Form 3200-9
UNITED STATES
(April 2011)
DEPARTMENT OF THE INTERIOR
FORM APPROVED
BUREAU OF LAND MANAGEMENT
OMB No. 1004-0132
Expires: December 31, 2013
NOTICE OF INTENT TO CONDUCT GEOTHERMAL RESOURCE
EXPLORATION OPERATIONS
Applicant( s)
Address (include zip code)
Operator (name and telephone number) include area code
Address (include zip code)
Contractor(s)
Address
(include zip code)
hereby apply for authorization to conduct exploration operations pursuant to the provisions of 43 CFR 3250 now or hereafter in force across and upon
the following-described lands (give description of lands by township, attach map or maps showing lands to be entered or affected).
Type of operations to be conducted (give brief description).
Exploration operations will be conducted during the period (date) from
to
Attached
Surety bond
Rider to Nationwide bond
Rider to Statewide bond
Bond to be furnished
$
Upon completion of exploration operations, the undersigned agrees to notify the Bureau of Land Management (BLM) that authorized exploration
operations have been completed in conformance with the general and special terms and stipulations of the notice.
The undersigned hereby agrees (1) that he will not enter upon the described land until he has been informed in writing whether there are special
stipulations applicable to his Notice of Intent, as to either time or method of operation or otherwise, and if there are such stipulations, what those
(2)
that he will comply with those special stipulations, if any; and (3) that he will not enter upon the described lands until his entry
stipulations are,
been
the BLM
has
approved by
.
The undersigned agrees to be bound by the terms and conditions of this notice to conduct exploration operations when approved by the BLM.
The undersigned agrees that the filing of this Notice under the
4. All vehicles must be operated at a reasonable rate of speed and, in the
of
regulations (43 CFR Subpart 3250) does not vest or confer any
operation
vehicles, due care must be taken to safeguard livestock
preference right to a geothermal resources lease.
and wildlife in the vicinity of operations. Existing roads and trails
If
to
must be used wherever possible.
new roads and trails are
be
The undersigned agrees further that all exploration operations must
consulted prior to
the BLM must be
construction
constructed,
be conducted pursuant to the following terms and conditions:
as to location and specifications. Reclamation and/or seeding of
be
with
1. Exploration operations must
conducted in compliance
all
as
new roads and trails must be made
requested by the BLM.
Federal, State, and local laws, ordinances, or regulations which
are applicable to the area of operations including, but not limited
to, those
pertaining to fire, sanitation, conservation, water
5. Upon expiration, conclusion, or abandonment of operations conducted
pollution, fish, and game. All operations hereunder must be
conducted
in a prudent manner.
pursuant to this Notice, all equipment must be removed from the land,
and the land must be restored as nearly as practicable to its original
2. Due care must be exercised in protecting the described lands
condition by such measures as the BLM may specify.
from damage. All necessary precautions must be taken to avoid
All geophysical holes shall be safely plugged. The BLM must be
any damage other than normal wear and tear to improvements on
furnished a Notice of Completion of Geothermal Resource
the land including, but not limited to, gates, bridges, roads,
Exploration Operations (Form 3200-10) immediately upon cessation
culverts, cattle guards, fences, dams, dikes, vegetative cover,
of all such operations and must be further informed of the completion
improvements, stock watering, and other facilities.
of reclamation work as soon as possible.
3. All drill holes must be capped when not in use and appropriate
procedures must be taken to protect against hazards in order to
protect the lives, safety, or property of other persons or of
6. Location and depth of water sands encountered must be disclosed to
wildlife and livestock.
the BLM.
(Continued on page 2)