Form 5600-FM-BMP0340 "Blast Report" - Pennsylvania

What Is Form 5600-FM-BMP0340?

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 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-BMP0340 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-BMP0340 "Blast Report" - Pennsylvania

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5600-FM-BMP0340
Rev. 6/2018
COMMONWEALTH OF PENNSYLVANIA
Form
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF MINING PRGRAMS
BLAST REPORT
RESPONSIBLE PARTY INFORMATION/DATE/TIME
Permittee
Blasting Contractor
Permit #.
Date
Time
A.M.
P.M.
Permit Municipality/County
/
EXPLOSIVES LOADING AND AMOUNTS
Type of Material
Stemming
Min.
(ft.) Max.
(ft.)
No. of Holes
Type Stem.
Diameter
Min.
(in.) Max.
(in.)
No. of Rows (burden):
Depth
Min.
(ft.) Max.
(ft.)
Burden
Min.
(ft.) Max.
(ft.)
Sub Drilling
(ft.)
Spacing
Min.
(ft.) Max.
(ft.)
Max No.
Decks/Hole
Maximum No. of Holes Per Delay
Deck Separation
Min.
(ft.) Max.
(ft.)
Max. Lbs./Delay Less Than 8 ms.
(lbs.)
Wt./Deck
Min.
(lbs.) Max.
(lbs.)
Maximum Powder Factor
(
/
)
lbs
YD
Explosives (Mfr/Type/density of blasting agents)
Amount (lbs)
Detonators (Mfr/Type/Delay MS)
Amount (qty)
Total
Total
Were Mats Used?
Yes
No
Describe matting:
Type of initiation
Elec.
Non-electric
Electronic
Other
Explain Other
SCALED DISTANCE/BLAST LOCATION
Distance (feet)/Direction (degrees) to Closest Building/structure
/
Description of Closest Building/structure and Address (if applicable)
Blast Site (lat/lon)
/
Scaled Distance
Ds =
D
/
W
SEISMOGRAPH MONITORING
Yes
No
1. Seismograph Location Distance (feet) and Direction
2. Seismograph
Location
Distance
(feet)
and
Direction
(degrees) from Blast
/
(degrees) from Blast
/
Description of Seismograph Location
Description of Seismograph Location
Location (lat/lon)
/
Location (lat/lon)
/
Seismograph Operator (print)
(sign)
Seismograph Operator (print)
(sign)
WEATHER
Weather (description, general)
Temp
Wind Direction
Wind Velocity (mph)
DRILL LOG (ATTACHMENT)
BLASTER-IN-CHARGE/BLAST CREW
Blaster-in-charge (print)
(sign)
BL-
Blasting Crew
Remarks:
- 1 -
5600-FM-BMP0340
Rev. 6/2018
COMMONWEALTH OF PENNSYLVANIA
Form
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF MINING PRGRAMS
BLAST REPORT
RESPONSIBLE PARTY INFORMATION/DATE/TIME
Permittee
Blasting Contractor
Permit #.
Date
Time
A.M.
P.M.
Permit Municipality/County
/
EXPLOSIVES LOADING AND AMOUNTS
Type of Material
Stemming
Min.
(ft.) Max.
(ft.)
No. of Holes
Type Stem.
Diameter
Min.
(in.) Max.
(in.)
No. of Rows (burden):
Depth
Min.
(ft.) Max.
(ft.)
Burden
Min.
(ft.) Max.
(ft.)
Sub Drilling
(ft.)
Spacing
Min.
(ft.) Max.
(ft.)
Max No.
Decks/Hole
Maximum No. of Holes Per Delay
Deck Separation
Min.
(ft.) Max.
(ft.)
Max. Lbs./Delay Less Than 8 ms.
(lbs.)
Wt./Deck
Min.
(lbs.) Max.
(lbs.)
Maximum Powder Factor
(
/
)
lbs
YD
Explosives (Mfr/Type/density of blasting agents)
Amount (lbs)
Detonators (Mfr/Type/Delay MS)
Amount (qty)
Total
Total
Were Mats Used?
Yes
No
Describe matting:
Type of initiation
Elec.
Non-electric
Electronic
Other
Explain Other
SCALED DISTANCE/BLAST LOCATION
Distance (feet)/Direction (degrees) to Closest Building/structure
/
Description of Closest Building/structure and Address (if applicable)
Blast Site (lat/lon)
/
Scaled Distance
Ds =
D
/
W
SEISMOGRAPH MONITORING
Yes
No
1. Seismograph Location Distance (feet) and Direction
2. Seismograph
Location
Distance
(feet)
and
Direction
(degrees) from Blast
/
(degrees) from Blast
/
Description of Seismograph Location
Description of Seismograph Location
Location (lat/lon)
/
Location (lat/lon)
/
Seismograph Operator (print)
(sign)
Seismograph Operator (print)
(sign)
WEATHER
Weather (description, general)
Temp
Wind Direction
Wind Velocity (mph)
DRILL LOG (ATTACHMENT)
BLASTER-IN-CHARGE/BLAST CREW
Blaster-in-charge (print)
(sign)
BL-
Blasting Crew
Remarks:
- 1 -
5600-FM-BMP0340
Rev. 6/2018
Form
Date:
Time:
A.M.
P.M.
Permit #:
Timing Diagram 1 and Blast Hole Layouts.
Indicate North
Layout 1. Layout 2. Layout 3. Layout 4. Layout 5. Layout 6. Layout 7. Layout 8. Layout 9.
- 2 -
5600-FM-BMP0340
Rev. 6/2018
Form
Date:
Time:
A.M.
P.M.
Permit #:
Timing Diagram 2.
Indicate North
Additional Remarks:
ADDITIONAL SEISMOGRAPH MONITORING
3.
Seismograph Location Distance (feet) and Direction
4.
Seismograph Location Distance (feet) and Direction
(degrees) from Blast
/
(degrees) from Blast
/
Description of Seismograph Location
Description of Seismograph Location
Location (lat/lon)
/
Location (lat/lon)
/
Seismograph Operator (print)
(sign)
Seismograph Operator (print)
(sign)
- 3 -
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