APPLICATION FOR A WATER MONITORING AUTHORITY

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1 Related ATP/PL No. (Office Use Only) APPLICATION FOR A WATER MONITORING AUTHORITY Petroleum and Gas (Production and Safety) Act Section 191 Petroleum Act 1923 Section 75WB Form Number WRA-01A Version Number 4 Mines ABN OFFICIAL USE ONLY PART A Received AT Received BY The original completed application and any attachments, together with one copy of this application and any attachments, must be submitted to the relevant office. If completing this form in writing, please print clearly in ink and use block letters. DATE / / TIME AM : PM APPLICATION DETAILS 1. Is the area being applied for within the tenure area of another petroleum authority? PART B FEE paid RECEIPT no. YES NO PART C ENTERED on register by 2. Please state the Authority to Prospect or Petroleum Lease number(s) to which the land required for a Water Monitoring Authority relates: (SIGNATURE) DATE / / Question 1 The application may be made over land in the area of another petroleum authority. If YES, proceed to Question 2. If NO, proceed to Question 2. Tenure Type Authority to Prospect (ATP) Petroleum Lease (PL) Number(s) Question 2 The application may be made for one or more petroleum tenures held by the same applicant.

2 2 Question 3 Insert the full name of each applicant/holder (including the principal holder ) and their, where applicable, and the percentage interest held. If insufficient space, please attach list. Note: Only a company or registered body under the Corporations Act, adult individuals, or government owned corporation can be the holder of a petroleum authority. 3. Petroleum tenure holder details: Question 3.1 The total interest must equal 100%. If you are entering these details online, right click on the 0 and select Update Field. Question 3.2 Tenancy: If there are 2 or more applicants, indicate if the interests will be held as Tenants in Common or as Joint Tenants. If interests are not specified, tenancy will be registered as Tenants in Common. NOTE: Joint Tenants must be of equal interest held. Total Percentage % Tenancy 3.2 Tenants in Common Joint Tenants

3 3 Question 4 The holders are to nominate one person (the principal holder ), pursuant to section 852 of the Petroleum and Gas (Production and Safety) Act 2004 or section 129 of the Petroleum Act 1923, whose address will be used for the service of notices and other documents. Question 5 Each holder must supply proof of identity. 4. Specify the name and address of 1 person upon whom any notices or other documents will be served. Full Name or Company Name Address Phone Number ( ) Fax Number ( ) 5. Proof of identity of holder(s) must accompany this application. This proof may consist of: For an Individual: For a Company: Certified Photocopy of Driver s Licence, passport or Card 18+ (minimum age of 18 years). Certified Photocopy of Certificate of Incorporation or Australian Companies Number (A.C.N.) or Australian Registered Business Number (A.R.B.N.). 6. Please specify (on the following page) the area of land the subject of this application: NOTE: (a) The area of land the subject of this application may only be that which is reasonably required to allow the holder to comply with, or assess the need to comply with, the make good obligation for the petroleum tenure held by the applicant. (b) The application may be made for land outside the area of the petroleum tenure or in the area of another petroleum authority. The description of this land will be based on the Block Identification Map (BIM) Series B in terms of blocks and sub-blocks as defined on those maps available at Queensland Mines and Energy.

4 4 DESCRIPTION OF AREA Question 6 (Continued) If insufficient space, please attach list. BIM & block ALL a b c d e f g h j k l m n o p q r s t u v w x y z Total number of sub-blocks

5 5 Question 7 The following details must be included on a sheet attached to this application and labelled Attachment 1. Question 8 The following details must be included on a sheet attached to this application and labelled Attachment Required Land: Please provide the following: Details about why the land the subject of this application is required to comply with, or assess the need to comply with, the make good obligation for the tenure. 8. Proposed Activities: Please provide the following: Details about the nature and extent of the activities proposed to be carried out under the Water Monitoring Authority, such as: - Why do you intend to monitor? - What activities do you intend to do? Signature and Endorsement If more than one applicant/holder, the application must be signed by each applicant/holder. If an agent or the holder of a power of attorney is signing a document, required to be lodged by an Act, on behalf of another, then it is necessary for the agent or holder of the power of attorney to produce current, written evidence of their authority to act. Failure to do so may render the document to be of no effect. SIGNATURE AND ENDORSEMENT I/We declare that: (a) the information provided in this application is correct to the best of my/our knowledge; and (b) I/We am/are aware of the requirements under the Petroleum and Gas (Production and Safety) Act 2004 and the Petroleum Act 1923, including the Regulations made under these Acts, applying to Water Monitoring Authorities. Full Name and Position of Holders Signature of Holders Date All of the holders of the petroleum tenure MUST execute the appointment of agent or the power of attorney for the appointment or power of attorney to be effective. A company signing an appointment of agent or power of attorney must do so in accordance with the corporation law and/or the articles of association of the company (as can be disclosed by an ASIC search).

