5600-FM-BMP0147
10/2013
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF MINING PROGRAMS
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
Stage 1 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)
Potassium
Phosphorus
(ppm)
Magnesium
(meq/100 g)
Calcium
Cation
Exchange
Capacity
Test Methods
*Indicate Sample No. on map at location sampled.
B.
C.
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.
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.
-1-
5600-FM-BMP0147
10/2013
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
-2-
Date