PLACER WATER LICENCE AND CLASS 4 MINING LAND USE APPROVAL APPLICATION FORM

Transcription

1 GENERAL: Water Board PLACER Yukon Office des eaux du Yukon WATER LICENCE AND CLASS 4 MINING LAND USE APPROVAL APPLICATION FORM To conduct placer ining activities in Yukon, perits and licences ay be required fro various territorial and federal agencies. Coplete applications will be reviewed and held on file until a copleted project confiration for is received, showing that the project as applied for has been assessed by the YESAB (Yukon Environental and Socio-econoic Assessent Board) and a decision docuent has been issued. OPERATIONAL PERMITS: The following perits ay be required in addition to the Water Licence and MLU Approval (note: This list is not coprehensive. The Applicant is responsible for ensuring that they have the required perits for any activities that they undertake before activities coence): Environental Health Certificate: For cap operation and construction of sewage disposal systes including outhouses and septic systes, and for soe drinking water supply systes and kitchens. Contact: Health and Social Services Departent, Environental Health Services at Blasting Certificate and Magazine Perit: For storage, transportation, and use of explosives. Contact: Yukon Workers Copensation Health and Safety Board, Occupational Health and Safety at Lands Perit: For land based activities off clais, such as access road construction or barge landings. Contact: Energy, Mines and Resources, Lands Branch at Building Perit: For construction of buildings, including plubing and electrical peritting. Contact: Counity Services Departent, Counity Services and Infrastructure Developent Branch, Building Safety at DFO Site Specific Authorization: For alteration of the bed or banks of a watercourse not authorized under the Watershed Authorization. Standards are set out in the Fish Habitat Design, Operation and Reclaation Workbook and Worksheets for Placer Mining in the Yukon Territory. Contact: DFO, Ecosyste Manageent Branch at FINANCIAL SECURITY: Financial security ay be required as a condition of the Water Licence and/or MLU Approval. Updated January, 2012 Page i

2 AMENDMENTS: Changes in operation, including addition of grants or changes in the ining plan ay require an aendent to the Water Licence or Mining Land Use Approval. Contact the Yukon Water Board Secretariat for ore inforation and required fors and fees for aendents. If you are using this for for an aendent application, please only coplete the sections of the for that apply to the aendent. Please include a cover letter detailing aendents required. FEES: All fees ust be subitted with the copleted application. Applications will not be processed until all applicable fees have been received. Application for a water use licence $30 Application for a water use licence aendent $30 Water Use deposit fee (equivalent to 1 year of water use) Contact Secretariat Application for a 5 year, class 4 ining land use approval $250 Application for a 10 year, class 4 ining land use approval $500 Application for aendent, class 4 ining land use approval $150 STRUCTURES AND CAMP FACILITIES: The construction/installation and use of all surface structures ust be requested and approved in advance of their construction. Structures ust be necessary for the ining activity and be teporary in nature. Recreational cabins and coercial recreation businesses are not authorized under the Placer Mining Act or Waters Act. APPLICATION INSTRUCTIONS: Tiing: In order to receive your Water Licence and Mining Land Use Approval before the placer ining season starts, we need your help. Please subit your coplete applications as early as possible! Contact the Water Board Secretariat for a current estiate of tielines for processing applications. Aendents and renewals of existing licences take the sae aount of tie to process as new applications. If your licence expires, you ay lose your previous right to the water. Filling out the Fors: Water Board policy requires that applications be copleted in ink, single sided, and be of sufficient quality to be legible when reproduced by photocopying or scanning. Attachents: Attachents to your application can be in black and white or colour and should be at least 8 ½ x 11 in size. If oversized or colour attachents are required to clarify ore coplex operations, they can be subitted for inclusion in the register. Subission: Copleted applications can be eailed to: ywb@yukonwaterboard.ca or delivered to: Yukon Water Board Suite 106, 419 Range Road Whitehorse YT Y1A 3V1 Updated January, 2012 Page ii

