E NVIRONMENT AND SUSTAINABLE RESOURCE DEVELOPMENT SURFACE MATERIALS RETURN

  COMMITTEE ASSISTANCE DEPARTMENT INTERNATIONAL & ENVIRONMENTAL PLANNING
CHECKLIST TEST ENVIRONMENT CHECKLIST TEST ENVIRONMENT THE DEFINITION
WHY A NATIONAL ENVIRONMENTAL METHODS INDEX IS

ANNEX B2 PRODUCT ENVIRONMENTAL ATTRIBUTES COMPUTERS AND
CONNECTICUT DEPARTMENT OF ENERGY AND ENVIRONMENTAL PROTECTION NOTICE
CONSTRUCTION ENVIRONMENTAL SAFETY & HEALTH PLAN (CESHP)

LM 17A - Surface Materials Return for SMC PPL

EE NVIRONMENT AND SUSTAINABLE RESOURCE DEVELOPMENT SURFACE MATERIALS RETURN nvironment and

Sustainable Resource Development


Surface Materials Return

(Peat Companies use alternate form)


Surface Materials Return for SMC/PPL #      


Invoice Date

Ticket Number

Material type

Volume

Weight

Purchaser/

Receiver

Material Use

Yards

Metres

Tons

Tonnes

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     


*See below for conversion factors. Please use one standard of unit only (e.g. yards).


ATTACH FURTHER PAGES AS REQUIRED


Total Materials Removed:

Cubic Yards

Cubic Metres

Tons

Tonnes

Gravel/Mixed Sand and Gravel

     

     

     

     

Sand

     

     

     

     

Marl

     

     

     

     

Manufacturing Clay

     

     

     

     

Non-manufacturing Clay

     

     

     

     

     

     

     

     

     


The above is the volume or weight removed from the above disposition during the period of       to       , for all activities, including Public Works. If used for a public work, provide written confirmation from the owner of the public work.


________________________________________

Signature of Operator or Agent


cubic metres 1.308 = cubic yards

*

Conversion factor for sand


1.365 tonnes = 1 cubic metre

1 cubic metre = 1.308 cubic yards


Conversion factor for gravel


1.632 tonnes = 1 cubic metre

1 cubic metre = 1.308 cubic yards

number of tonnes

1.365

1.308 = cubic yards

number of tonnes

1.632

1.308 = cubic yards


Personal information required for this form is collected in accordance with Section 33(a)(c) of the Freedom of Information and Protection of Privacy Act (FOIP Act) and Section 8 of the Public Lands Act and Section 6 of the Public Lands Administration Regulation. The personal information collected will be used to correspond with the applicant regarding their application. Should you require further information about the collection or use of your personal information, contact Environment and Sustainable Resource Development at 780-427-3570.

April 2013

Surface Materials Return

© 2013 Government of Alberta

Page 1 of 1



CONTRACT OPERATOR FACILITY LIST OHIO ENVIRONMENTAL PROTECTION
OFFICE OF ENVIRONMENTAL HEALTH AND SAFETY 333 SOUTH
POSITION PAPER ENVIRONMENTAL FOUNDATION LTD FORESTS TO


Tags: development surface, resource development, sustainable, materials, nvironment, return, surface, development, resource