Form 5600-FM-BMP0086 "Small Noncoal Blast Plan Checklist" - Pennsylvania

What Is Form 5600-FM-BMP0086?

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 June 1, 2018;
  • 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-FM-BMP0086 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-FM-BMP0086 "Small Noncoal Blast Plan Checklist" - Pennsylvania

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5600-FM-BMP0086
Rev. 6/2018
COMMONWEALTH OF PENNSYLVANIA
Checklist
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF MINING PROGRAMS
SMALL NONCOAL BLAST PLAN CHECKLIST
PERMITTEE:
PERMIT NO:
ADDRESS:
TOWNSHIP:
COUNTY:
YES NO
NA
Are there four copies of the Module 16 blast plan application?
Was the blasting contractor identified. § 211.121(a)
Was the ATF license or permit number for the permittee or the blasting contractor provided.
(§ 211.124(a)(3)
Was the $475.00 fee, a requirement of 25 PA Code Chapter 77.106, submitted with the
application?
1.
Has information been submitted for all of the applicable blast loading plans? (§§ 211.124(a)(15),
211.124(b)(6), 77.453)
2.
Is an alternative peak particle velocity or airblast level being requested? (§§ 211.151(c), (d) and
(e)) Department approval is necessary and may be granted at the Department’s discretion for any
peak particle velocity or airblast limit that is alternative to the limits in (§§ 211.151(c) and (d).
Alternative peak particle velocity or airblast levels which are high enough for there to be potential
to damage to a structure can be approved only if there is a knowing and specific waiver provided
by the property owner.
3.
Has it been indicated if the sequence and timing of hole detonation be determined by considering
factors such as geology, direction and proximity of homes or other structures, permit boundaries,
or the locations of underground or overhead utilities. (§ 77.453(a)(4))
4.
Has it been indicated if the loading of holes be determined by considering factors such as geology,
direction and proximity of homes or other structures, permit boundaries, or the locations of
underground or overhead utilities. (§ 77.564(a)(2))
5.
Has it been Indicated if blasting is planned within 1,000 of a dwelling or other occupied building.
§ 77.564(a)(2))
Has the distance to the nearest dwelling or other structure from the blasting been provided?
6.
If blasting will occur within 1,000 feet of any public building or school, has how the notification
required by 25 Pa Code Section § 77.564(g)(3) will be made been provided?.
7.
Has it been indicated if blasting is planned within 300 feet of an occupied dwelling?
(§ 77.564(g)(4))
If blasting is planned within 300 feet of an occupied dwelling has a written consent of the property
owner been provided? (§ 77.564(g)(4))
8.
Will there be blasting within 800 feet of a public highway? (§ 77.564(g)(1))
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5600-FM-BMP0086
Rev. 6/2018
COMMONWEALTH OF PENNSYLVANIA
Checklist
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF MINING PROGRAMS
SMALL NONCOAL BLAST PLAN CHECKLIST
PERMITTEE:
PERMIT NO:
ADDRESS:
TOWNSHIP:
COUNTY:
YES NO
NA
Are there four copies of the Module 16 blast plan application?
Was the blasting contractor identified. § 211.121(a)
Was the ATF license or permit number for the permittee or the blasting contractor provided.
(§ 211.124(a)(3)
Was the $475.00 fee, a requirement of 25 PA Code Chapter 77.106, submitted with the
application?
1.
Has information been submitted for all of the applicable blast loading plans? (§§ 211.124(a)(15),
211.124(b)(6), 77.453)
2.
Is an alternative peak particle velocity or airblast level being requested? (§§ 211.151(c), (d) and
(e)) Department approval is necessary and may be granted at the Department’s discretion for any
peak particle velocity or airblast limit that is alternative to the limits in (§§ 211.151(c) and (d).
Alternative peak particle velocity or airblast levels which are high enough for there to be potential
to damage to a structure can be approved only if there is a knowing and specific waiver provided
by the property owner.
3.
Has it been indicated if the sequence and timing of hole detonation be determined by considering
factors such as geology, direction and proximity of homes or other structures, permit boundaries,
