Form 134 Application for Permit to Conduct G&G Prospecting

OMB Control Number 1010-0072

OMB Approval Expires 02/28/2009

UNITED STATES

DEPARTMENT OF THE INTERIOR

MINERALS MANAGEMENT SERVICE

______________________________________________________________________

(Insert Appropriate Regional Office)

Requirements for Geological and Geophysical Prospecting

or Scientific Research in the Outer Continental Shelf

Related to Minerals Other than Oil, Gas, and Sulphur

Application for Permit to Conduct Geological or Geophysical

Prospecting for Mineral Resources or Scientific Research

in the Outer Continental Shelf Related to

Minerals Other than Oil, Gas, and Sulphur

(Attachment 1)

Nonexclusive Use Agreement for Scientific Research

(Attachment 2)

SUBMIT: Original, two copies, and one public information copy (all with original signatures).

Paperwork Reduction Act of 1995 (PRA) Statement: The PRA (44 U.S.C. Chapter 35) requires us to inform you that the Minerals Management Service (MMS) collects this information to evaluate applications for permits to conduct pre-lease prospecting offshore and to monitor activities of scientific research conducted under notices. The MMS uses the information to ensure there is no environmental degradation, personnel harm, damage to historical or cultural sites, or interference with other uses. Responses are required to obtain a benefit. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid Office of Management and Budget control number.

The reporting burden for this form is estimated to average 8 hours per response, including the time for reviewing instructions, gathering and maintaining data, and completing and reviewing the form. Direct your comments regarding the burden estimate or any other aspect of this form to the Information Collection Clearance Officer, Mail Stop 4230, Minerals Management Service, 1849 C Street, NW, Washington, DC 20240.

UNITED STATES

DEPARTMENT OF THE INTERIOR

MINERALS MANAGEMENT SERVICE

REQUIREMENTS FOR GEOLOGICAL AND GEOPHYSICAL PROSPECTING

OR SCIENTIFIC RESEARCH IN THE OUTER CONTINENTAL SHELF

RELATED TO MINERALS OTHER THAN OIL, GAS, AND SULPHUR

Authority

You must perform all geological and geophysical prospecting or scientific research activities authorized and conducted in the Outer Continental Shelf (OCS) according to the OCS Lands Act, 30 CFR Part 280, and other applicable Federal statutes and regulations, as amended.

General Requirements of Permits and Notices

You must conduct geological and geophysical activities for mineral prospecting or scientific research activities authorized under 30 CFR Part 280 so that those activities do not:

A. Interfere with or endanger operations under any lease or right-of-way or permit issued or maintained under the OCS Lands Act;

B. Cause harm or damage to aquatic life or to the marine, coastal, or human environment;

C. Cause pollution;

D. Create hazardous or unsafe conditions;

E. Unreasonably interfere with or harm other uses of the area; or

F. Disturb archaeological resources.

Any person conducting geological or geophysical activities for mineral prospecting or scientific research under 30 CFR Part 280 must immediately report to us if you:

A. Detect hydrocarbon and/or mineral occurrences;

B. Encounter environmental hazards which constitute an imminent threat to human activity; or

C. Are aware of activities which adversely affect the environment, aquatic life, archaeological resources, or other uses of the area in which you are conducting prospecting or scientific research activities.

Any person conducting shallow or deep stratigraphic test drilling activities under a permit for mineral prospecting or scientific research under 30 CFR Part 280 must utilize the best available and safest technologies that MMS determines to be economically feasible.

The authorization MMS grants you under 30 CFR Part 280 to conduct geological and geophysical prospecting for minerals other than oil, gas, and sulphur or for scientific research does not confer a right to any discovered oil, gas, or other minerals, or to a lease under the OCS Lands Act.

Time Restriction for Permits and Notices

We limit the term of a permit to a period not to exceed 3 years but we issue it in 1-year increments. We limit extensions to a period of not more than two 1-year extensions from the initial termination date of the permit.

Geological and Geophysical Activities Requiring Permits and Notices

Geological and Geophysical Prospecting for Mineral Resources

You may not conduct geological and geophysical prospecting for minerals other than oil, gas, and sulphur in the OCS without an approved permit unless you conduct such activities under a lease issued or maintained according to the OCS Lands Act. You must obtain separate permits for either geological or geophysical prospecting for mineral resources. If MMS disapproves an application, the statement of rejection will give the reasons for the denial and will advise the applicant of those changes needed for you to obtain approval.

Geological and Geophysical Scientific Research

You may not conduct geological and geophysical scientific research related to minerals other than oil, gas, and sulphur in the OCS without an approved permit or filing of a notice. You must obtain separate permits for geological and geophysical scientific research which involves the use of solid or liquid explosives or the drilling of a deep stratigraphic test. If MMS disapproves your application, the statement of rejection will give the reasons for the denial and will advise the applicant of the changes needed for you to obtain approval.

