Form 5600-FM-BMP0086 "Small Noncoal Blast Plan" - 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.

ADVERTISEMENT
ADVERTISEMENT

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

713 times
Rate (4.3 / 5) 43 votes
5600-FM-BMP0086
Rev. 6/2018
COMMONWEALTH OF PENNSYLVANIA
Form
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF MINING PROGRAMS
Small Noncoal Blast Plan
[Chapter 211/§§77.108(e)(11), 77.453, 77.561, 77.563, 77.564]
Permittee
New
Permit No.
Revised
Mine Name
County
Township
Blasting Contractor:
Blasting Contractor or Permittee ATF Permit License No.:
Emergency Contact
Name:
Title:
Phone:
An application for proposed blasting shall contain a blasting plan for the proposed permit area, explaining
how the applicant intends to comply with §§ 77.561-77.565 (relating to use of explosives) and including the
following; drilling patterns, including size, number, depths and spacing of holes, charge and packing of holes,
types of initiation and detonation controls, sequence and timing of firing holes, and scaled distance. Persons
responsible for blasting operations at a blasting site shall be familiar with the blasting plan and site-specific
performance standards (25 Pa. Code Chapter §77.453).
A
permit
issued
under
the
Noncoal
Surface
Mining
and
Conservation
and
Reclamation
Act (52 P. S. §§ 3301-3326), and the regulations promulgated thereunder (25 Pa. Code Chapter 77), authorizing
blasting activity shall act as a blasting activity permit issued under 25 Pa. Code Chapter 211. An application
for a blasting activity permit shall be prepared by a blaster and shall include information needed by the
Department to determine compliance with applicable laws and regulations and conditions necessary to ensure
that the proposed blasting activity complies with the applicable statutes and 25 Pa. Code Chapter 211. (25 Pa.
Code Chapter §211.121, 25 Pa. Code Chapter §211.124).
Sections 1 through 11 and Sections 13 through 18 must be submitted with the permit application. If blasting
will be conducted at scaled distances below 70 Section 12 (relating to public notice of blasting schedule) must
be submitted prior to blast plan approval. There shall be no blasting until a blast plan has been approved by
the Department.
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
1.
Blast Loading Plan 1 (§77.453)
MAX
MAX
BURDEN
SPACING
HOLE DEPTH
STEMMING
Hole
#
#
DIA.
HOLES
ROWS
MIN.
MAX.
MIN.
MAX.
MIN.
MAX.
MIN.
TYPE
A
B
- 1 -
5600-FM-BMP0086
Rev. 6/2018
COMMONWEALTH OF PENNSYLVANIA
Form
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF MINING PROGRAMS
Small Noncoal Blast Plan
[Chapter 211/§§77.108(e)(11), 77.453, 77.561, 77.563, 77.564]
Permittee
New
Permit No.
Revised
Mine Name
County
Township
Blasting Contractor:
Blasting Contractor or Permittee ATF Permit License No.:
Emergency Contact
Name:
Title:
Phone:
An application for proposed blasting shall contain a blasting plan for the proposed permit area, explaining
how the applicant intends to comply with §§ 77.561-77.565 (relating to use of explosives) and including the
following; drilling patterns, including size, number, depths and spacing of holes, charge and packing of holes,
types of initiation and detonation controls, sequence and timing of firing holes, and scaled distance. Persons
responsible for blasting operations at a blasting site shall be familiar with the blasting plan and site-specific
performance standards (25 Pa. Code Chapter §77.453).
A
permit
issued
under
the
Noncoal
Surface
Mining
and
Conservation
and
Reclamation
Act (52 P. S. §§ 3301-3326), and the regulations promulgated thereunder (25 Pa. Code Chapter 77), authorizing
blasting activity shall act as a blasting activity permit issued under 25 Pa. Code Chapter 211. An application
for a blasting activity permit shall be prepared by a blaster and shall include information needed by the
Department to determine compliance with applicable laws and regulations and conditions necessary to ensure
that the proposed blasting activity complies with the applicable statutes and 25 Pa. Code Chapter 211. (25 Pa.
Code Chapter §211.121, 25 Pa. Code Chapter §211.124).
Sections 1 through 11 and Sections 13 through 18 must be submitted with the permit application. If blasting
will be conducted at scaled distances below 70 Section 12 (relating to public notice of blasting schedule) must
be submitted prior to blast plan approval. There shall be no blasting until a blast plan has been approved by
the Department.
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
1.
Blast Loading Plan 1 (§77.453)
MAX
MAX
BURDEN
SPACING
HOLE DEPTH
STEMMING
Hole
#
#
DIA.
HOLES
ROWS
MIN.
MAX.
MIN.
MAX.
MIN.
MAX.
MIN.
TYPE
A
B
- 1 -
5600-FM-BMP0086
Rev. 6/2018
Form
C
D
E
F
Maximum explosives weight per delay (less than 8ms)
Minimum Scaled Distance
Specific type(s) of explosives
Method of blast initiation
Electric
Non-Electric
Other
Explain Other
Comments:
A
B
C
D
E
F
- 2 -
5600-FM-BMP0086
Rev. 6/2018
Form
2.
Peak Particle Velocity and Airblast Limits (§ 211.151 (c),(d))
Blasts shall be designed and conducted to meet the maximum allowable peak particle velocity indicated by
