Form BOEM-0134 Application for Permit to Conduct G&G Propsecting for ot

OMB Control Number 1010-0072

OMB Approval Expires xx/xx/xxxx

UNITED STATES

DEPARTMENT OF THE INTERIOR

BUREAU OF OCEAN ENERGY MANAGEMENT

______________________________________________________________________

(Insert Appropriate Regional Office)

Requirements for Geological and Geophysical Prospecting

or Scientific Research on 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

on 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 plus three copies, totaling four copies, which include one digital copy 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 Bureau of Ocean Energy Management (BOEM) collects this information to evaluate applications for permits to conduct pre-lease prospecting offshore and to monitor activities of scientific research conducted under notices. BOEM 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 or retain 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 10 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, Bureau of Ocean Energy Management, MS HM-3127, 381 Elden Street, Herndon, Virginia 20170.

UNITED STATES

DEPARTMENT OF THE INTERIOR

BUREAU OF OCEAN ENERGY MANAGEMENT

REQUIREMENTS FOR GEOLOGICAL AND GEOPHYSICAL PROSPECTING

OR SCIENTIFIC RESEARCH ON 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 on the Outer Continental Shelf (OCS) according to the OCS Lands Act, 30 CFR Part 580, 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 580 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 580 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 580 must utilize the best available and safest technologies that BOEM determines to be economically feasible.

The authorization BOEM grants you under 30 CFR Part 580 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 BOEM 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 BOEM 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 BOEM at least 60 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 public-information, page-size plat(s) showing the location of the proposed area of activity (Section B.2 or C.1). In addition, each applicant for a geological or geophysical permit must submit the appropriate attachment to section D of the application. This includes a detailed map of the proposed activity for Section D.8 (Geological Application) or Section D.12 (Geophysical Application). Only applicants for a Notice of scientific research must 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 BOEM-0134 and with the executed permit we will make them available to the public

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 BOEM 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 with an original plus three copies, totaling four copies, which include one digital copy and one public information copy (all with original signatures) at the following locations at least 60 days before you begin operations:

A. For the OCS off the State of Alaska:

Regional Supervisor for Resource Evaluation

Bureau of Ocean Energy Management

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

Bureau of Ocean Energy Management

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

Bureau of Ocean Energy Management

Pacific OCS Region

770 Paseo Camarillo

Camarillo, California 93010-6064

Attachment 1

UNITED STATES

DEPARTMENT OF THE INTERIOR

BUREAU OF OCEAN ENERGY MANAGEMENT

______________________________________________

(Insert Appropriate Regional Office)

APPLICATION FOR PERMIT TO CONDUCT GEOLOGICAL OR GEOPHYSICAL

PROSPECTING FOR MINERAL RESOURCES OR SCIENTIFIC RESEARCH

ON 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

_____________________________________________________________

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 plus three copies, totaling four copies, which include one digital copy, and one public information copy.

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

To be completed by BOEM

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 your proposed survey activities (i.e., vessel use, benthic impacts, acoustic sources, etc) and describe the environmental effects of the proposed activity, including potential adverse effects on marine life. Describe what steps are planned to minimize these adverse effects (mitigation measures). For example: 1) Potential Effect: Excessive sound level Mitigation: Soft Start, MMOs, mammal exclusion zone or 2) Potential Effect: Bottom disturbance: Mitigation: ROV deployment/retrieval of bottom nodes (use continuation sheets as necessary or provide a separate attachment):

_____________________________________________________________________________

_____________________________________________________________________________

4. The expected commencement date is: ______________________________________________

The expected completion date is: __________________________________________________

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

May be contacted at: ____________________________________________________________

Telephone (Local) _______________________ (Marine) _____________________________

Email Address: _________________________ Radio call sign ___________________________

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

Name (s) Registry Number(s) Registered owners)

___________________ ________________________ __________________________

___________________ ________________________ __________________________

___________________ ________________________ __________________________

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. Attach a page-size plat showing: 1) The generalized proposed location for each test. Where appropriate, a polygon enclosing the test sites may be used and 2) BOEM protraction areas; coastline; point of reference

3. Distance and direction from a point of reference to area of activity __________________________

__________________________________________________________________________________

C. Complete for Geophysical Prospecting for Mineral Resources or

Geophysical Scientific Research

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

a) Acquisition method (OBN, OBC, Streamer):________________________________

b) Type of acquisition: (High Resolution Seismic, 2D Seismic, 3D Seismic, gravity, magnetic, CSEM, etc. _______________________________________

2. Attach a page-size plat showing:

a) The generalized proposed location of the activity with a representative polygon

b) BOEM protraction areas; coastline; point of reference

c) Distance and direction from a point of reference to area of activity

____________________________

3. List all energy source types to be used in the operation(s): (Air gun, air gun array(s), sub-bottom profiler, sparker, towed dipole, side scan sonar, 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 BOEM-0134 to apply for each geological or geophysical prospecting permit.