You must file a notice with MMS at least 30 days before you begin scientific research not requiring a permit. We may inform you of all environmental laws and regulations pertaining to the OCS.

Information Required for Permits

Each applicant for a permit must complete the applicable sections of the Application for Permit (Attachment 1) and must include a page-size plat(s) showing the location of the proposed activity. The plat(s) should show geographic coordinates relative to the MMS area and block numbers, an easily identified onshore point of reference, and the distance and direction from the point of reference to area of activity. Do not include line locations on these plat(s). In addition, each applicant for a geological or geophysical permit must submit the appropriate attachment to section D of the application. Each applicant for a scientific research permit must also complete a Nonexclusive Use Agreement (Attachment 2).

The information you provide on the Application for Permit (excluding section D) and on the Nonexclusive Use Agreement, including continuation sheets and the page-size plat(s), is NON-PROPRIETARY INFORMATION. These non-proprietary portions of the application constitute the "public information" copy of Form MMS-134 and with the executed permit we will make them available to the public upon request.

The information listed in section D is PROPRIETARY INFORMATION. We will not make this information available to the public without the consent of the applicant/permittee for a period mandated by law or regulation. However, we may determine that earlier release is necessary to properly develop the area permitted.

Modifications to Approved Permits

The MMS Regional Supervisor must approve any modification to the permitted operations.

Filing Locations for Permits to Conduct Prospecting for Mineral

Resources and for Permits or Notices to Conduct Scientific Research

File each notice or application for a permit in triplicate, plus one public information copy, at the following locations 30 days before you begin operations:

A. For the OCS off the State of Alaska:

Regional Supervisor for Resource Evaluation

Minerals Management Service

Alaska OCS Region

3801 Centerpoint Dr., Suite #500

Anchorage, Alaska 99503-5820

B For the OCS in the Gulf of Mexico, off the Atlantic Coast, Puerto Rico, and U.S. Territories in the Caribbean Sea:

Regional Supervisor for Resource Evaluation

Minerals Management Service

Gulf of Mexico OCS Region

1201 Elmwood Park Boulevard

New Orleans, Louisiana 70123-2394

C. For the OCS off the States of California, Oregon, Washington, or Hawaii and other Pacific Federal Territories:

Regional Supervisor for Resource Evaluation

Minerals Management Service

Pacific OCS Region

770 Paseo Camarillo

Camarillo, California 93010-6064

Attachment 1

UNITED STATES

DEPARTMENT OF THE INTERIOR

MINERALS MANAGEMENT SERVICE

______________________________________________

(Insert Appropriate Regional Office)

APPLICATION FOR PERMIT TO CONDUCT GEOLOGICAL OR GEOPHYSICAL

PROSPECTING FOR MINERAL RESOURCES OR SCIENTIFIC RESEARCH

IN THE OUTER CONTINENTAL SHELF RELATED TO

MINERALS OTHER THAN OIL, GAS, AND SULPHUR

(Section 11, Outer Continental Shelf Lands Act of August 7, 1953, as amended on September 18, 1978, by Public Law 95-372, 92 Statute 629, 43 U.S.C. 1340; and 30 CFR Part 251)

______________________________________________________________

Name of Applicant

______________________________________________________________

Number and Street

______________________________________________________________

City, State, and Zip Code

______________________________________________________________

Name of Service Company or Purchaser

(if different from above)

Application is made for the following activity: (check one)

_______Geological prospecting for mineral resources

_______Geological scientific research

_______Geophysical prospecting for mineral resources

_______Geophysical scientific research

Submit: Original, two copies, and one public information copy.

================================================

To be completed by MMS

Permit Number: __________________________ Date: ________________________

A. General Information

1. The activity will be conducted by:

________________________________ For_________________________________

Service Company Name Purchaser(s) of the Data

________________________________ _________________________________

Number and Street Number and Street

_________________________________ _________________________________

City, State, and Zip Code City, State, and Zip Code

_________________________________ _______________________________

Telephone/FAX Numbers Telephone/FAX Numbers

________________________________ ________________________________

E-Mail Address E-Mail Address

2. The purpose of the activity is: _________ Mineral prospecting

_________ Scientific research

3. Describe the environmental effects of the proposed activity, including potential adverse effects on marine life and what steps you plan to minimize these adverse effects (use continuation sheets as necessary):

_____________________________________________________________________________

_____________________________________________________________________________

4. The expected commencement date is: ______________________________________________

The expected completion date is: __________________________________________________

5. The name of the individual in charge of the field operation is: ___________________________

May be contacted at: ____________________________________________________________

Telephone (Local) _______________________ (Marine) _____________________________

Radio call sign ___________________________

6. The vessel(s) to be used in the operation is (are):

Name ______________________________ Registry number __________________________

Registered owner _______________________________________________________________

7. The port from which the vessel(s) will operate is: _____________________________________

8. Briefly describe the navigation system (vessel navigation only): _________________________

_____________________________________________________________________________

B. Complete for Geological Prospecting for Mineral Resources or

Geological Scientific Research

1. The type of operation(s) to be used is: (check one)

(a) __________ Deep stratigraphic test, or

(b) __________ Shallow stratigraphic test with proposed total depth of _____________________, or

