BLACKJEWEL Belle A yr and Eagle Butte Mines

August 12, 2019

Mr. Tyler Harris Project Manager Underground Injection Control Program 200 W 17th St Cheyenne, WY 82002

Re: UIC Permit No. 08-646 Renewal

Dear Tyler:

Department of Environmental Quality

I] ~- AUG 1 9 2019 \ ',,

r Quanty DMslon

Blackjewel LLC. herein submits Belle Ayr Mine's permit renewal application for UIC permit No. 08-646.

Enclosed is the completed application, if you require additional information please contact me at 307-687-3308.

Mark Thrall Environmental Manager Belle Ayr and Eagle Butte Mines

Blackjewel, LLC, P.O. Box 3039, 2273 Bishop Road, Gillette, WY 82717-3039, 307-687-3400

Date Application Received

UNDERGROUND INJECTION CONTROL PROGRAM

CLASS V

APPLICATION FOR INDIVIDUAL PERMIT COVERAGE

(Non-domestic Wastewater Facil ities)

AGENCY USE ONLY

Permit Number Facility Number

Use this application for non-domestic wastewater Class V injection wells (see attached Table 1 for a list of facility

types that require permit coverage). Please answer every item on this form to the best of you r knowledge and

attach the requ ired documents. The WDEQ has sixty (60) days to determine application completeness.

SECTION 1: TYPE OF APPLICATION (Check one)

[OJ NEW FACILITY PERMIT 08-646 I Belle Ayr Mine

PERMIT RENEWAL. ___________ _

(Provide UIC permit and/or facility#)

[ g ] PERMIT MODIFICATION __________ _

(Provide UIC permit and/or facility #)

SECTION 2:

COMPANY/OWNER CONTACT INFORMATION

COMPANY NAME: Blac.kjewel --------------------------------

Box 3039 Gillette WY 82717

COMPANY MAILING ADDRESS: _______________________ _

COMPANY CONTACT: Mark Thrall 307-687-3308

------------ PHONE NUMBER: ________ _

TITLE: Environmental Manager

CONTACT TYPE 101 OPERATOR

(Choose one or more)

EMAIL ADDRESS: Mark.thrall@blackjewel.us

I ol coNsuLTANT [ El j OWNER (Please specify business

type)

rFil Coal Mine L-=:J OTHER (Please specify)_ ___________ ___

PRIMARY CONTACT [0] YES I D j NO CONTACT ROLE : Environmental Manager

Rev 02/27/ 2019 UIC CLASS V FORM - IP APPLICATION Page 1 of 9

SECTION 3: FACILITY CONTACT INFORMATION

FACILITY NAME: Belle Ayr Mine -------------------------------------

Campbell COUNTY: ________________ _

FACILITY MAILING PO Box 3039 Gillette WY. 82717 ADDRESS : __________________________________________________________________ _

FACILITY PHYSICAL 2273 Bishop Road, Gillette WY. 82716 ADDRESS: __________________________________________________________________ _

FACILITY CONTACT: Mark Thrall PHONE NUMBER: 307-687-3308 --------------------------- --------------------

TITLE : Environmental manager EMAIL ADDRESS: Mark.thrall@blackjewel.us

CONTACT MAILING Box 3039 Gillette WY. 82717 ADDRESS: __________________________________________________________________ _

CONTACT TYPE (choose one or more)

101 OPERATOR I D I CONSULTANT 101 OWNER (Please specify type) ____________ _

I D I OTHER (Please specify) ______________________________________________ _

PRIMARY CONTACT: [@] YES [Q] NO CONTACT ROLE: Environmental Managr

List all persons or firms authorized to act on behalf oft he applicant during the processing of the application. Provide

contact names, mailing addresses, phone numbers, and e-mail addresses for all additional contacts.