3 APPLICATION CHECKLIST: Please review and coplete the following checklist and ake certain that all applicable ites are included before subitting the application. Applicable Fees (see page ii, fees ). Applicable Fors copleted and signed (only those that apply) Schedule 4 Application For (Please indicate preferred contact ethod) Financial Responsibility (box 100) Officers of the Copany (box 101) Certification (box 149) Agent Authorization For (box 150) Environental Health For (box 151) Project Confiration For (box 152) (To be provided once the YESAA Decision Docuent is issued) A recent Clai Status Report fro the Mining Recorders Office. The Clai Status Report shall only include those grants that are included in the application. If the grants are on First Nation Settleent Land, the Water Licence can only be issued until the expiry date of the grants. Written authorization/ agreeent fro grant owners. This only applies when the applicant does not own all the grants listed in the application. The Agreeent ust include the following: Explicit perission to use the grants (listed) for the ining activities proposed in the application Period of tie for which the agreeent is in effect Signatures of both the grant owners and the applicant Blacking out of financial details A copy of the Mining Recorder s clai ap(s) at a scale sufficient to show all grants included in the application, which ust be outlined or highlighted. Grant nubers ust be legible. Maps can be viewed and printed fro the Mining Recorder s website at Copleted, current, legible sketches and narrative of the proposed operation (pages 2-4). Required DFO worksheets. Only subit worksheets that apply to your operation. A Spill Contingency Plan that contains all of the inforation outlined in the Spill Contingency Plan teplate, and includes plans for all fuels, hazardous aterials, or special wastes that ight be on site. Updated January, 2012 Page iii

4 DEFINITIONS: Bar Black Muck Cap Structure - Peranent Cap Structure - Teporary Cap Structure - Seasonal Corridor Crossing Seasonal Diversion Teporary Diversion Peranent Diversion Ford eans any area of sand, ud, shingle or gravel, located within the natural boundaries of a river, which does not support peranent vegetation and is exposed fro water during part or ost of the year. A bar ay link an island to the ainland. The bar ay also be considered to be a side channel of the river between the ainland and an island, in which water ay or ay not flow. eans soil consisting priarily of decoposed organic aterials eans a surface structure suitable for indefinite use, including any building with a foundation. eans surface structure used for ore than one season which is not of peranent construction and does not include seasonal structures. eans a surface structure that is disantled and oved at the end of each ining season. eans a path fro which trees and brush have been cut to accoodate a trail, water line, fuel line or power line. eans any bridge, causeway or structure or any ebankent, cutting, excavation, land clearing or other works used or intended to be used to enable persons, vehicles or achinery to cross any watercourse. eans any direct or indirect alteration of a portion, or all, of the water flow in the route, bed, bank or boundaries of a river, strea, lake or watercourse and is inplace for less than one year. eans any direct or indirect alteration of a portion, or all, of the water flowing in the route, bed, bank or boundaries of a river, strea, lake or watercourse and is in place for a period of 2 to 5 years. eans any direct or indirect alteration of a portion, or all, of the water flowing in the route, bed, bank or boundaries of a river, strea, lake or watercourse and is in place for a period of over 5 years. eans a shallow area in a watercourse than can be crossed by a vehicle. Updated January, 2012 Page iv

5 Gross Vehicle Weight eans the overall total weight of a vehicle when loaded. Instrea Reservoir Out of Stea Channel Reservoir Instrea Settling Facility Out of Stea Channel Settling Facility Isolated Road Liit Low ground pressure vehicle Mining Cut Natural boundary eans any water ipoundent structure, where water is collected and retained for use, which is constructed in a natural channel or in a diversion. eans a water ipoundent structure, pond, or series of ponds where effluent is collected and retained, which is constructed out of the natural channel or the diversion and through which the entire creek flow ay be directed at any tie. eans a water ipoundent structure, pond, or series of ponds where effluent is collected and retained for treatent, which is constructed in a natural channel or in a diversion. eans a water ipoundent structure, pond, or series of ponds where effluent is collected and retained for treatent, which is constructed out of the natural channel or the diversion and through which the entire creek flow ay be directed at any tie. eans a road that does not provide access to a public highway directly or through a private road. eans right or left side of the watercourse, looking downstrea. eans a vehicle that applies 35 kpa of pressure or less to the ground surface. eans the excavation fro which gold bearing aterial is taken. eans the visible high water ark of any body of water where the presence and action of the water is so coon and usual and so long continued so as to ark upon the soil of the bed of the body of water a character that is distinct fro the banks in respect to vegetation or to the nature of the soil. The best estiates of the edge of dorant or old side channels and arsh areas are considered to be natural boundaries. Updated January, 2012 Page v

