FS-2700-4o Oil or Gas Pipeline Facility Permit

Authorization ID: #AUTH_ID#
Contact ID: #HOLDER_ID#
Expiration Date: #EXPIRATION_DATE#
Use Code: #USE_CODE#

FS-2700-4o(XX/202X)
OMB 0596-0082

U.S. DEPARTMENT OF AGRICULTURE
FOREST SERVICE
OIL OR GAS PIPELINE FACILITY PERMIT
AUTHORITY:
Section 28 of the Mineral Leasing Act of 1920, as amended, 30 U.S.C. 185

This oil or gas pipeline facility permit (the permit), dated #DATE#, is issued by the United States
Department of Agriculture, Forest Service (the Forest Service), to #HOLDER_NAME# of
#HOLDER_ADD_LINE_1#, #HOLDER_ADD_LINE_2#, #HOLDER_ADD_LINE_3#, #HOLDER_CITY#,
#HOLDER_STATE# #HOLDER_ZIP# (hereinafter “the holder”).

This permit is issued for the purpose of:
[construction/reconstruction,] maintenance and operation of [a/an] [oil/natural gas/synthetic liquid
fuel/synthetic gaseous fuel/other specified refined product] [gathering/distribution/transmission] pipeline
that is [above-ground/buried [number] feet below ground], [number] inches in diameter, and constructed
of [types of material] and that has a linear right-of-way width of [number] feet.
The linear right-of-way and access roads and trails for each oil or gas pipeline facility authorized by this
permit shall be referred to collectively as “the permit area.” A legal description and a map of the permit
area for each oil or gas pipeline facility authorized by this permit are contained in Appendix B, and the
access roads and trails for each oil or gas pipeline facility authorized by this permit are listed and
identified on the map in Appendix C. The pipeline facility or facilities authorized by this permit shall be
referred to collectively as “the pipeline facilities.”
In addition, this permit gives the holder:
1. The right of ingress to and egress from the linear rights-of-way for the pipeline facilities along access
roads and trails, listed in Appendix C, and the right to construct, reconstruct, and maintain access roads
and trails, in accordance with the following provisions:
(a) All drawings for development, layout, construction, reconstruction, or alteration of access roads and
trails, as well as revisions to those drawings, must be prepared by a professional engineer (PE) or other
qualified professional acceptable to the authorized officer. These drawings and drawing revisions must
Page 1 of 31

have written approval from the authorized officer before they are implemented. The authorized officer
may require the holder to furnish as-built drawings, maps, or surveys upon completion of the work.
(b) The Forest Service does not have an obligation to maintain access roads and trails.
(c) The rights granted in paragraph 1 shall be subordinate to any right to use an access road or trail
subsequently granted by the United States to a local public road authority for a public road, provided that
the holder shall continue to have access to that right-of-way to operate and maintain the pipeline facilities,
manage vegetation, and address public safety related to the pipeline facilities.
2. The right to install, maintain, and use gates and fences in the permit area with the prior written
approval of the authorized officer. All gates shall have reflective markings in accordance with Forest
Service Engineering Manual EM 7100-15.
The following appendices are attached to and incorporated into this permit:
APPENDIX A: Definitions
APPENDIX B: Maps, Legal Descriptions, Surveys, Plats, Site Plans, and Engineering Drawings of the
Permit Area
APPENDIX C: List and Location of Access Roads and Trails and National Forest System Roads and
National Forest System Trails Used by the Holder
APPENDIX D: Operating Plan
APPENDIX E: List and Location of Pipeline Facilities Other Than Access Roads and Trails
APPENDIX F. Initial and Follow-Up Environmental Site Assessments
APPENDIX G. Bonding
I. GENERAL TERMS
A. AUTHORITY. This permit is issued pursuant to Mineral Leasing Ac of 1920, as amended, 30 U.S.C.
185, and 36 CFR Part 251, Subpart B, as amended, and is subject to their provisions.
B. AUTHORIZED OFFICER. The authorized officer is the Regional Forester, the Forest or Grassland
Supervisor, a District Ranger, or the Station, Institute, or Area Director with delegated authority pursuant
to Forest Service Manual 2700.

