1010-FM-GC0086 1/2013 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF ENVIRONMENTAL PROTECTION GRANTS CENTER

SURFACE MINING CONSERVATION AND RECLAMATION ACT GRANT PROGRAM

Goals and Accomplishments Worksheets

Project Name

Project Number County

This Report is (choose one): Project Goals Project Accomplishments (to be submitted with final report and As-Build Drawings)

Project Type AML/AMD (fill out sheet) Please fill out all the appropriate information corresponding to your project type. Leave blank any information that does not apply to your specific project. If you have any questions, call your project advisor.

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Receiving Stream name/location Receiving Stream Benefits Upstream Quality Downstream Quality Before After Before After Iron mg/L Iron mg/L pH S.U. pH S.U.

Acid mg/L as CaCO3 Acid mg/L as CaCO3

Alk mg/L as CaCO3 Alk mg/L as CaCO3 Al mg/L Al mg/L Mn mg/L Mn Mg/L Passive AMD Treatment Active AMD Treatment Anoxic Limestone Drain Chemical Reagent Used tons Limestone(LS) Dispensing System Successive Alkalinity Producing System (SAP) Dispensing System Components tons (LS) tons organic matter Dispensing System Components Wetlands aerobic acres Dispensing System Components anaerobic acres Settling Ponds # capacity (gpm) Diversion Wells # Settling Ponds # capacity (gpm) total LS capacity Settling Ponds # capacity (gpm) Limestone Channel ft. OLC ft. MOLC Limestone Dosing/Dumping tons LS Reverse Alkalinity Producing Systems # Bactericide Remediation lbs/acre Beneficial Use of Dredged Material tons Raw Water Quality Treatment Results RAW gpm average gpm high FINAL gpm average gpm high Contaminants removed/Contained by system (average) pH pH Acid ppd Acid ppd Iron ppd Iron ppd Al ppd Al ppd Mn ppd Mn ppd SO4 ppd Excess Alkalinity added ppd Predicted lifespan of system years Sludge Capacity years

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Additional Information: Attach AS-Built Drawings Attach O&M Plan