SECTION 4: FACILITY LOCATION INFORMATION

FACILITY LOCATION

Township 48 Range 71

Section: 35

Quarter/Quarter NENW --------- ---------- -------- -----------44.10031

Latitude: NAD83, decimal degrees: __________________________ _

. . -105.35395 Longltude:NAD83, dec1mal degrees: ________________________ _

LAND OWNERSHIP Private --~---------------

If Other, describe: ________________________ ___

SECTION 5: WELL/FACILITY CLASSIFICATION AND PERMIT TYPE

A. Determine your Class V facility classification (select one, see Table 1, Item E in "Instructions"):

We 11/Fac i I ity Classification _s_F_2 ______________________________ _

Rev 02/27/2019 UIC CLASS V FORM- IP APPLICATION Page 2 of 9

B. Select your permit type: [gj Area Permit 0 Single Permit

If the facility only has one injection well, select "Single Permit", if it has multiple injection wells, select "Area Permit" , provided that :

1. The receiving formation is the same for all injection wells . 2. The wells are owned by the same person or company. 3. The injectate for all wells is similar in term s of chemistry and composition (similar waste

streams) .

If applying for an Area permit, provide information (as an attachment to this application) to satisfy all items in this application for each injection well.

C. Attach a list of all other permits your facility has been required to obtain prior to construct and/or commencement of operations . Include permit number or permit designation and regulating authority.

SECTION 6: WELL/FACILITY PERMIT INFORMATION

A. If the facility owner/operator is not the owner of the surface rights where the facility is located, attach copies of the access agreement between the owner(s) and the facility owner/operator. This requ irement can be met by having the owner(s) of the property write a letter consenting to the activities proposed in this application. If there are more than one surface ri ghts owners, attach a table detailing surface rights owner's names, mailing addresses, and telephone numbers.

B. Provide a brief description of the nature of the business and the activit ies at the facility being permitted:

C. Provide the types, sources, and general descriptions of the fluids proposed for injection, including chemical, physical, rad iological, and toxic characteristics (attach analytical data to this application, if available, and/or MSDS sheets) .

Coal mine, includes office, preparation plant and maintenance shops

Waste water and domestic sewage

D. Facility's average disposal capacity in gallons or barrels per day (circle one): 4'000 gpd

E. Facility's maximum disposal capacity in gallons or barrels per day (circle one): g,ooo gpd

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F. 15'

Depth of injection zone (feet below ground surface) _______ _

G. Required permit application attachments: 1) Plan view of the facility and property showing the location of the injection well(s).

2) A topographic map and other pertinent maps, extending at least one (1) mile but not less than the Area of Review for Individual Permit applications.

The topographic map shall depict all of the following: a) Property boundaries and surrounding land uses, b) The facil ity and each of its intake and discharge structures, c) Each well, drywell, or subsurface fluid distribution systems where fluids from the facility are

injected underground, d) Other wells, springs, surface water bodies, and drinking water wells listed in public records or

otherwise known to the applicant. e) North arrow f) Map scale g) Topographic interval (feet)

3) Construction and engineering details in accordance with WWQRR Chapter 25 (septic systems), Chapter 26 (wells) and/or Chapter 27 (Class V systems): a) Vertical well construction information:

Rev 02/ 27/ 2019

i.) For new wells, provide proposed total depth, proposed bit sizes, casing string details, tubing diameter, cementing plans, and wellhead type/description .

ii.) For existing wells, provide all the information in (i) above, and a copy of the daily drilling logs for the well.

iii.) Provide a detailed diagram that shows the following 1. Hole size(s) 2. Casing string details 3. Cemented portions of the well outside of each casing string (if any), include cement

bond logs. 4. Receiving formation 5. Packer depth 6. All underground sources of drinking water.

iv.) Include complete wellbore lithology and copies of any geophysical logs. v.) Well information, including:

1. Average injection rate (in barrels or gallons per day, please indicate units) 2. Maximum injection rate (in ba rrels or gallons per day, please indicate units) 3. Injection interval name, description, and thickness 4. Surface well casing elevation

vi.) For Septic Systems only, provide the following : 1. Drainfield Construction Information

a. Dra infield top and bottom elevations b. Size and location of drainfield, c. Size, construction, and location of all holding tanks (septic tanks), d. Piping details e. Depth to static water level

Details should be sufficient to show compliance with all applicable sections found in Chapters 26 and 27, Wyoming Water Quality Rules and Regulations .