6 Operation Person-day Riparian Zone Road Trail Trenching Vegetative Mat Watercourse Weir Work Area eans a placer land use operation. eans the use of the capsite by one person during a period of 24 hours. eans a portion of the strea bank, either vegetated or not, iediately adjacent to the strea channel and is easured fro the high water ark on each bank of the watercourse and follows the shape of the channel. eans a pathway for vehicular traffic, the construction of which requires the oveent of rock or earth. eans an access to a site within a clai or lease that is constructed with little or no oveent of rock or earth. eans excavation that extends below the vegetative at, undertaken as part of an operation. eans the organic surface of soil, characterized by the accuulation of organic atter, or partly decoposed organic atter, derived ainly fro leaves, twigs and woody aterials, and includes the root ass of living vegetation. eans any strea, lake, pond, river, creek, spring, ravine, or swap whether ordinarily containing water or not. eans a low da built across a watercourse to raise the water level, divert the water, or control its flow. eans any area disturbed and/or altered by ining activities, excluding any stable diversion channel" Updated January, 2012 Page vi

7 PLACER WATER LICENCE AND CLASS 4 MINING LAND USE APPROVAL APPLICATION FORM Applicant Nae: (1) (The Water Licence and Approval will be issued under this nae): Watercourse(s): (2) Mining District: (3) Nearest Yukon Counity: (4) NTS Map sheet #: (5) Longitude and latitude: (centre of project) (6) Total # of grants: (7) Registered owner(s) of grants: (8) If registered owners of grants are different than the applicant, attach an agreeent. Attach DFO appendix A worksheet. Please refer to the appropriate Watershed Authorization and ap and coplete the following (for assistance contact DFO or the district ining inspections office). DFO HABITAT SUITABILITY: Does your operation require a Site Specific Authorization (SSA) fro DFO? (9) Yes, If yes, your application ight be delayed until the SSA is issued. No DFO Watershed: (10) DFO Watershed Category: (11) Category A Category B If all grants are in the sae zone, write all in the appropriate row. (12) Operational Specificatin Fro grant Togrant # High Moderate High Moderate Moderate Moderate Low Low Restoration classification (if different fro operational) Water Quality **Please attach additional pages if necessary** Updated January, 2012 Page 1 of 26

8 MINING PLAN NARRATIVE: (13) Updated January, 2012 Page 2 of 26

9 MINING SITE PLAN SKETCH: (14) Attach additional pages as necessary. Updated January, 2012 Page 3 of 26

10 CROSS SECTION OF VALLEY: (15) Attach additional pages as necessary. CROSS SECTION OF SETTLING FACILITIES AND RESERVOIRS: (16) Attach additional pages as necessary. Updated January, 2012 Page 4 of 26

11 WATER USE: (17) This includes withdrawal fro the watercourse and fro artificial reservoirs. Water withdrawal fro artificial reservoirs with no natural inflow does not have to be included in your licensed water use quantity. Sluicing: Hydraulic Stripping: Cap: 3 /day 3 /day 3 /day SLUICING: (18) Please provide the estiated volue of aterial that will be processed through the sluice plant. Year 1: 3 Year 5: 3 Year 9: 3 Year 2: 3 Year 6: 3 Year 10: 3 Year 3: 3 Year 7: 3 Year 4: 3 Year 8: 3 LICENCED WATER USE: This is for water withdrawal taken directly fro a watercourse for all purposes, including sluicing, hydraulic stripping, and cap use. The total of the axiu daily withdrawal aounts ust be the sae as the requested aount on the Schedule 4, and will be the axiu daily aount allowed in the licence. Use a separate line for each watercourse. Attach separate page if necessary. (19) Watercourse Tributary of Maxiu withdrawal ( 3 /day) (if recycling) Make Up water ( 3 /day) Estiated Flow ( 3 /day) Mining Season Spring Freshet Describe the ethod used to estiate flows during spring freshet and ining season? Attach DFO Appendix C worksheet FLOW RATE CONVERSION: 1 gallon/second (US) = /day 1 gallon/second (UK) = /day 1 gallon/inute (US) = /day 1 gallon/inute (UK) = /day Updated January, 2012 Page 5 of 26

12 HYDRAULIC STRIPPING: Is hydraulic stripping proposed? Yes (coplete boxes 21 through 26) No (proceed to box 27) (20) What is the iniu distance between the hydraulic stripping and the (21) nearest watercourse? List the grant nubers where hydraulic stripping will occur: (22) Describe the aterial that will be hydraulically stripped: (23) Where will the stripped aterial be settled? (24) How will the stripped aterial be transported to the settling facility? (25) Will the water used in hydraulic stripping report to a watercourse? (26) No Yes, If yes, identify the watercourse, and describe how the discharge standard will be et. CREEK AS A CONDUIT: Will the watercourse channel be used as a conduit to transport effluent? no, (proceed to box 31) yes, (coplete boxes 28-30) What is the valley width where the watercourse will be used as a conduit? (27) (28) For what distance will be watercourse be used as a conduit? (29) Explain why it is necessary to use the creek as a conduit: (30) Updated January, 2012 Page 6 of 26

