Form 5600-PM-MR0026 "Surface Mining Near Underground Mines - Msha Coordination" - Pennsylvania

What Is Form 5600-PM-MR0026?

This is a legal form that was released by the Pennsylvania Department of Environmental Protection - a government authority operating within Pennsylvania. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 1, 2005;
  • The latest edition provided by the Pennsylvania Department of Environmental Protection;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form 5600-PM-MR0026 by clicking the link below or browse more documents and templates provided by the Pennsylvania Department of Environmental Protection.

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Download Form 5600-PM-MR0026 "Surface Mining Near Underground Mines - Msha Coordination" - Pennsylvania

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5600-PM-MR0026
12/2005
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF MINING AND RECLAMATION
SURFACE MINING NEAR UNDERGROUND MINES - MSHA COORDINATION
INSTRUCTIONS
Any surface coal mining activities within 500 feet of an active underground mine must be jointly approved by the
Department and the Mine Safety and Health Administration (MSHA).
In order to obtain MSHA approval, submit 4 copies of the following information along with your permit application to the
Department. The Department will forward the information to MSHA.
All applicants will be required to comply with MSHA’s rules and regulations during mining activities on this permit.
SECTION A. APPLICANT INFORMATION
Applicant Name:
Mine Name:
MSHA Pit No:
MSHA I.D. No.:
Mailing Address:
(Street # and Name or P.O. Box)
City
State
Zip Code + Four
- VOLUNTARY -
Federal Tax ID #
Social Security Number
Telephone #
Fax #
if Individual
Mining Operators License #
Application Contact:
Last Name
First Name
MI
Social Security #
Voluntary
Title
:
Mailing Address
Street # and Name or P.O. Box
City
State
Zip Code + Four
SECTION B. LOCATION OF UNDERGROUND MINE(S)
Underground mine(s) affected
MSHA I.D. No.
Horizontal distance (feet) to the active workings of the underground mine.
Vertical distance (feet) to the active workings of the underground mine.
Horizontal distance (feet) to any abandoned areas of the active underground mine.
Vertical distance (feet) to any abandoned areas of the active underground mine.
Is the mine flooded?
Yes
No
Uncertain
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5600-PM-MR0026
12/2005
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF MINING AND RECLAMATION
SURFACE MINING NEAR UNDERGROUND MINES - MSHA COORDINATION
INSTRUCTIONS
Any surface coal mining activities within 500 feet of an active underground mine must be jointly approved by the
Department and the Mine Safety and Health Administration (MSHA).
In order to obtain MSHA approval, submit 4 copies of the following information along with your permit application to the
Department. The Department will forward the information to MSHA.
All applicants will be required to comply with MSHA’s rules and regulations during mining activities on this permit.
SECTION A. APPLICANT INFORMATION
Applicant Name:
Mine Name:
MSHA Pit No:
MSHA I.D. No.:
Mailing Address:
(Street # and Name or P.O. Box)
City
State
Zip Code + Four
- VOLUNTARY -
Federal Tax ID #
Social Security Number
Telephone #
Fax #
if Individual
Mining Operators License #
Application Contact:
Last Name
First Name
MI
Social Security #
Voluntary
Title
:
Mailing Address
Street # and Name or P.O. Box
City
State
Zip Code + Four
SECTION B. LOCATION OF UNDERGROUND MINE(S)
Underground mine(s) affected
MSHA I.D. No.
Horizontal distance (feet) to the active workings of the underground mine.
Vertical distance (feet) to the active workings of the underground mine.
Horizontal distance (feet) to any abandoned areas of the active underground mine.
Vertical distance (feet) to any abandoned areas of the active underground mine.
Is the mine flooded?
Yes
No
Uncertain
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5600-PM-MR0026
12/2005
SECTION C. SITE INFORMATION
1.
Are there any existing or planned impoundments on this surface mine property that are or will be subject to MSHA
regulation?
Yes
No
Impoundment I.D. No.
2.
Will blasting be conducted over or adjacent to an active or abandoned portion of an active underground mine?
Yes
No
If yes, please complete Section D.
3.
Describe the mining operations that could affect the safety of the surface and/or underground miners.
4.
Attach a map and overlay of the permit area and the affected underground mine.
5.
Attach a geologic section of the strata to be affected (i.e., a description of the rock strata between the surface mining
and underground mining operations).
6.
List the coal seam(s) that will be mined.
SECTION D. BLASTING INFORMATION
1.
Type of material to be blasted:
2.
Maximum number of holes to be blasted:
3.
Hole diameter (inches):
Minimum
Maximum
4.
Hole depth (feet):
Minimum
Maximum
5.
Hole spacing (feet):
Minimum
Maximum
6.
Over burden depth (feet):
Minimum
Maximum
7.
Maximum lbs./delay period:
8.
Stemming amount:
Minimum
Maximum
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5600-PM-MR0026
12/2005
SECTION D. BLASTING INFORMATION Cont.
9.
Illustrate the typical arrangement of the explosives within the borehole.
- 3 -
5600-PM-MR0026
12/2005
SECTION D. BLASTING INFORMATION Cont.
10.
Typical delay sequence (include an example of firing time of deck charges and/or holes).
11.
Planned scaled distance for blast:
S
=
M
=
D
D
W ½
S
= Scaled Distance
D
M
= Measured distance
D
W = Maximum Weight of Explosives per Delay Period
12.
Will surface mine blasting be correlated with underground mine activity?
Yes
No
13.
How will this be accomplished?
14.
Have there been complaints from underground miners regarding surface blasting?
Yes
No
If Yes, please explain.
15.
If requested by MSHA, will the seismic effects of the surface blasting be monitored in the underground mine
and will records analyses of that monitoring be made available?
Yes
No
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5600-PM-MR0026
12/2005
SECTION E. AFFIDAVIT
Signature of Applicant or Responsible Official
Day of
(month)
(day)
Name (Typed)
Address
Address
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