UIC CLASS V FORM - IP APPliCATION Page 4 of 9

4) For vertical injection well(s), complete Table 2, Section 5 and an injection well diagram (see example provided in Instructions, Section H) for each proposed, renewing, or modified injection well. Attach additional tables as needed.

TABLE 2: VERTICAL WELL DETAILS

WeiiiD Does not apply

SEO orWOGCC Permit#

Latitude (NAD83, decimal degrees)

Longitude (NAD83, decimal degrees)

Well Location

(T /R/5/Qtr/Qtr)

Total Depth Drilled

Packer Depth (if applicable)

Well Casing Elevation

Casing Diameter

Drill Bit Diameter

Tubing Diameter

Receiving Formation(s)

(Injection Zone(s))

Injection Interval

Top Depth

Injection Interval Bottom Depth

Upper Confining (UC) Formation

UC Formation Top Elevation

NOTE: All new facilities must complete and submit an Injection Well Notification of Construction Completion, Form UIC-4, to the UIC Program upon construction completion for each new injection well.

H. Attach additional information as required by permit type: 1) Facility type SBS, see Chapter 27, Section 13(e)

a) A plan to ensure contaminants don't enter the waste stream . b) Information showing that the injection will accomplish the goals stated in the permit application. c) Target restoration values for the groundwater in the affected areas.

I. Applicant must submit information necessary for the department to make an assessment of the vulnerability of the environmental and public health from the injection into the Class V well, as follows :

Rev 02/27/2019 UIC CLASS V FORM- IP APPLICATION Page 5 of 9

1) Depth to seasonally high groundwater in the shallowest aquifer:_5_' ________ _

2) For all wells identified within the area of review, provide a table conta ining the following: a) Well ID, b) Wyoming State Engineer's Office well permit number, c) Well owner' s name, d) Well depth, e) Well screening intervals, f) Well use, g) Well locations in relation to the facility.

3) Provide documentation that the disposal capacity of the facility in gallons per day was calculated according to Table 1, Chapter 25, Section 2.

Does the facility have a meter to measu re injectate volume? 101 Yes I Dj No If yes, attach the previous two (2) years injectate volume records, if applying for a permit renewal or modification.

4) Provide information on groundwater quality, litho logy, geology, and hydrology in the formations underlying the facility.

J. Additional information as required by permit type :

1) Facility type SBS, see Chapter 27, Section 13(e) a) A plan to ensure contaminants don't enter th e waste stream. b) Information showing that the injection will accomplish the goals stated in the permit application . c) The target restoration values for the groundwater in the affected areas . d) If proposing to utilize a remed iation method that has the potential to cause an exceedance of the

Class of Use for the receiving formation/aquifer for any constituent listed in WWQ~R, Chapter 8, Table 1, the pe rmittee must also submit the following:

i. Background (ambient) groundwater quality data for any constituents of concern identified by the UIC Program,

ii . A proposal for mon itoring the effect of the remediation on groundwater quality in the receiving formation/aquifer, to includ e, but not limited to :

1. Downgradient groundwater monitoring well(s), including siting and construction details,

2. A proposed monitoring schedule, 3. A proposed sampling and ana lysis plan, 4. A plan for altering/halting the remediation activit ies in the event the remediation

causes a demonstrable negative change in fo rmation/aquifer water quality.

2) Facility type SCS (Coal Bed Methane Produced Water Injection): a) Attach a description of provisions proposed to control waste stream quality and prevent the

injection of hazardous wastes. Injection of drilling fluids, spent oilfield chemicals, industrial wastes, and/or hazardous wastes is not allowed.

b) Attach information used to determine the receiving formation's fracture pressure as defined in WWQRR, Chapter 27, and provisions that shall be implemented to control injection pressures.

c) Attach sufficient groundwater quality data (see WWQRR, Chapter 8, Table 1} to classify each rece iving aquifer. If analyses are not ava ilable during the application process, attach a plan describing how groundwater quality data will be obtained during the well completion process.

d) Attach a copy of the proposed Mechanical Integrity Testing methods, as required by WWQRR

Rev 02/27/2019 UIC CLASS V FORM - IP APPLICATION Page 6 of 9

Chapter 27, Section 13 (p)(vii).