13 RESERVOIRS: (pup ponds) Will reservoirs be instrea and/or out-of-strea? (check all that apply) Out-of-Strea Reservoir Reservoir Diensions: Length: Width: Depth: Freeboard: Conveyed to the reservoir by: (31) Gravity (ditch/culvert fro the watercourse) Pup and hose/pipeline Groundwater seepage Instrea -Dug Outs Dugout within the strea channel Dugout in the strea bank Dugout Diensions: Length: Width: Depth: (32) Coplete and attach DFO Appendix G1 and G2 worksheets Instrea -Das or Weirs Wing Da Cross-Valley Da Weir Da or Weir Diensions: Length: Height: Width at crest: Width at base: Freeboard: (33) Coplete and attach DFO Appendix G1 and G2 worksheets Construction ethod and aterials: (34) Will a bypass be constructed at seasonal closure in preparation for spring freshet? (35) Yes No What easures will be taken to ensure that spring freshet does not washout the (36) out-of-strea reservoirs and/or intake structures? Coplete and attach DFO Appendix B worksheet, (For any work proposed in the riparian zone to access the watercourse for water withdrawal) Provide details of the instrea/out-of-strea reservoirs on sketch of the ining site plan. WATER FOR SLUICING: How will you get supply water fro the reservoir to the sluice plant? (37) Intake ditch gravity fed Culvert gravity fed Pup and hose/pipeline Other: Updated January, 2012 Page 7 of 26

14 SETTLING FACILITIES: Are you proposing to use instrea and/or out-of-strea settling facilities? (38) Instrea (coplete boxes 39-46) Out-of-strea (coplete boxes 47-52) Provide details on the sketch of the ining site plan Coplete and attach DFO workbook Appendix B, for any work proposed in the riparian zone to construct instrea settling ponds, intake structures, or discharge structures INSTREAM SETTLING: Please describe the instrea settling facilities, and explain why they ust be instrea: (39) What percentage of the strea flow is directed through the settling ponds? (40) % How wide is the valley instrea settling ponds are required? (41) How will you ensure the stability of your instrea settling ponds? (42) Will settling ponds be cleaned out during the ining season? (43) No Yes, If yes, where will the sludge/ fines be placed? For the instrea settling facility, describe the design and construction of the (44) structure at the final point of control (ex. culvert, spillway, pipe) including diensions: Will there be a bypass channel built to direct spring freshet around the settling (45) ponds at seasonal closure? Yes, If yes, describe the diensions and construction: No, Ponds will be reclaied at the end of each season (spring freshet cannot be routed through work areas). Describe how ponds will be reclaied to ensure that sedient is not obilized during (46) spring freshet: Updated January, 2012 Page 8 of 26

15 OUT-OF-STREAM SETTLING: Will settling facilities reain in one place, or ove as ining progresses? (47) Reain in place on grant nuber(s): Move as ining progresses on grant nubers: Will there be a surface discharge fro the settling pond to a watercourse? (48) Yes, If yes, describe the design and construction of the structure (ex. ditch, culvert, pipe, other, including diensions): No, If no, please confir that 100% recycling will occur: Could there be discharge fro the settling facilities to a watercourse through (49) seepage? No Yes, If yes, please explain, including identifying the watercourse: How will you ensure the stability of your settling ponds? (50) Will settling ponds be cleaned out during the ining season? (51) No Yes, If yes, where will the sludge/ fines be placed? What easures will be taken to ensure that spring freshet and flood events do not (52) washout settling ponds or intake structures? Updated January, 2012 Page 9 of 26

16 DIVERSIONS: Are you constructing diversions? (53) No, (proceed to box 57) Yes, (coplete box 54-56) Refer to the DFO Fish Habitat Design, Operation and Reclaation Workbook and Worksheets prior to copleting this section Will diversions be: (check all that apply) (54) Seasonal, (in place for one ining season or less) Teporary, (in place for ore than one ining season, up to five years) Peranent, (in place for six years or ore) Note: - seasonal and teporary diversions will usually require a peranent restoration channel - end of season bypass channels around instrea settling facilities are not considered diversions and do not require worksheets to be copleted What is the total length of the existing watercourse(s) that will be diverted? (55) List the clais that the diversion(s) will be located on, by grant nubers: (56) Provide details on the sketch of the ining site plan Coplete and attach DFO workbook Appendices WATERCOURSE CROSSINGS: Will you be crossing a watercourse? (Applies to on-clai crossings only) (57) No, (Proceed to box 92) Yes, If yes will the crossings be by: Ford(s) (coplete boxes 58-66) Bridge(s) (coplete boxes 67-75) Culvert(s) (coplete boxes 75-83) Other Crossing Type, including pipelines, (coplete boxes 84-91) Indicate the location of all watercourse crossings on the sketch of the ining site plan Updated January, 2012 Page 10 of 26