C. TERM. This permit shall expire at midnight on #EXPIRATION DATE#. Expiration of this
permit shall not require notice, a decision document, or any environmental analysis or other
documentation.
D. CONTINUATION OF USE AND OCCUPANCY. An application for a new permit for the pipeline
facilities must be submitted at least 6 months before expiration of this permit. Prior to issuing a new
permit for the pipeline facilities, the authorized officer shall require that the holder submit all plans,
contracts and other agreements, and other information or material deemed necessary by the authorized
officer to determine whether a new permit shall be issued and the terms that should be included int eh
new permit. Such information or material may include but is not limited to conditions for, and agreements
among owners or operators, regarding the addition of pumping facilities, looping, or otherwise increasing
the pipeline facilities’ capacity in response to actual or anticipated increases in demand; conditions for
adding or abandoning intake, offtake, or storage points or facilities; and minimum shipment or purchase
tenders. Upon expiration of this permit, the authorized officer shall issue a new permit for the pipeline
facilities, provided that (1) the holder desires to renew the use and occupancy; (2) the pipeline facilities
are consistent with the applicable land management plan and applicable laws and regulations; (3) the
Page 2 of 31

pipeline facilities are still being operated for the purposes previously authorized; and (4) the holder is in
compliance with all the terms of this permit. The authorized officer may prescribe new terms when a new
permit is issued.
E. AMENDMENT. The terms of this permit may be amended by the holder every 10 years from the
date of issuance of this permit when, at the discretion of the grantor, such action is deemed necessary to
incorporate new terms that may be required by law, regulation, or directive. Amendments to this permit
made by the authorized officer must be in writing and must be signed and dated by the authorized officer.
This permit also may be amended at any time by written agreement of the authorized officer and the
holder. Amendments to this permit made by the authorized officer and the holder must be in writing and
must be signed and dated by the authorized officer and the holder.
F. COMPLIANCE WITH LAWS, REGULATIONS, AND OTHER LEGAL REQUIREMENTS. In
exercising the rights and privileges granted by this permit, the holder shall comply with all present and
future federal laws and regulations and all present and future state, county, and municipal laws,
regulations, and other legal requirements that apply to the permit area, to the extent they do not conflict
with federal law, regulation, or policy. The Forest Service assumes no responsibility for enforcing laws,
regulations, and other legal requirements that fall under the jurisdiction of other governmental entities.
G. RESERVATIONS. All rights not specifically and exclusively granted to the holder are reserved to the
Forest Service, including:
1. The right of access to the permit area, including a continuing right of physical entry to the permit area
and pipeline facilities for inspection, monitoring, or any other purpose consistent with any right or
obligation of the United States under any law or regulation.
2. The right to use, administer, and dispose of all natural resources and improvements in the permit area
other than the pipeline facilities, including the right to use roads and trails and authorize rights-of-way and
other uses in the permit area in any way that is not inconsistent with the holder's rights and privileges
under this permit, after consultation with all parties involved. Except for any restrictions that the holder
and the Forest Service agree are necessary to protect public health and safety, property, and the
installation and operation of the pipeline facilities, the permit area shall remain open to the public for all
lawful purposes.
H. ASSIGNABILITY. This permit is not assignable or transferable.
I.

TRANSFER OF TITLE TO THE IMPROVEMENTS

1. Notification of Transfer. The holder shall notify the authorized officer when a transfer of title to all or
part of the pipeline facilities is planned.
2. Transfer of Title. Any transfer of title to the pipeline facilities shall result in termination of the permit.
The party who acquires title to the pipeline facilities must submit an application for a permit. The Forest
Service is not obligated to issue a new permit to the party who acquires title to the pipeline facilities. The
authorized officer shall determine that the applicant meets requirements under applicable federal
regulations.

J. PARTNERSHIP DOCUMENTATION. Before issuance of this permit, the holder shall provide the
authorized officer:
1. A copy of the holder’s partnership agreement, including documentation of the identity and authority of
the partners who will act on behalf of the holder under this permit.

Page 3 of 31

2. A list of the name and address of each partner in the holder.

K. CHANGE IN CONTROL OF THE BUSINESS ENTITY
1. Notification of Change in Control. The holder shall notify the authorized officer when a change in
control of the business entity that holds this permit is planned.
(a) In the case of a corporation, control is an interest, beneficial or otherwise, of sufficient outstanding
voting securities or capital of the business so as to permit the exercise of managerial authority over the
actions and operations of the corporation or election of a majority of the board of directors of the
corporation.
(b) In the case of a partnership, limited partnership, joint venture, or individual entrepreneurship, control
is a beneficial ownership of or interest in the entity or its capital so as to permit the exercise of managerial
authority over the actions and operations of the entity.
(c) In other circumstances, control is any arrangement under which a third party has the ability to
exercise management authority over the actions or operations of the business.
2. Effect of Change in Control. Any change in control of the business entity as defined in paragraph 1 of
this clause shall result in termination of this permit. The party acquiring control must submit an
application for a special use permit. The Forest Service is not obligated to issue a new permit to the party
who acquires control. The authorized officer shall determine whether the applicant meets the
requirements established by applicable federal regulations.
II. IMPROVEMENTS
A. LIMITATIONS ON USE. Nothing in this permit gives or implies permission to build or maintain any
structure or facility or to conduct any activity unless specifically authorized by this permit. Any use not
specifically authorized by this permit must be proposed in accordance with 36 CFR 251.54 or
251.61. Approval of such a proposed use through issuance of a new permit or permit amendment is at
the sole discretion of the authorized officer.
B. DRAWINGS. All drawings for development, layout, construction, reconstruction, or alteration of
improvements in the permit area, as well as revisions to those drawings, must be prepared by a
professional engineer, architect, landscape architect, or other qualified professional acceptable to the
authorized officer. These drawings and drawing revisions must have written approval from the authorized
officer before they are implemented. The authorized officer may require the holder to furnish as-built
drawings, maps, or surveys upon completion of the work.