e) Attach proof that all surface rights, mineral, water rights, and oil and gas and/or coal rights owners located within a Y, mile of the facility have been notified of your intent to obtain coverage under a General Permit.

f) Attach copies of the well construction plans and all surface facilities used as part of the coal bed methane injection facility.

g) Attach a description of the proposed pre-treatment plan to ensure that biological, hazardous, toxic or potentially toxic materials are not discharged to groundwater at concentrations greater than the class of use standards established in WWQRR, Chapter 8.

h) Attach a Spill Prevention Plan describing how biological, hazardous, toxic or potentially toxic materials will be prevented from entering the facility's waste stream prior to injection:

i) Attach a description of the disinfection process that will be implemented if analyses demonstrate that coliform, sulfate reducing, or iron fixing bacteria are present in groundwater pumped from the coal seam(s).

j) As of July 1, 2018, submission of financial assurance as established in WWQRR, Chapter 27, Section 19(C).

NOTE: All SCS applicants are also required to have a WYPDES permit (http:/ /deq.wyoming.gov/wqd/wypdes/)

3) A calculation of the Area of Review (AOR) (see Instructions, Item F) for each injection well. a) Attach documentation explaining the source and use of the data and calculation method(s) used to

determine the AOR for the proposed/renewed/modified facility. b) Attach a legal description of each injection well's AOR in Township, Range, Section, and

Quarter/Quarter (general land survey system) coordinates to the nearest ten {10) acres in Table 3 below. An example of a completed Table 3 is located in the Instructions, Item H.).

Table 3- Area of Review Legal Description (attach one completed table for each injection well)

WeiiiD Township Range Section Quarter Quarter/Quarter

leach field 48N 71W 26 sw SESW

48N 71W 26 sw swsw 48N 71W 27 SE SESE

48N 71W 34 NE NENE

48N 71W 34 NE SENE

48N 71W 3S NW NENW

48N 71W 35 NW NWNW

48N 71W 35 NW SENW

48N 71W 35 NW SWNW

Rev 02/27/2019 UIC CLASS V FORM- IP APPLICA Tl ON Page 7 of 9

SECTION 6: CERTIFICATION REQUIREMENTS

A. Sage Grouse Core Determination Area : Pursuant to the requirements of the Governor's Executive Order 2015-4 (SGEO), Greater Sage Grouse Area Protection, applicants for new UIC permits must determine if any part of their project falls within a Greater Sage Grouse Core Area (SGCA) before applying for permit coverage . If any part of the project falls with in an SGCA, the first point of contact for addressing sage grouse issues is the Wyoming Game and Fish Department (WGFD). Please coordinate with the WGFD and obtain written confirmation of consistency with the Executive Order prior to applying for coverage under a UIC permit and submit this documentation as part of the permit application package. Note that the application w ill not be processed until a letter confi rming cons istency with the Executive Order has been obtained.

Additiona l informat ion on SGCAs can be found on the Wyoming Game and Fish Habitat website, at : https ://wgfd. wyo.gov / H a bita t /Sage-G rou se-M anagement

Please check one of the following:

Some part, or all, of my project falls within an SGCA and I have contacted the WGFD for an SGEO review. A letter from the WGFD confirming consistency with the Executive Order is attached.

Some part, or all, of my project falls within an SGCA and I have contacted the WGFD for an SGEO review. It does not comply with the SGEO. I have valid and existing rights related to this permit. I have committed to the attached recommendations that will minimize impacts to sage grouse.

By checking this box, I certify that I have reviewed the SGCAs available on-line, and determined that no portion of my project falls within an SGCA. (No additional requirements apply.)

B. Access for Inspections:

As part of the ir [application/renewal/perm it modification], the applicant shall certify under penalty of perjury that the appl icant has secured and shall maintain permission for Department of Environmental Quality personnel and their invitees to access the permitted [site/facility], includ ing (i) permission to access the land where the [site/facility] is located, (ii) permission to collect resource data as defined by Wyoming Statute § 6-3-414, and (iii) permission to enter and cross all properties necessary to access the [site/facility] if the [site/facility] cannot be directly accessed from a public road . A map of the access route(s) to the [site/facility] shall accompany the [application/renewal/transfer].