17 FORDS: (If your project includes ore than one ford, attach additional pages as necessary.) Watercourse Nae: Ford # of (58) Grant nuber(s) where ford will be located: (59) How frequently will the ford be used? (60) (include a description of equipent that will be using the ford) What is the height of the banks of the watercourse at the ford location? (61) The ford (s) are: (62) Existing (if existing, skip to box 66), or To be constructed? (if a new ford, coplete the following questions) Describe how the ford will be constructed, and ethods to control the release of (63) sedient during construction: Describe the strea bed aterial, strea bank aterial, and strea bank vegetation (64) at the ford location: Provide a schedule for ford construction: (65) Ford Cross Section: (66) (Include approaches, erosion protection, and watercourse levels at high and low flows.) Coplete and attach DFO workbook Appendix B. BRIDGES: (If your project includes ore than one bridge, attach additional pages as necessary.) Updated January, 2012 Page 11 of 26

18 Watercourse Nae: Bridge # of (67) What is the width of the creek where you propose to construct a bridge: (68) Grant nuber(s) where bridge will be located: (69) At high flow, what is the vertical distance between the watercourse and the botto (70) of the bridge? What are the diensions of the bridge? (71) Describe the bridge design and construction, including deck aterial, abutent (72) aterial, odifications to the bed or banks of the watercourse, and ethods to control the release of sedient during construction or placeent: Describe the strea bed aterial, strea bank aterial, and strea bank (73) vegetation at the bridge location: Provide a schedule for bridge construction: (74) Bridge Cross Section: (75) (Include approaches, erosion protection, bridge structure, and distance fro bridge deck to the watercourse.) Coplete and attach DFO workbook Appendix B, for each bridge. CULVERTS: (If your project includes ore than one culvert, attach additional pages as necessary.) Updated January, 2012 Page 12 of 26

19 Watercourse Nae: Culvert # of (76) Grant nuber(s) where culvert will be located: (77) Provide the type, diaeter, and length of culvert: (78) Provide the following watercourse diensions at the location of the proposed culvert?(79) Maxiu Depth of Watercourse Maxiu Width of Watercourse Describe how the culvert will be installed, and ethods to control the release of (80) sedient during construction or placeent: Describe the strea bed aterial, strea bank aterial, and strea bank vegetation (81) at the culvert location: Provide a schedule for the culvert installation (tie of year): (82) Culvert Cross Section: (Include approaches, erosion protection, culvert structure, and watercourse levels at high and low flows.) (83) Note: - the installation of culverts referred to in this section pertain only to watercourse crossings (i.e. do not include culverts used for the conveyance of effluent between out-of-strea settling ponds) OTHER CROSSINGS: (Attach additional pages as necessary.) Updated January, 2012 Page 13 of 26

20 Watercourse Nae: Crossing # of (84) Grant nuber(s) where crossing will be located: (85) Describe the type and nature of the crossing (pipeline, powerline, etc.): (86) The crossing(s) is: (87) Existing (if existing, skip to box 91), or To be constructed? (if a new crossing, coplete the following questions) Describe how the crossing will be constructed, and ethods to control the release (88) of sedient during construction: Describe the strea bed aterial, strea bank aterial, and strea bank vegetation (89) at the crossing location: Provide a schedule for construction: (90) Crossing Cross Section: (91) (Include structures, erosion protection, and watercourse levels at high and low flows.) Coplete and attach DFO workbook Appendix B, for each crossing. FINAL SITE DECOMMISSIONING: (92) If any water related structures (das, reservoirs, ditches, settling ponds, culverts, fords, bridges, etc.) are going to be left in place at the copletion of ining, please describe what easures will be taken to ensure stability, and explain why they will not be reclaied: Updated January, 2012 Page 14 of 26