6 6 The following items must accompany this application. THE FOLLOWING MUST ACCOMPANY THIS COMPLETED APPLICATION FORM WHEN LODGED: 1. Prescribed application fee. Please Tick See the Application for Water Monitoring Authority Information Sheet (pg. 7) for further information. 2. Proof of identity of the applicant(s). 3. Details about why the land the subject of this application is required to comply with, or assess the need to comply with, the make good obligation for the tenure are attached and labelled Attachment Details about the nature and extent of the activities proposed to be carried out under the Water Monitoring Authority are attached and labelled Attachment (Where applicable) Agent or power of attorney s authority to act. 6. A copy of the completed application and any attachments. Disclaimer The Queensland Government is collecting information provided on this form for the purposes of assessing the suitability of your application for a water monitoring authority and maintain the public searchable register under the Petroleum and Gas (Production and Safety) Act 2004 ( the P&G Act ) and the Petroleum Act 1923 ( the Act ). This information is authorised by sections 191and 565 of the P&G Act and section 75 WB and 80B of the Act. Some or all of this information may be provided to other agencies of the Queensland Government for the issuing of an environmental authority, to make register searches, extracts or copies under section 566 of the P&G Act and 80CA of the Act. Your personal information will not otherwise be disclosed to any other third party without your consent, unless authorised or required by law.

7 7 INFORMATION SHEET APPLICATION FOR A WATER MONITORING AUTHORITY (WMA) This information sheet is a summary only. Please refer to the Petroleum and Gas (Production and Safety) Act 2004, the Petroleum Act 1923 and the Water Act 2000 ( Water Act ) for further information. A WMA allows the holder to carry out any of the following activities in the area of the authority to comply with, or assess the need to comply with, the make good obligation for the associated petroleum tenure: (a) (b) (c) (d) (e) Gathering information about, or auditing, an existing Water Act bore; Gathering information for an underground water impact report, pre-closure report, monitoring report or review report; Monitoring the effect of the exercise of the underground water rights for the tenure; Constructing or plugging and abandoning a water observation bore; Carrying out restoration measures in relation to an existing Water Act bore for which the make good obligation applies. The Minister must decide whether to grant the WMA. If the Minister decides to grant the authority, the Minister must fix the area of the authority. The Minister may also: (a) impose conditions on the authority; and (b) decide a day for the authority to take effect. If no day of effect is stated, the authority takes effect on the day it is granted. If a condition is imposed on a WMA, it is a condition of each petroleum tenure to which the authority relates that the holder of the tenure must comply with this condition. If the Minister decides to grant a WMA and land the subject of this WMA is within the tenure area of a mining lease (other than a transportation mining lease), an authorised activity for the WMA may be carried out on this land only if the: mining lease holder has agreed in writing to the carrying out of the activity; and a copy of the agreement has been lodged the agreement is still in force. It should be noted that a WMA continues in force until there is no longer any petroleum tenure to which the authority relates.

8 8 Existing Water Act Bore An existing Water Act bore, for a petroleum tenure, is a water bore as defined under the Water Act if (a) the taking of, or interference with, water from the bore is authorised under the Water Act; and (b) if the Integrated Planning Act 1997 required a development approval under that Act in relation to the bore for operational work for the taking of, or interfering with, water under the Water Act that approval has been granted; and (c) the bore was in existence at the earlier of the following for the tenure (i) the start of approved testing for petroleum production; (ii) the start of petroleum production for commercial purposes. A replacement of a bore, mentioned above, to comply with the make good obligation, is also an existing Water Act bore for the petroleum tenure. Make Good Obligation If the exercise of a petroleum tenure holder s underground water rights unduly affects an existing Water Act bore, the holder must (a) within a reasonable period, take restoration measures to restore the supply of water to the owner of the bore; or (b) compensate the owner for the bore being unduly affected. If an existing Water Act bore is likely, after the petroleum tenure ends, to become unduly affected by the exercise of the rights, the holder must, before the tenure ends, comply with the above as if the bore is unduly affected by the exercise of the rights. These obligations are the make good obligation. The make good obligation applies (a) (b) whether the bore is inside or outside the area of the petroleum tenure; and even if the bore was first unduly affected by the rights after the tenure ends. If the make good obligation applies to more than 1 petroleum tenure holder for the same existing Water Act bore, the obligation applies to each of them jointly and severally. The make good obligation continues to apply despite the ending of the tenure.

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