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H1258 (2021/10)
SAND AND GRAVEL/QUARRY OPERATIONS NOTICE OF WORK
From: BC TRAN
To: Inspector of Mines, Ministry of Energy and Mines (MEM)
Southwest Regional Office
Suite 6 – 1810 Blanshard St., Victoria, BC V8W 9N3 southwestminesdivision @gov.bc.ca
South Central Regional Office
441 Columbia St., Kamloops, BC V2C 2T3 [email protected]
Southeast Regional Office
1902 Theatre Rd., Cranbrook, BC V1C 7G1 [email protected]
Northwest Regional Office
2nd Floor, 3726 Alfred Ave. Smithers, BC V0J 2N0 [email protected]
Northeast/ Central Regional Office
350 - 1011 4th Ave. Prince George, BC V2L 3H9 [email protected]
Notification as per TRAN/MEMPR Memorandum of Understanding – Ministry of Transportation and Infrastructure obligations – Section 4.
Pit/Quarry Name: Project Number:
Highway District: Maintenance Contract Service Area:
Pit/Quarry Location:
UTM Zone: 8 9 10 11 Northing: Easting:
Pit/Mine Manager: Pit Supervisor:
Contractor: Planned Quantity:
Description of Work: Excavation Blasting Reclamation
Screening Equip. Ser. No.
Crushing Equip. Ser. No.
Conveyor System Equip. Ser. No.
Start Date: Completion Date: DD MM YYYY DD MM YYYY
Completed H1258 Form shall be submitted to the Ministry Representative fourteen (14) days prior to commencing any work in the pit. If the work in the pit is to extend beyond the completion date, a revised H1258 form shall be submitted to the Ministry Representative two (2) days prior to the expiration of the completion date.
Date: Signature: Print Name:
DD MM YYYY
Position:
cc: District Manager Transportation (choose the Highways District)
cc: BC TRAN Regional Aggregate Resource Manager (choose the Aggregate Resource Manager)
South Coast Suite 310 – 1500 Woolridge St, Coquitlam, BC V3K 0B8 Phone: 604-250-7448 [email protected]
Southern Interior 447 Columbia Avenue Kamloops, BC V2C 2T3 Phone: 250 371-3965 [email protected]
Northern 213 – 1011 4th Avenue Prince George, BC V2L 3H9 Phone: 250 565-4234 [email protected]