5600-FM-BMP0147 10/2013

PLANTING AND SOIL TEST REPORT

FOR LARGE NONCOAL

Permittee

Surface Mining Permit No. Operation Name

Municipality County

Acres (represented by this report) Date Planting Completed / /

Instructions: Complete this report and submit it with the completion report when requesting approval for completed Stage1 reclamation. Submit the report in duplicate (original and one copy) to the appropriate district office.

A. Soil Test

1.  Describe the procedure and methods used to collect soil samples.

2.  Provide the following for each soil sample analyzed (and not previously reported). If tests were performed at the Penn State University Merkle Laboratory, attach a copy of their Soil Test Report in lieu of below. If not, identify the laboratory.

Sample No.* / Date Sampled / Soil pH / Buffer pH / Lime Reg. (lbs/ac.100% CaCO3) / Phosphorus (ppm) / Potassium / Magnesium / Calcium / Cation Exchange Capacity
(meq/100 g)
Test Methods

*Indicate Sample No. on map at location sampled.

B. Soil Amendments and Nutrients

1.  List the type(s), rate(s) per acre and chemical and physical analysis of the liming material(s) or other neutralizing material(s) applied to the site and when applied.
2.  List the type(s), rate(s) per acre and chemical analysis of the fertilizer(s) or plant nutrients applied to the site and when applied.

C. Plant

1. What is the approved post mining land use?

2.  Provide species and rates per acre of grasses, trees and shrubs planted.

3.  Indicate percent vegetative groundcover of permanent plant species.


PLANTING AND SOIL TEST REPORT

FOR LARGE NONCOAL

(Continued)

D. Crop Yields (for areas with a postmining land use of cropland/Stage II reclamation only)

Complete the following for the current and preceding growing season:

Year / Crops Grown / Actual Yield / Target Yield / Measurement Technique

I have reviewed the cropping information provided above (Part D) and believe that it is true and accurate to the best of my knowledge.

Signature of Landowner(s) Date

Signature of Permittee/Responsible Official Title Date

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