or the locations of underground or overhead utilities. (§ 77.453(a)(4))
4.
Has it been indicated if the loading of holes be determined by considering factors such as geology,
direction and proximity of homes or other structures, permit boundaries, or the locations of
underground or overhead utilities. (§ 77.564(a)(2))
5.
Has it been Indicated if blasting is planned within 1,000 of a dwelling or other occupied building.
§ 77.564(a)(2))
Has the distance to the nearest dwelling or other structure from the blasting been provided?
6.
If blasting will occur within 1,000 feet of any public building or school, has how the notification
required by 25 Pa Code Section § 77.564(g)(3) will be made been provided?.
7.
Has it been indicated if blasting is planned within 300 feet of an occupied dwelling?
(§ 77.564(g)(4))
If blasting is planned within 300 feet of an occupied dwelling has a written consent of the property
owner been provided? (§ 77.564(g)(4))
8.
Will there be blasting within 800 feet of a public highway? (§ 77.564(g)(1))
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5600-FM-BMP0086
Rev. 6/2018
Checklist
9.
Has it been indicated how the blast area, as defined in 25 Pa Code Section 211.101, will be
determined, the procedures for notification of all persons who may have access to the blast area,
and how the blast area will be secured and safeguarded. (This information can be submitted as
an attachment) (§§ 77.564(d)(1), 77.564(e))
10. Has it been indicated if blasting will occur within 500 feet to any point over or adjacent to an active
or abandoned portion of an active underground mine? (§ 77.551)
If has been indicated that blasting will occur within 500 feet of an active or abandoned deep mine
has a completed MSHA form been attached.
11. Has it been indicated if blasting will occur within 200 feet of utilities, pipelines, or storage facilities?
(§§ 211.181, 77.564(g)(2))
If blasting is proposed within 200 feet of utilities, pipelines, or storage facilities has a copy of the
notice or letter sent to each of the utilities, pipeline or storage facilities been included? (A PA One-
call receipt may be accepted as a copy of a notice for utility owners who are PA One-call members)
If a waiver of a provision or provisions of § 211.182 is requested has a letter from the utility owning
the lines been included for DEP review?
12. Has it been indicated if blasting will be conducted at a scaled distance of 70 or greater, as
determined by the formula Ds=D/√w? (§ 77.108(e)(11))
If blasting will not be conducted at a scaled distance of 70 or greater have the copy of the required
public notice of the blasting schedule and the list of local governments and public utilities who
received copies of the blasting schedule been provided. This information should be submitted as
an attachment. (§ 77.563)
13. If the applicant is a noncoal surface mine operator who produces more than 2,000 tons (1,814
metric tons) of marketable minerals per year from all its noncoal surface mining operations has
proof of insurance covering the proposed blasting been submitted? (§ 211.124(a)(11)
14. Does the PA Licensed Blaster who prepared this application have a PA General or a Surface
Mining Blaster’s License? (§§ 211.124(a)(16))
Has the name of the PA Blaster who prepared this application been printed or typed and signed
and the blaster’s License number provided? (§ 211.124(a)(16))
15. Has the permittee or an authorized representative of the permit signed the application and is
permittee’s or authorized representative’s name printed or typed and signed? (§§ 211.124(a)(15),
211.124(b)(6))
16. Have four copies of a map that shows where blasting will be conducted been provided with
this applications. copies of the blast plan application? The map should accurately show, at a
minimum, permit boundaries, the locations of streams, gas wells and lines, other underground
utilities, overhead utilities, If explosives are going to be stored on the mine site, the location of the
explosives storage and the nearest dewllings and other structures. (§§211.124(7), 77.454(a)(9))
17. Has the checklist for all attachements been completed?
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