21 OTHER AFFECTED PARTIES: Identify the nearest upstrea water user(s) or potentially affected upstrea users (93) (placer operations, trappers, residences, etc.): Identify the nearest downstrea water user(s) or potentially affected downstreausers (94) (placer operations, trappers, residences, etc.): Section 12(4) of the Waters Act states that the Board ay not issue a water use licence unless the applicant (95) satisfies the Board that the issuance of the licence will not adversely affect, in any significant way, the use of waters by any existing licensee. Do you believe that your proposed use of water or deposit of waste will have an adverse effect on an existing licensee? Yes, If yes, describe the itigations proposed: No, In which First Nation s traditional territory is your project located? (96) Is any part of the project located on First Nation Settleent Land? (97) Yes No Have you entered into a copensation agreeent with any potentially affected (98) parties? Yes, If yes, please attach a copy of the agreeent. No Have you discussed the proposed operation with any individuals or organizations (99) that ay be affected by the project? Yes, If yes, please indicate who, and what input you received. No Updated January, 2012 Page 15 of 26

22 FINANCIAL RESPONSIBILITY: (100) The Waters Act requires that the Yukon Water Board not issue a licence unless it is satisfied that the financial ability of the applicant, taking into account the applicant s past perforance, is adequate for: i. the copletion of the appurtenant undertaking; and ii. such itigative easures as ay be required; and iii. the satisfactory aintenance and restoration of the site in the event of any future closing or abandonent of that undertaking. Do you have the financial resources to coplete the undertaking proposed in this water use application? Yes No Signature: Nae (printed): OFFICERS OF THE COMPANY (coplete only if applicant is a liited copany or corporation) (101) Licences can only be issued to a liited copany or corporation if they are registered to do business in Yukon. The Yukon Water Board will not consider issuing a licence to a copany or corporation unless this section is copleted. I, certify that (nae of business entity) is incorporated or registered pursuant to the Business Corporations Act of the Yukon or is registered in the province or territory of and is registered in Yukon as an extraterritorial corporation. The officers of the copany are (Nae and Title please print): Signature: Date: Attach a Corporate Suary issued by Yukon Corporate Affairs, and a certificate of registration. Updated January, 2012 Page 16 of 26

23 MINING LAND USE This section is for non-water related inforation as part of the Class 4 Mining Land Use Approval Application. MINING SEASON: Approxiate Mining Season Start Date (day/): (102) Approxiate Mining Season End Date (day/): SUMMARY OF OPERATION WORK PLAN: Describe your progra chronologically giving approxiate dates or onths (103) of work to be done. (This should include a plan of all ining and exploration activities -road construction, drilling, stripping, cap set up, and progressive and final reclaation) ADDITIONAL GRANTS: The Water Board will not consider including grants in the approval that are for exploration purposes only that will not require a water licence. For exploration peritting, please contact EMR Mining Lands for the appropriate class application for. Are you proposing to add additional grants than those already stated in the (104) water licence portion of this application? Yes, (coplete box 105) No, (proceed to box 106) If you propose to include additional grants for the ining land use approval that (105) are not included in the water licence application, explain how they are related to, and required for, the proposed project (i.e. for cap or access purposes): Attach a separate Clai Status Report listing clais to be included in the Mining Land Use Approval only. Updated January, 2012 Page 17 of 26

24 FUEL STORAGE AND HANDLING: Will fuel be stored on clais? (106) No, proceed to box 112 Yes, If yes, will storage capacity exceed 4,000 litres in total at any tie? No, Yes, If yes, are fuel storage containers with a capacity of over 4,000 litres registered? No, Yes What ethods of secondary containent are used? (107) (bered, lined with ipereable aterial, double wall tanks, etc.) List all fuel storage: (108) Type of fuel Container Type Capacity (litres) Distance fro Nearest Watercourse ( Nae of Watercourse Tank Registration nuber Describe ethods of fuel transport and delivery: (109) Describe refuelling procedure, including location, distance fro nearest watercourse (110) and itigations in place to prevent spills: Describe what will be done at the end of each season to ensure fuel storage facilities (111) are left in a stable, safe condition: Indicate the location of fuel storage site(s) on the ining plan sketch. Attach a copy of your fuel spill contingency plan. (All Mining Land Use operations require a spill eergency plan to be in place and posted on site wherever fuel is stored or transferred.) Updated January, 2012 Page 18 of 26

