DEQ OPENCUT MINING SECTION • PO BOX 200901 • HELENA MT 59620-0901 • PHONE: 406-444-4970 • FAX: 406-444-4988 • Email:

PHASE I RELEASE REQUEST (Non-Governmental Operators Only)

(ARM 17.24.203)

Guidance: Releases are typically inspected between May and September, when ground conditions and vegetation can be assessed. Although statutory timelines are Opencut’s first priority, Opencut staff does their best to inspect release requests in conjunction with other field inspections. Therefore, depending on when the release request is submitted,and where the site is located, it may be 12 to 18 months before Opencut can inspect and process the release request. Opencut suggests Operators submit release requestsas soon as reclamation is achieved.

Operators must complete this form to request release of an Opencut Mining Permit.Governmental Operatorsare eligible forreclamation liability releasePhase II only and cannot use this form for Phase I release.

Phase I: Operator has, in accordance with the permit, consolidated any stockpiles to be left for the landowner, properly disposed of all refuse, graded slopes and created final topography to the slopes specified in the permit, applied soil and overburden, and seeded the site with the approved seed mix.

Fill in all applicable boxes and blanks; write “none” if that is the correct response.

By completing this form in the field, Operators can assess site conditionsrelative tothe release criteria the Opencut Mining Sectionusesfor most sites. If a question does not apply to the reclamation requirements described in thePlan of Operation (Plan), provide an explanationin the appropriate section of this form.

Operator:

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DEQ OPENCUT MINING SECTION • PO BOX 200901 • HELENA MT 59620-0901 • PHONE: 406-444-4970 • FAX: 406-444-4988 • Email:

Site Name:

County:

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DEQ OPENCUT MINING SECTION • PO BOX 200901 • HELENA MT 59620-0901 • PHONE: 406-444-4970 • FAX: 406-444-4988 • Email:

Mailing Address:

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DEQ OPENCUT MINING SECTION • PO BOX 200901 • HELENA MT 59620-0901 • PHONE: 406-444-4970 • FAX: 406-444-4988 • Email:

City:

State:

Zip:

Phase II Release Request – 03/16 - Page 1 of 2

DEQ OPENCUT MINING SECTION • PO BOX 200901 • HELENA MT 59620-0901 • PHONE: 406-444-4970 • FAX: 406-444-4988 • Email:

Office Phone:

Cell Phone:

Phase II Release Request – 03/16 - Page 1 of 2

DEQ OPENCUT MINING SECTION • PO BOX 200901 • HELENA MT 59620-0901 • PHONE: 406-444-4970 • FAX: 406-444-4988 • Email:

Contact Person Name:

Email:

Phase II Release Request – 03/16 - Page 1 of 2

DEQ OPENCUT MINING SECTION • PO BOX 200901 • HELENA MT 59620-0901 • PHONE: 406-444-4970 • FAX: 406-444-4988 • Email:

Phase II Release Request – 03/16 - Page 1 of 2

DEQ OPENCUT MINING SECTION • PO BOX 200901 • HELENA MT 59620-0901 • PHONE: 406-444-4970 • FAX: 406-444-4988 • Email:

Landowner:

Phone:

Phase II Release Request – 03/16 - Page 1 of 2

DEQ OPENCUT MINING SECTION • PO BOX 200901 • HELENA MT 59620-0901 • PHONE: 406-444-4970 • FAX: 406-444-4988 • Email:

Mailing Address:

Phase II Release Request – 03/16 - Page 1 of 2

DEQ OPENCUT MINING SECTION • PO BOX 200901 • HELENA MT 59620-0901 • PHONE: 406-444-4970 • FAX: 406-444-4988 • Email:

City:

State:

Zip:

Phase II Release Request – 03/16 - Page 1 of 2

DEQ OPENCUT MINING SECTION • PO BOX 200901 • HELENA MT 59620-0901 • PHONE: 406-444-4970 • FAX: 406-444-4988 • Email:

Before requesting a Phase I release the Operator must inspect the site and confirm reclamation work was conducted in accordance with the Plan.

The Release Request Area was inspected by the Operator or its representative on:

(mm/dd/yyyy): by (Operator name):

(Must be inspected within 12 months of submitting this form)

Phase I Release Request – 10/17 Page 1 of 2

DEQ OPENCUT MINING SECTION • PO BOX 200901 • HELENA MT 59620-0901 • PHONE: 406-444-4970 • FAX: 406-444-4988 • Email:

Permit #:

Permitted Acreage:

Phase I Release Request – 10/17 Page 1 of 2

DEQ OPENCUT MINING SECTION • PO BOX 200901 • HELENA MT 59620-0901 • PHONE: 406-444-4970 • FAX: 406-444-4988 • Email:

Phase I Release Request – 10/17 Page 1 of 2

DEQ OPENCUT MINING SECTION • PO BOX 200901 • HELENA MT 59620-0901 • PHONE: 406-444-4970 • FAX: 406-444-4988 • Email:

PHASE I RELEASE –NON-GOVERNMENTAL OPERATORS ONLY

PHASE I RELEASEis requested forEntire Permitted Site or acres.

The following items have been completed to meet Phase I release requirements:

  1. Reclaimed slopes were measured and were found equal to, or flatter than, the slopes specified in the plan.

Yes No - Explain:

  1. Soil and Overburden (if applicable) were spread across the area to the depths specified in the permit.

Yes No - Explain:

  1. Area was seeded with seed mix specified in the permit.

Yes (date seeded - m/d/y): No – Explain:

  1. Release Request Area is free of trash, metal scrap, other wastes, and asphalt or concrete debris.

Yes No - Explain:

  1. An internal road remains. Yes No (if “No” skip to #6)
  2. Is the internal road permitted to remain and is it displayed on the Reclamation Map?

Yes No - Explain:

  1. A mineral stockpile remains for the landowner.Yes No (if “No” skip to #7)
  2. Is the mineral stockpile permitted to remain, accessible by a road, and have a shaped and seeded soil stockpile located within 100 feet? Stockpile area and road must be displayed on the Reclamation Map.

Yes No - Explain:

  1. Noxious and annual weeds in the Phase I Release Request Area are under control.

Yes No - Explain:

  1. All permit boundary markers are in place to define release request area and existing permit.

Yes No - Explain:

  1. A Boundary Coordinate Table (BCT) and Map is provided displaying the proposed Phase I release area.

Yes No - Explain:

Exemption: Entire permitted acreage requested for Phase I release

  1. At least four photographs taken from the north, south, east and west corners of each release request area have been provided. Photos must adequatelyrepresentthat Phase I reclamation has been completed.

Yes No–This application cannot be approved until the required photos are provided.

If approved, the Phase Irelease area is no longer permitted for any Opencut operations exceptreclamation.

Operator attests the information provided for this Release Request is complete and accurate to the best of their knowledge:

Phase I Release Request – 10/17 Page 1 of 2

DEQ OPENCUT MINING SECTION • PO BOX 200901 • HELENA MT 59620-0901 • PHONE: 406-444-4970 • FAX: 406-444-4988 • Email:

Name (print or type):

Title:

Phase I Release Request – 10/17 Page 1 of 2

DEQ OPENCUT MINING SECTION • PO BOX 200901 • HELENA MT 59620-0901 • PHONE: 406-444-4970 • FAX: 406-444-4988 • Email:

Signature:

Date:

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