Figure 1 of 25 PA Code Chapter § 211.151 (c) and not exceed the noise levels specified in Table 1 of 25 PA
Code Chapter § 211.151 (d) at the closest building not owned or leased by the permittee or its customer.
The Department may establish an alternative peak particle velocity or airblast level if it determines that an
alternative standard is appropriate or if the owner and lessee, if leased to another party, of a structure located
on the permit area have each signed a waiver releasing the vibration limit. The waiver shall be clear, knowing
and specific. (attachment(s) NOTE: Additional review time will be necessary if the applicant submits a waiver
for an alternative peak particle or airblast limit at a structure.
3.
Will 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))
Yes
No
4.
Will 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))
Yes
No
5.
Blasting near Dwellings, Public Buildings or Schools (§ 77.453(g)(3))
Will blasting occur within 1,000 feet of any dwelling, public building or school?
Yes
No
Indicate distance to the nearest dwelling or structure, neither owned nor leased by Permittee, from the area
where blasting will occur.
feet
6.
If blasting will occur within 1,000 feet of any public building or school, explain how notification required by
25 Pa Code Section § 77.564(g)(3) will be made.
7.
Blasting Within 300 Feet of Occupied Dwellings (§ 77.564(g)(4))
Will blasting be conducted within 300 feet of an occupied dwelling?
Yes
No
If blasting is proposed within 300 feet of an occupied dwelling provide a notarized written waiver from the owner
each dwelling specifying the distance blasting may occur to the dwelling (Note: If the waiver includes an
increase in the peak particle velocity limits or in the airblast limits, in 25 Pa Code Section § 211.151(c) and (d),
the alternative limits must be specified in the waiver). (Attachment)
8.
Blasting Within 800 Feet of Public Roads (§ 77.564(g)(1))
Will blasting will be conducted within 800 feet of any public road?
Yes
No
If blasting will be conducted within 800 feet of any public road describe the precautions that will be taken to
protect the travelling public (can be submitted as an attachment):
- 3 -
5600-FM-BMP0086
Rev. 6/2018
Form
9.
Blast Area § 77.564(d)(1)( § 77.564(e))
Describe 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 (can be submitted as an attachment):
10.
Underground Mines (§ 77.551)
Will blasting occur within 500 feet to any point over or adjacent to an active or abandoned portion of an active
underground mine?
Yes
No
If yes attach completed MSHA form. (Attachment)
11.
Underground Utility Lines: (§ § 211.181-182)
Will blasting be conducted within 200 of feet Underground Utility Lines?
Yes
No
If underground utililities are located within 200 feet of the area where blasting will occur, attach a copy of the
notification sent to the owner(s) (submit as an attachment).
If there are any requests for waiver of any of the provisions of 211.182 attach copies of any agreements with
the owner(s) of the utilities (submit as an attachment).
12.
Public Notice of Blasting Schedule (§ 77.108(e)(11)) (§ 77.563)
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 the following to the Department prior to the initiation of blasting conducted at a scaled distances
of 70 or less in accordance with 25 Pa Code § 77.563:
a)
A Copy of the public notice of the blasting schedule that is published in a newspaper of general circulation
in the locality of the area where blasting will occur (submit as an attachment)
b)
A List of the Local governments and public utilities that are located within 1,000 feet of the area where
blasting will occur, who received copies of the blasting schedule. (Note: These shall be sent a copy of
the blasting schedule.) (submit as an attachment)
13.
Proof of Insurance (§ 211.124(a)(11)
If the applicant is a non-coal surface mine operator who produces more than 2,000 tons (1,814 metric tons) of
marketable minerals per year from all its non-coal surface mining operations submit proof of insurance covering
the proposed blasting activities (attachment).
- 4 -
5600-FM-BMP0086
Rev. 6/2018
Form
14.
Blast Plan Preparer (§ 211.124(a))
The PA licensed blaster who prepared this application must print and sign name below. (General or Surface
Mining Authorization Only)
Licensed Blaster
Print
Licensed Blaster
Date
Blaster’s license Number BL-
Sign
(General or Surface Mining Authorization)
15.
Permittee Authorization Representative (§ 77.107)
The permittee or an authorized representative of the permittee must print and sign name below.
Permittee or Authorized Representative
Print
Permittee or Authorized Representative
Date
Sign
16.
Map (attachment-delineates where blasting will occur. A copy of the topographic map or areal photo map
required by § 77.108(b)(9)) § 211.124(7))
17.
List of attachments (Check all that apply)
Dwelling Waiver
Road Precaution Description
Blast Area Security Plan
MSHA Form
Utility Notification
Blast Schedule Public Notice
Map
Proof of Insurance
Other
- 5 -
Page of 6