25 OVERBURDEN REMOVAL AND OPERATIONAL PRACTICES: Please provide estiates of overburden reoval: (112) Mechanical Hydraulic Mechanical Hydraulic Year Year Year Year Year Year Year Year Year Year Estiated depth of black uck: (113) Describe the ethod for disposition of overburden, including location (114) and ethods for preventing erosion: (reeber to ark location on ining plan sketch) What is the approxiate iniu distance between the stockpiled (115) overburden and the watercourse? What is the estiated height of overburden piles prior to reclaation? (116) How will slope stability of overburden and tailings piles be aintained? (117) 2:1 iniu slope (horizontal to vertical) will be aintained. If a 2:1 iniu slope cannot be aintained, please explain why not, and additional itigation easures proposed to aintain stability and reduce erosion: Other techniques (provide details): How long will overburden and tailings be stored before final reclaation? (118) What easures will be taken to ensure ining cuts are stabilized and erosion (119) is controlled? Will ine cuts or trenches extend below the water table? (120) No, Yes, If yes, explain ethods for dewatering, and where water will be disposed of: Updated January, 2012 Page 19 of 26

26 DRILLING: Will there be drilling on grants? (121) No, (proceed to box 123) Yes, If yes, will clearings be ade for drill sites? No, Yes, If yes, how any clearings will be constructed each year? Per clai: total each year: Clearing area for each drill site: ( 2 ) Describe the construction and reclaation ethod for the clearings: Will water or drill additives be used for drilling? (122) No, Yes, If yes, describe the sup that will be constructed to contain the water, additives and drill waste, and how it will be reclaied, and list proposed additives and indicate if they are bio-degradable: EXPLOSIVES: Will explosives be used? No, (proceed to box 124) Yes, If yes, what type: (123) If yes, your application will be copied to Occupational Health and Safety for confiration of blasting perits. TIMBER USE: Burning of brush or tiber ay require a burning perit and have seasonal restrictions. Harvest of tiber for purposes other than iner-like work requires a tiber perit fro Yukon Forestry. Off clais a land use and tiber perit ay also be required to cut trees. Consult with EMR Land Use Branch and Forest Manageent Branch for ore inforation. Will tiber be cut? (124) No, (proceed to box 125) Yes, If yes, what will happen to cut logs? Stockpiled Burned Libed/bucked and disperse Used for ining activities/structures Used for reclaation/spread over access routes Updated January, 2012 Page 20 of 26

27 ACCESS: Any access proposed off the grants included in this application ay require an agreeent with other grant holders, or a Land Use Perit fro Lands Branch. Contact a ining inspector, Lands Branch, or a Licensing Officer for ore inforation. Any new access constructed will have to be reclaied by the expiry date of the Approval. The following questions deal with access on placer clais only. Will existing roads be upgraded? (125) No, Yes, If yes, describe upgrading work that will be done, including total length and width of upgrade(s): Length: () Width: () Will new roads be developed? (Roads are defined as requiring the oveent of rock or earth.) (126) No, Yes, If yes, describe construction ethods, including total length and width of proposed roads: Length: () Width: () Will new trails or corridors be developed? (127) Trails are defined as requiring no oveent of rock or earth, corridors do not require the reoval of the vegetative at, and include survey lines and clearing for water lines etc. No, Yes, If yes, describe construction ethods, including total length and width of proposed trails or corridors: Length: () Width: () Other new access proposed? (i.e. winter trails or roads, helicopter pads, airstrips) (128) No, Yes, If yes, provide a description and construction ethods, including total length and width: Length: () Width: () Include a clai ap indicating the location of access roads, trails, cap, and fuel storage in relation to clais. Updated January, 2012 Page 21 of 26

28 EQUIPMENT: List all equipent that will be used on site, including the weight of any heavy (129) equipent over 20 tons: Is there existing heavy equipent access? (130) Yes, No, If no, how will heavy equipent be brought to the site? CAMP FACILITIES: Will there be a cap on clais? (131) No, (proceed to box 137) Yes, (coplete questions ) If the cap(s) will support ore than 50 people, additional inforation will be required. Please contact a Licencing Officer for ore inforation. How any caps will your project have? (132) What is the axiu nuber of people staying in the cap(s) at one tie? (133) What will cap structures consist of? (134) Trailer(s), How any? Log structure, How any? Tents, How any? Other, How any? Please specify type: Frae structure, How any? RV or travel trailer, How any? Will cap structures be located within 30 etres of a watercourse? (135) No, Yes, If yes, please describe the iniu distance fro the watercourse, and why this is necessary: Please describe what will be done at the end of each season to ensure cap (136) facilities are left in a stable, safe condition that will not attract wildlife: Mark the location on the ining plan sketch. Please coplete the Environental Health application for if a sewage disposal syste will be constructed (including pit privies or outhouses) or if drinking water will be withdrawn fro a watercourse. Updated January, 2012 Page 22 of 26