(c) __________ Other _______________________________________________________________

2. Exact geographic coordinates of proposed test(s) (attach a page-size plat(s)): _______________

_________________________________________________________________________________

C. Complete for Geophysical Prospecting for Mineral Resources or

Geophysical Scientific Research

1. Proposed location of the activity (attach a page-size plat(s)): ____________________________

2. The type(s) of operation(s) to be used is (are): _______________________________________

_____________________________________________________________________________

(Seismic, gravity, magnetic, etc.)

3. The instrumentation and/or technique(s) to be used in the operation(s) is (are): ______________

_____________________________________________________________________________

(Air gun, sparker, etc.)

4. Explosive charges will ______ will not ______ be used. If applicable, indicate the type of explosive and maximum charge size (in pounds) to be used:

Type ___________________ Pounds ____________ Equivalent Pounds of TNT ___________

D. Proprietary Information Attachments

Use the appropriate form on page 9 for a “geological” permit application or the form on page 10 for a “geophysical” permit application. You must submit a separate form MMS-134 to apply for each geological or geophysical prospecting permit.

E. Certification

I hereby certify that foregoing and attached information are true and correct.

SIGNED ____________________________________________ DATE _____________________

TITLE __________________________________________________________________________

================================================

TO BE COMPLETED BY MMS

Permit No.__________________ Assigned by ________________________________ Date ________

of MMS

This application is hereby:

a. _____ Approved

b. _____ Returned for reasons in the attached

The approved permit is:

a. _____ Attached

b. _____ Will be forwarded at a later date

SIGNED __________________________ TITLE Regional Supervisor DATE _____________

Section D Proprietary Information Attachment

Required for an Application for Geological Prospecting Permit

1. Brief description of method of shallow drilling or sampling: _________________________________

_________________________________________________________________________________

2. Brief description of shallow drilling or sampling equipment to be used: ________________________

_________________________________________________________________________________

_________________________________________________________________________________

3. Number of boring or sample locations to be occupied: ______________________________________

_________________________________________________________________________________

4. Navigation system or method to be used to position sample locations: _________________________

_________________________________________________________________________________

_________________________________________________________________________________

5. Method of sample analyses, storage, and handling: ________________________________________

_________________________________________________________________________________

6. Description and list of the final analyzed and/or processed data which will result from operations

under the proposed activity: _________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

7. Estimated date on which samples, logs, and analyzed and/or processed data will be ready for

inspection: _______________________________________________________________________

8. Attach map(s), plat(s), and chart(s) (preferably at a scale of 1:250,000) showing latitude and longitude, scale, specific block numbers, specific boring sample locations, and total number of borings or samples proposed.

Section D Proprietary Information Attachment

Required for an Application for Geophysical Prospecting Permit

1. Brief description of the energy source and streamer (receiving array): ________________________

_________________________________________________________________________________

_________________________________________________________________________________

2. Total energy output per impulse: ______________________________________________________

3. Number of impulses per linear mile: ___________________________________________________

4. Towing depth of the energy source: ____________________________________________________

5. Towing depth of the streamer: ________________________________________________________

6. Navigation system or method to be used to position shotpoint locations: _______________________

_________________________________________________________________________________

_________________________________________________________________________________

7. Area of activity and total number of line miles proposed: ___________________________________

8. Description and list of the final processed data which will result from operations under the proposed

activity: __________________________________________________________________________

_________________________________________________________________________________

9. Estimated date on which processed data will be available for inspection: _______________________

10. Attach map(s), plat(s), and chart(s) (preferably at a scale of 1:250,000) showing latitude and longitude, scale, specific block numbers, specific track lines with line identifications, and the total number of line miles proposed.

Attachment 2

UNITED STATES

DEPARTMENT OF THE INTERIOR

MINERALS MANAGEMENT SERVICE

______________________________________________

(Insert Appropriate Regional Office)

NONEXCLUSIVE USE AGREEMENT FOR SCIENTIFIC RESEARCH

IN THE OUTER CONTINENTAL SHELF

A. State the time and manner in which data and information resulting from the proposed activity will be made available to the public for inspection and reproduction, such time being the earliest practicable time.

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

B. ____________________________________ (applicant) agrees that the data and information resulting from the proposed activity will not be sold or withheld for exclusive use.

_____________________________________________

(Signature of Applicant)

_____________________________________________

(Type or Print Name of Applicant)

_____________________________________________

(Title)

_____________________________________________

(Date)

Submit: Original, two copies, and one public information copy.

MMS Form MMS-134 (January 2006 – Supersedes all previous editions of form MMS-134 which may not be used.) Page 5 of 11