Form BOEM-0134 App. for Permit/Authorization to Conduct G&G Prospecting

OMB Control No.: 1010-0072

Expiration Date XXXXXX

UNITED STATES

DEPARTMENT OF THE INTERIOR

BUREAU OF OCEAN ENERGY MANAGEMENT

______________________________________________________________________

(Insert Appropriate Regional Office)

Requirements for Geological and Geophysical Prospecting, Exploration,

or Scientific Research on the Outer Continental Shelf

Related to Minerals Other than Oil, Gas, and Sulphur

Application for Permit or Authorization to

Conduct Geological or Geophysical

Prospecting or Exploration for Mineral Resources or

Notice of 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: Two originals, one digital copy, and one public copy (all with original signatures).

Paperwork Reduction Act of 1995 (PRA) Statement: The PRA (44 U.S.C. Chapter 35 et seq.) requires us to inform you that the Bureau of Ocean Energy Management (BOEM) collects this information to evaluate applications for permits or authorizations to conduct pre-lease prospecting or exploration 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 88 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, 45600 Woodland Road, Sterling, Virginia 20166.

UNITED STATES

DEPARTMENT OF THE INTERIOR

BUREAU OF OCEAN ENERGY MANAGEMENT

REQUIREMENTS FOR GEOLOGICAL AND GEOPHYSICAL

PROSPECTING, EXPLORATION, 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, exploration, or scientific research activities authorized and conducted on the Outer Continental Shelf (OCS) according to the OCS Lands Act, 30 CFR Part 580, as applicable, 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, exploration, or scientific research activities authorized under Section 11 of the OCS Lands Act, 30 CFR Part 580, as applicable, and in compliance with all applicable mitigation measures 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 (including submarine cables); or

F. Disturb archaeological resources.

Any person conducting geological or geophysical activities for mineral prospecting, exploration or scientific research under Section 11 of the OCS Lands Act and 30 CFR Part 580, as applicable, 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 Section 11 of the OCS Lands Act and 30 CFR Part 580, as applicable, to conduct geological and geophysical prospecting or exploration 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, Authorizations, and Notices

We limit the term of a permit or authorization 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, Authorizations, and Notices Geological and Geophysical Prospecting for Mineral Resources

You may not conduct geological and geophysical prospecting or exploration for minerals other than oil, gas, and sulphur in the OCS without an approved permit or authorization unless you conduct such activities under a lease issued or maintained according to the OCS Lands Act. You must obtain separate permits or authorizations for either geological or geophysical prospecting or exploration 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 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. BOEM recommends that you submit your notice 90-120 days prior to beginning your work to ensure timely review of your notice by BOEM

Information Required for Permits or Authorizations

Each applicant for a permit or authorization must complete the applicable sections of the Application for Permit or Authorization (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 or authorization 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 or Authorization (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 or Authorizations

The BOEM Regional Supervisor must approve any modification to the permitted or authorized operations.

Filing Locations for Permits or Authorizations to Conduct Prospecting or

Exploration for Mineral Resources and for

Permits or Notices to Conduct Scientific Research

File two originals, one digital copy, and one public copy (all with original signatures) at the following locations at least 30 days before you begin operations. BOEM recommends that you submit your notice or application 90-120 days prior to beginning your work to ensure timely review of your notice by BOEM.

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 99503-5823

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 Office of Strategic Resources

Bureau of Ocean Energy Management

Pacific OCS Region

760 Paseo Camarillo

Camarillo, California 93010-6092

Attachment 1

UNITED STATES

DEPARTMENT OF THE INTERIOR

BUREAU OF OCEAN ENERGY MANAGEMENT

______________________________________________

(Insert Appropriate Regional Office)

APPLICATION FOR PERMIT OR AUTHORIZATION TO CONDUCT GEOLOGICAL OR GEOPHYSICAL PROSPECTING OR EXPLORATION FOR

MINERAL RESOURCES OR NOTICE OF 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 Parts 580 and 280, as applicable)

______________________________________________________________

Name of Applicant

______________________________________________________________

Number and Street

______________________________________________________________

City, State, and Zip Code

_____________________________________________________________

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

_______Geological prospecting or exploration for mineral resources

_______Geological scientific research

_______Geophysical prospecting or exploration 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)/User(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 or exploration

_________ 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: Marine Mammal Observers, mammal exclusion zone or 2) Potential Effect: Bottom disturbance; Mitigation: ROV deployment/retrieval of vibracoring rigs (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 or Exploration 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) __________ Vibracoring __________________________________________________________

(d) __________ 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 __________________________

4. Label as “Public Information”

__________________________________________________________________________________

C. Complete for Geophysical Prospecting or Exploration for Mineral Resources or

Geophysical Scientific Research

1. For the proposed operation:

(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____________________________ (d) Label as “Public Information.”

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 or authorization application or the form on page 10 for a “geophysical” permit or authorization application. You must submit a separate form BOEM-0134 to apply for each geological or geophysical prospecting permit or exploration authorization.

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 or authorization 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 or

Exploration Authorization

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. Label the hardcopy map “Proprietary,” if the data are for commercial purposes and are considered proprietary. Along with the hardcopy map, submit on CD, the ArcGIS shapefiles 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 or

Exploration Authorization

1. Detailed narrative, modeling of sound propagation, and visual description of the energy source(s) and streamer(s) (receiving array):

_________________________________________________________________________________

_________________________________________________________________________________

2. Attach a map view diagram that illustrates 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, Source Level (SL) in dB re 1µPa @1m in water (RMS) and if applicable, Source Level (SL) in dB re 1µPa @1m in water (Peak to Peak).  If the manufacturer does not provide a peak to peak level (many side scan sonars, etc.), please enter N/A.  Additionally, provide the operational frequency ranges.

Energy Source	Manufacturer	Model	Array or Airgun Size (cu. in.)	Source Level (SL) in dB re 1µPa @1m in water (RMS)	Source Level (SL)   in dB re 1µPa @1m in water (Peak to Peak)	Frequency (Hz-kHz range)

For air guns/air gun arrays, provide the maximum distance from the sound source to the following SPL in RMS db levels: (Required for Alaska Region; GOM Region only requires this information for surveys in the GOM that will use simsource during acquisition; Not required for Atlantic permits).

dB level	Maximum Distance from Source
190 db
180 db
160 db

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. The map should be labeled “Proprietary,” if the data are for commercial purposes and are considered proprietary. 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 shapefiles 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 shapefile.

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: Two originals, one digital copy, and one public copy (all with original signatures).

FORM BOEM-0134 (month/year) Page 5 of 12

Previous Editions are Obsolete.