29 WASTE MANAGEMENT: Debris, equipent, fuel barrels, scrap etal and other waste ust be stored safely, so as to not attract wildlife, and disposed of according to the Solid Waste Regulations. Describe disposal ethods for non-hazardous waste and where it will be disposed of (137) (scrap etal, barrels, kitchen waste): Will waste aterial be stored or disposed of within 30 of a watercourse? (138) No, Yes, If yes, please explain: HAZARDOUS WASTE MANAGEMENT: Hazardous aterial ust be labeled and stored in accordance with Workplace Hazardous Materials Inforation Syste (WHMIS). Consult with Yukon Occupational Health and Safety Branch and Special Waste Regulation for ore inforation. List hazardous aterials and special wastes that ight be used or stored on site (139) (used batteries, waste oil, used filters, etc.): Describe handling, storage ethod, storage location, transportation, and disposal (140) ethods for hazardous aterials and special wastes. (If waste oil and fuel products will be burned on site, they ust be burned in a CSA approved burning device, and an air eissions perit ay be required. Contact Yukon Departent of Environent for ore inforation): Will cheicals be used to process ining concentrates? (141) No, Yes, If yes, nae all cheicals and describe ethods for storage, retrieval, and disposal: Updated January, 2012 Page 23 of 26

30 EXISTING DEVELOPMENT (within 1 k of proposed project) (142) Evidence of ineral exploration work: Active Abandoned Describe existing disturbance: Evidence of ineral production: Active Abandoned Describe existing disturbance: Placer Hard rock Placer Hard rock Abandoned Equipent (describe): Existing roads (describe): Existing trails (describe): Existing airstrip (describe): Existing helipad (describe): Agricultural activity (describe): Forest harvesting (describe): Quarrying (describe): Archaeological (describe): Burial grounds (describe): Peranent structures (i.e. cabins) (describe): Trapping (describe): Fishing/hunting lodge/cap (describe): Recreational use (describe): Oil and Gas exploration/extraction (describe): Power/counications/hydroelectric developent (describe): Transission lines (describe): Pipelines (describe): Counication tower (describe): Fire observation towers (describe): Other (describe): Critical wildlife habitat (consult with regional wildlife biologist for inforation). Describe, including itigation to prevent disturbing wildlife or critical habitat: Include a clai ap indicating the location of existing developent in relation to clais. (It is iportant to list all existing developents on grants to avoid assuing liability for their reclaation.) Updated January, 2012 Page 24 of 26

31 FINAL SITE RECLAMATION: What easures will be taken for final reclaation of the operation? (143) Backfill ining cuts Re-contour overburden piles Reove all equipent Reove all storage tanks and fuel Re-contour tailings piles Reove all waste Spread black uck/vegetative at over reclaied areas Reove all structures (buildings, das, ponds, caps, etc.) Describe in detail the ethod for reoval of all water related structures: (144) If any easures in box 143 will not be done, or any water related structures will be (145) left in place, please explain why: Describe any other reclaation activities planned: (146) Are there any disturbed areas where a 2:1 slope cannot be achieved (147) for final reclaation? No, Yes, If yes, explain why, and what additional erosion control and/or onitoring easures planned to ensure slope stability: Will all access roads, trails, bridges, and culverts be reoved and/or reclaied at (148) the end of the operation? No, If no, explain why not: Yes, If yes, explain how: CERTIFICATION (149) I certify that all of the inforation contained in this application is coplete and accurate to the best of y knowledge and that any changes will be reported to the Yukon Water Board and Governent of Yukon, Mining Lands. Nae of Applicant Signature of Applicant Date Updated January, 2012 Page 25 of 26

32 PROJECT CONFIRMATION FORM (152) IMPORTANT INFORMATION ABOUT YOUR WATER USE APPLICATION # In ost cases, the Yukon Water Board cannot issue a water use licence until a Decision Docuent has been issued under the Yukon Environental and Socio Econoic Assessent Act ( YESAA ), and any licence that is issued cannot be contrary to that Decision Docuent. Once you have received your Decision Docuent fro the YESAA process, please provide us with the attached for indicating that your Water Use Application confors to the Project proposed and assessed by YESAA and incorporates any required changes that have arisen during that process. You can e-ail the for to us at ywb@yukonwaterboard.ca or send it by fax to (867) If your project has changed, please provide the Water Board with either a new, or an aended, application. PROJECT CONFIRMATION (Do not coplete this for until after YESAA has been copleted) I hereby certify that a YESAA decision docuent has been issued and the above noted water use application is accurate and coplete and reflective of the project proposed and assessed under YESAA. YESAA File Nuber: Nae: (please print) Signature: Date: Updated January, 2012 Page 26 of 26