Form 5600-PM-BMP0031 "Application for Explosive Storage License(S)" - Pennsylvania

What Is Form 5600-PM-BMP0031?

This is a legal form that was released by the Pennsylvania Department of Environmental Protection - a government authority operating within Pennsylvania. Check the official instructions before completing and submitting the form.

Form Details:

  • Released on April 1, 2014;
  • 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-BMP0031 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-BMP0031 "Application for Explosive Storage License(S)" - Pennsylvania

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DEPARTMENT USE ONLY
5600-PM-BMP0031
4/2014
COMMONWEALTH OF PENNSYLVANIA
Plan #
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF MINING PROGRAMS
APPLICATION FOR EXPLOSIVE STORAGE LICENSE(S)
Applicant: Please complete all appropriate items on form. Mail the completed application to the appropriate
District Mining Office. (See attached list) A fee of $50 for each license, and $50 for the site inspection must be
remitted upon Department approval of the magazine(s), magazine location(s), and security plan
implementation. Make checks payable to "Commonwealth of Pennsylvania." Type or Print Legibly.
1. Name:
2. Tax ID/EIN:
3. Site Name:
4. ATF License:
5. Mailing Address:
(Street – P.O. Box)
6.
7.
8.
City
State
Zip Code
9. Type of Business/Mining:
10. Business Telephone Number:
(
)
11. 24-Hour Emergency Telephone:
12. Email Address:
13. County:
14. Municipality:
15. Authorized Representative Name and Title (Please Print):
Name:
Title:
16. Authorized Representative Signature:
17. Date:
18. Which Type of Magazine(s)?
Indoor Magazine(s)
Outdoor Magazine(s)
19. Is/are this/these indoor magazine(s) in a secure, intrusion resistant and theft resistant building(s)?
Yes
No
Not Applicable
20. Is this application for an additional magazine at a site that has an implemented approved storage security plan?
Yes
No
If yes, please provide the security plan number.
21. If this is an application for an additional magazine at a site that has an implemented, approved storage security
plan, will additional security be required to meet the regulatory standards at § 25 PA Code 211.115?
Yes
No
Note: If this application is for indoor magazine(s) in a theft resistant or intrusion resistant building or if this
application is for an additional magazine at a site that has an implemented approved storage security plan and does
not require additional security measures do not provide attachments for the "Security Measures" section
below.
Security Measures (Attachments for Outdoor Magazine(s))
1. Outer Perimeter Security
1a. Attachment
Yes
No
2. Inner Perimeter Security
2a. Attachment
Yes
No
3. Other Security
3a. Attachment
Yes
No
4. Description Narrative
Required Attachment
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DEPARTMENT USE ONLY
5600-PM-BMP0031
4/2014
COMMONWEALTH OF PENNSYLVANIA
Plan #
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF MINING PROGRAMS
APPLICATION FOR EXPLOSIVE STORAGE LICENSE(S)
Applicant: Please complete all appropriate items on form. Mail the completed application to the appropriate
District Mining Office. (See attached list) A fee of $50 for each license, and $50 for the site inspection must be
remitted upon Department approval of the magazine(s), magazine location(s), and security plan
implementation. Make checks payable to "Commonwealth of Pennsylvania." Type or Print Legibly.
1. Name:
2. Tax ID/EIN:
3. Site Name:
4. ATF License:
5. Mailing Address:
(Street – P.O. Box)
6.
7.
8.
City
State
Zip Code
9. Type of Business/Mining:
10. Business Telephone Number:
(
)
11. 24-Hour Emergency Telephone:
12. Email Address:
13. County:
14. Municipality:
15. Authorized Representative Name and Title (Please Print):
Name:
Title:
16. Authorized Representative Signature:
17. Date:
18. Which Type of Magazine(s)?
Indoor Magazine(s)
Outdoor Magazine(s)
19. Is/are this/these indoor magazine(s) in a secure, intrusion resistant and theft resistant building(s)?
Yes
No
Not Applicable
20. Is this application for an additional magazine at a site that has an implemented approved storage security plan?
Yes
No
If yes, please provide the security plan number.
21. If this is an application for an additional magazine at a site that has an implemented, approved storage security
plan, will additional security be required to meet the regulatory standards at § 25 PA Code 211.115?
Yes
No
Note: If this application is for indoor magazine(s) in a theft resistant or intrusion resistant building or if this
application is for an additional magazine at a site that has an implemented approved storage security plan and does
not require additional security measures do not provide attachments for the "Security Measures" section
below.
Security Measures (Attachments for Outdoor Magazine(s))
1. Outer Perimeter Security
1a. Attachment
Yes
No
2. Inner Perimeter Security
2a. Attachment
Yes
No
3. Other Security
3a. Attachment
Yes
No
4. Description Narrative
Required Attachment
- 1 -
5. Latitude and Longitude at the access point
- 1 -
5600-PM-BMP0031
4/2014
DEPARTMENT USE ONLY
Plan #
Proposed Magazine Information
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Distance
Distance
Distance to
to Dwelling
to Highway
Passenger
Description –
Type 1, 2, 4, 5,
(for
(for
Railway (for
(eg Magazine #1,
If this Magazine is
4 Fireworks or
Amount of
Outdoor
Outdoor
Outdoor
Drop
Grouped, indicate
Department
Drop Trailer
Type of
Barricaded
Explosives*
Magazines
Magazines
Magazines
Trailer Site #1,
which Magazines it
Use Only
Site
Explosives
Yes or No
(Pounds)
only)
only)
only)
etc.)
is Grouped with
DEPARTMENT USE ONLY
Check #
Amount
Trans #
Date Inspected
Reviewer (Blasting Inspector)
Print Name
Signature
Magazines and Their Locations Meet Regulatory Standards and Security Plan is Implemented as Approved
Yes
No
*The amount of explosives in pounds. 1000 caps = 1.5 pounds of explosives.
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