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HAVE YOU OR ANY PERSON NAMED ON THIS APPLICATION OR DELEGATED AUTHORITY FOR HANDLING <br />EXPLOSIVES: <br />Heen under indictment in any court for a crime punishable by imprisonment for a term <br />exceeding 1 year? <br />Been a fugitive from justice? <br />c. Been an unlawful user of or addicted to marijuana or any depressant, stimulant or <br />narcotic drug? <br />d. Ever been convicted in any court of a crime punishable by imprisonment for a term <br />exceeding 1 year? <br />e. Ever been certified ae a mental incompetent or been committed to an inetitution7 <br />f. At this time under 21 years of age? <br />Y&S NO ~_ if YES, indicate the item (e) and provide a summary explanation, <br />continuing on a separate sheet ae necessary. <br />Upon award of the Mine Safety and Training explosives permit the permit holder ie <br />responsible for the maintenance of the permit to provide safety and security for <br />explosives storage and use. The permit holder shall: <br />1. Notify Mine Safety and Training of any cessation of operation, so that a <br />closeout inspection can be conducted; a closeout inspection ie mandatory. The <br />permit holder ie responsible for abandoned explosives. <br />2. Notify Mine Safety and Training immediately of any incident of theft, and <br />preserve the scene for investigation. <br />3. Maintain a consistent log of explosive materials within the inventory, avoid <br />discrepancies, and document each item's use; use older explosives first to avoid <br />deterioration, and follow manufacturers recommended procedures for disposal of <br />deteriorated explosives, documenting this action in the explosives log. <br />• 4. Always store explosives and initiators in their appropriate containers. <br />Explosives stored in day boxes should not exceed time or quantity limits. Avoid <br />explosive materials considered dangerous for mine use. <br />5. Ensure that only qualified persona, qualified under the provieione of this <br />permit, through past experience, certification, or other approved processes, will <br />handle explosives, and that no person qualified or otherwise shall remove <br />explosives from the permitted area without prior notification and approval from <br />Mine Safety and Training. <br />6. This permit ie not transferable, the explosives are to be used for mining and <br />support functions only, and while explosives are maintained in inventory, an <br />annual renewal ie mandatory. The Mine Safety and Training Authorized <br />Representative shall have right-of-entry for compliance inspection. <br />The permit holder understands a violation of the provieione of this permit, State Statute <br />or applicable Federal etanda rds Title 30 CFR Porte 56, 57, 75, 77; Title 27 CFR Part 55;: <br />18USC Chapter 40; referenced by Colorado governing the use or storage of explosives may <br />constitute grounds for the revocation or suspension of the permit. The permit holder will <br />provide a complete and accurate inventory of explosives at the time of a suspension of the <br />permit. A failure of the permit holder to take the appropriate corrective action will <br />result in a revocation of the permit. Upon revocation all explosives are to be returned <br />to the distributor. The permit holder by failure to act can be subject to forfeiture and <br />will be responsible for any costa associated with recovery and disposal of explosives. <br />gy; Oakrldl;e Energy Inc. <br />iignatu f App 'ca tDa y I'ergusu~t Name (Please Print or Type) <br />Consulting Gngl er Engineer 11 87 028 7176 <br />Security No. <br />M:\ADMIN\9969F.WPF <br />DEC 1 p 1992 <br />