I, , certify under penalty of perjury that [owner/applicant] has secured and shall maintain permission for the Department of Environmental Quality personnel and their invitees to access the permitted [site/facility], including (i) permission to access the land where the [site/facility] is located, {ii) permission to collect resource data as defined by Wyoming Statute§ 6-3-414, and (iii) permission to enter and cross all properties necessary to access the [site/facility] if the [site/facility] cannot be directly accessed from a public road.

Rev 02/27/2019 UIC CLASS V FO RM- IP APPLICATION Page 8 of 9

C. CERTIFICATION OF THE OWNER/OPERATOR OF THE FACILITY:

Please note: Professional Engineer' s and/or Geologist's Certifications are required for new and modified facilities.

" I certify under penalty of law that I have personally examined and am familiar with the information submitted in this document and all attachments and that based on my inquiry of those individuals immediately responsible for obtaining the information, I believe that the information is true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment."

Printed Name of Applicant

CERTIFICATION OF ENGINEER:

bv./&?..Jr4-"'/6/ ~/-~y-,:"?-­Title

Date Signed

"The engineering designs, plans, and specifications which are included in this application were all done by me or by

someone working directly for me. I have reviewed the designs, plans, and specifications and certify that they are all done according to the highest standards of Professional Engineering."

P. E. Number

Date Signed

CERTIFICATION OF GEOLOGIST:

"The geologic interpretations, cross sections, and hydrologic studies which are included in this application were all

done by me or by someone working directly for me. I have reviewed that work and certify that they are all done

according to the highest standards of Professional Geology."

Printed Name of Professional Geologist P. G. Number

(SEAL)

Signature of Professional Geologist Date Signed

Rev 02/27/2019 UIC ClASS V FORM- IP APPLICATION Page 9 of 9

MAP1 GENERAL LOCATION

BELLE AYR MINE UIC RENEWAL APPLICATION

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Checked By: JF Date: 07/03/08 Scale: 1:24,000

MAP2 SURFACE OWNERSHIP

BELLE AYR MINE UIC RENEWAL APPLICATION

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SHERIDAN, WY 82801 (307) 672-0761

MAP3 WATER RIGHTS

BELLE AYR MINE UIC RENEWAL APPLICATION

SOURCE: WfOMINGSTATE ENGINEER'S OFFICE MAY 2008

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·. bf- baked and fused bedrock (holocene and pleisi:lcene) of wasath and Fort Union formations. Includes residium (r'N and IF), collwiumand residuum (a), and minor sheetwash alluvium(sa) between outcrops of baltl!d and fused rock.

IW- residuum on Wasatch formation . Sand, silt and clay with pebbles and cobbles of sandstone and ironstone.

rs- residuum and sheet.Yash allwium(Holocene and Pleistocene). Sand, silt, and clay with occasional pebbles and cobbles.

ta- alluvium of low terraces (Holocene). Predominantly sand, silt, and clay wit h isolated pebbles and cobbles ofsandSone, ironstone, and baked and fused bedrock. Locally consiss of sand and silt with lenses of gravel.

fa- lood-plain alli.Nium (Holocene) . Silt and sand with Isolated pebbles and cobbles d sandstone. ironstone, and baked and fused bedrock. localty interbedded with clay or gravel.

fs- sheetwash alluo.Aum on buried alluo.Aal fans (Holocene). Sand. silt, and clay with pods and lenses of frne gravel CK isolated pebbles and cobbles of sandstone, ironstone. and baked and fused bedrock

dt- distlrbed terrain (Holocene). Terrain modified by mining and consruction.

Tw- Wasatch formation; GeneraDy drab bfown, yellcmish brown. and gray, soft. interbedded sandSone. shale, carbonaceous shale, and day with O'lin coal beds.

REVISIONS

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MAP4 SURFICIAL GEOLOGY

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UIC RENEWAL APPLICATION

SOURCE: BEllE AYR MINE PERMIT DOCUMENT 214 MAP 2 .5.2-3

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File: BA_UIC_SGeol Drawn By: CSA

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(307) 672-0761

Checked By: JF