone: 724-925-5500
project area, must give his or her permission in
Fax: 724-925-5557
writing to the project applicant to come onto the
Counties Served:
Allegheny, Armstrong, Fayette,
property to work on the proposed project.
Each
Greene, Washington and Westmoreland.
landowner must also give the Department of
Environmental Protection permission to come onto
California District Mining Office
the property to observe project activities, collect
25 Technology Drive
samples and otherwise do its job. Documentation of
Coal Center, PA 15423
landowner permission may be in the form of a letter
Telephone: 724-769-1100
to
the
applicant,
signed
by
the
landowner.
Counties Served:
All counties with underground
Documentation should be attached to Attachment D.
Bituminous
mining
and
subsidence
(Allegheny,
Once the project is approved, DEP will maintain a
Armstrong, Beaver, Bedford, Blair, Bradford, Butler,
Cambria, Cameron, Centre, Clarion, Clearfield, Clinton,
permanent record of the participants and landowners
who are protected under the Environmental Good
Crawford, Elk, Erie, Fayette, Forest, Fulton, Greene,
Huntingdon, Indiana, Jefferson, Lawrence, Lycoming,
Samaritan Act.
McKean, Mercer, Potter, Somerset, Sullivan, Tioga,
DEP DISTRICT MINING OFFICES
Venango, Warren, Washington, and Westmoreland).
Pottsville District Mining Office
5 West Laurel Boulevard
Pottsville, PA 17901-2454
Telephone: 570-621-3118
Counties Served: Berks, Bucks, Carbon, Chester,
Columbia, Dauphin, Delaware, Lackawanna, Lancaster,
Lebanon,
Lehigh,
Luzerne,
Monroe,
Montgomery,
Montour, Northampton, Northumberland, Philadelphia,
Pike, Schuylkill, Susquehanna, Wayne, Wyoming, and
York
Moshannon District Mining Office
186 Enterprise Drive
Philipsburg, PA 16866
Telephone: 814-342-8200
Counties
Served:
Bradford,
Cameron,
Centre,
Clearfield, Clinton, Lycoming, Potter, Snyder, Sullivan,
Tioga and Union.
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