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Bureau of Mining Programs
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Programs and Services
Coal Ash Beneficial Use
 

    Download all forms at Coal Ash forms at eLibrary or send a request to RA-coalash@state.pa.us for electronic copies in DOC or PDF format.

    The following forms replace any older versions. Please consult eLibrary for the latest versions.

  • Coal Ash Beneficial Use Certification Application 5600-PM-MR011
    This form is for new source certification request or to qualify a GP ash material for beneficial use; use for revisions to an existing source.
  • Coal Ash Quality Assessment for Beneficial Use 5600-PM-MR0012
    Submit this form in conjuction with 5600-PM-MR0011 for background samples; use for regular ash quality sampling; use for special sampling requests.
  • Coal Ash Water Quality Monitoring Report 5600-PM-MR0014
    Use this form in conjuction with Module 25 application at a mine site for background samples; use for regular quarterly sampling as part of the mining permit requirements; use for special sampling requests.
  • Coal Ash Beneficial Use 5600-PM-MR0013 has been replaced by Coal Ash Quality Assessment for Beneficial Use 5600-PM-MR0012.

    All ash certification submittals and monitoring should be sent to the following address:

    DEP - Bureau of Mining and Reclamation
    P.O. Box 8461
    Harrisburg, PA  17105-8461
    Attn: Coal Ash Certification

    Any data or application regarding the active mining permit site (e.g., Module 25 information, permit revision requests, special condition requirements and water quality monitoring reports) should be sent to the District Mining Office.

    All mine site operators utilizing coal ash for Beneficial Use are required to report the amounts/volumes used at each site every year as part of an annual report due by January 30.
    The following template can be used to supply this information to the local District Mining Office.
    Ash Volume Reporting Form (Word Doc)