E. Certification

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

Print Name:__________________________________________

SIGNED ____________________________________________ DATE _____________________

TITLE __________________________________________________________________________

COMPANY NAME:________________________________________________________________

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

TO BE COMPLETED BY BOEM

Permit No.__________________ Assigned by ________________________________ Date ________

of BOEM

This application is hereby:

a. _____ Accepted

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. Description of proposed coring, drilling or sampling method. Include heat flow measurements, and depth of penetration.: ____________________________________________________________________

_________________________________________________________________________________

2. Description of coring, drilling or sampling equipment to be used: ____________________________

_________________________________________________________________________________

3. List proposed coring, drilling or sample location(s) with their latitude and longitude coordinates and the total number of samples to be acquired. These locations may be sent digitally on a CD (attach separate page if necessary): _________________________________________________________________________________

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

_________________________________________________________________________________

_________________________________________________________________________________

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

_________________________________________________________________________________

6. List each test to be conducted on the samples with a brief description of its objective: ________________________________________________________________________________

________________________________________________________________________________

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) and/or an electronic version of same showing latitude and longitude, scale, protraction areas, specific block numbers, and specific sample location(s) in latitude(s) and longitude(s) for each of the proposed sample site(s). The map, plat or chart should be submitted at a sufficient size and scale to make out all details of the activities shown. Along with the hardcopy map, submit on CD, the ArcGIS shape files needed to reproduce the map of the proposed sample site(s) including individual site names in the attribute table.

Section D Proprietary Information Attachment

Required for an Application for Geophysical Prospecting Permit

1. Detailed narrative and visual description of the energy source(s) and receivers.

_________________________________________________________________________________

_________________________________________________________________________________

2. Attach a map view diagram to demonstrate vessel(s) source and receiver(s) configuration. Label each

vessel indicating its function and include the dimensions of streamer(s), tow fish, etc. Indicate the number of chase and alternate vessels to be used. ________________________________________

3. List each energy source to be used (e.g., airgun, airgun array(s), sparker, towed dipole, side scan sonar,

sub bottom profiler, etc.). Indicate the source’s manufacturer, model, total energy output per impulse in dB (RMS), peak to peak in db, frequency in Hz (if applicable) etc.______________________________

___________________________________________________________________________________

Energy Source	Manufacturer	Model	Gun Size (cu. in.)	Total Energy Output Peak to Peak in db, Amp, etc.	Total Energy Output rms in db,	Frequency (Hz-kHz range)

4. Shot (energy pulse) frequency per linear mile (statute): _____________________________________

5. Towing depth (ft/m) of the energy source: ________________________________________________

6. Towing depth (ft/m) of the receiver(s): ___________________________________________________

7. CSEM, OBN, Magnetotelluric, and OBC surveys: Describe the node deployment and retrieval procedures. Indicate the location (latitude and longitude coordinates), number and spacing of any ocean bottom receivers, cables, and anchors. If anchors will not be retrieved, provide their physical composition and rate of decomposition. Location data may be submitted digitally on a CD (attach separate page if necessary).

8. Navigation/positioning system or method used to position shotpoint locations and or ocean bottom receivers: ______________________________________________________________________

_______________________________________________________________________________

9. Proposed areal extent (blocks) for 3D surveys or total number of line miles proposed for 2D or high resolution survey: ________________________________________________________________

10. Estimated date (month and year) on which final data will be available for all proposed data sets: _______________________________________________________________________________

11. Attach map(s), plat(s), and chart(s) (preferably at a scale of 1:250,000) and an electronic version of

same showing latitude and longitude, scale, specific protraction areas, block numbers. The map, plat, or chart should be submitted at a sufficient size and scale to make out all details of the activities shown. For 2D data acquisition, provide specific track lines with line identifications with the total number of line miles proposed or a representative polygon and total number of blocks for 3D surveys. Along with the hardcopy map, submit on CD, the necessary ArcGIS shape files to reproduce the map for 2D track lines including individual line names in the attribute table. For 3D surveys provide a representative polygon as an ArcGIS shape file.

Attachment 2

UNITED STATES

DEPARTMENT OF THE INTERIOR

BUREAU OF OCEAN ENERGY MANAGEMENT

______________________________________________

(Insert Appropriate Regional Office)

NONEXCLUSIVE USE AGREEMENT FOR SCIENTIFIC RESEARCH

ON 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 plus three copies, totaling four copies, which include one digital copy and one public information copy (all with original signatures).

BOEM-0134 (Mo/Year – Supersedes all previous editions of this form which may not be used.) Page 5 of 12