< Include clause II.C only if this permit authorizes construction or reconstruction as detailed in the
purpose statement. Otherwise delete clause II.C and re-letter the clauses in section II.>
C. CONSTRUCTION OR RECONSTRUCTION. Any construction or reconstruction authorized by this
permit shall commence by #DATE#, and shall be completed by #DATE#.

D. RIGHT-OF-WAY WIDTH. The width of the linear right-of-way authorized by this permit is limited to
50 feet, plus the National Forest System lands occupied by the pipeline facilities. The width of the linear
right-of-way authorized by this permit is [number] feet.
E. RELOCATION. This permit is issued with the express understanding that should future location of
federally owned improvements or road rights-of-way require relocation of the pipeline facilities, the
relocation will be conducted by and at the expense of the holder within a reasonable period specified by
the authorized officer.
III. OPERATIONS
A. PERIOD OF USE. Use and occupancy of the permit area shall be exercised at least 240 days each
year.
B. CONDITION OF OPERATIONS. The holder shall maintain the pipeline facilities and permit area to
standards of repair, orderliness, neatness, sanitation, and safety acceptable to the authorized officer and
consistent with other provisions of this permit. Standards are subject to periodic change by the
authorized officer when deemed necessary to meet statutory, regulatory, or policy requirements or to
protect National Forest System resources and the public.
C. USE OF NATIONAL FOREST SYSTEM ROADS AND NATIONAL FOREST SYSTEM TRAILS. The
holder’s use of National Forest System roads and National Forest System trails shall comply with
applicable requirements in 36 CFR Part 212, Subpart A; 36 CFR Part 261, Subpart A; and orders issued
under 36 CFR Part 261, Subpart B. Motor vehicle use shall be consistent with designations made under
36 CFR Part 212, Subpart B, unless specifically provided otherwise in the operating plan. Over-snow
vehicle use shall be consistent with designations made under 36 CFR Part 212, Subpart C, unless
specifically provided otherwise in the operating plan.
D. OPERATING PLAN. The holder shall, in consultation with the authorized officer or the authorized
officer’s designated representative, prepare an operating plan that covers all operations authorized by this
permit. The operating plan shall outline steps the holder will take to protect public health and safety and
the environment and shall include sufficient detail and standards to enable the Forest Service to monitor
the holder’s operations for compliance with the terms of this permit. The operating plan shall be
submitted by the holder and approved in writing by the authorized officer or the authorized officer’s
designated representative prior to commencement of operations and shall be attached to this permit as
appendix D. At least every 10 years from the approval date of the operating plan in Appendix D, the
holder shall review and, as necessary or appropriate, propose updates to the operating plan to address
changed conditions. Proposed updates to the operating plan that are deemed significant by the
authorized officer shall be treated as proposed modifications and shall be submitted by the holder for
review and approval by the authorized officer. Proposed updates that are deemed non-significant by the
authorized officers may be made by written agreement of the holder and the authorized officer.
E. RESERVATION OF EXCESS FIBER OPTIC CABLE CAPACITY AND LEASING
1. Reservation of Excess Capacity. The holder may reserve fiber optic cable for the holder’s expansion
and may utilize the reserved fiber optic cable during the term of this permit without additional approval
from the authorized officer. Leasing of fiber optic cable by third parties is not authorized by this permit,
except as provided in clause III.E.2.
2. Leasing of the Holder’s Fiber Optic Cable. Leasing of the holder’s fiber optic cable to any third party or
parties must have prior written approval from the authorized officer. The Forest Service reserves the right to
disapprove the holder’s requests to lease fiber optic cable. The holder shall remain responsible for any third

Page 5 of 31

party’s compliance with all the terms of this permit. The holder shall ensure that any third-party lease include
provisions requiring the third party to obtain liability insurance for the third party’s use of the holder’s fiber optic
cable that includes the United States as an additional insured under the policy. The holder shall pay in
advance a single, additional annual land use fee for leasing fiber optic cable, regardless of the holder’s
eligibility for a land use fee waiver or exemption and regardless of the number of third parties, in accordance
with the linear right-of-way fee schedule in Forest Service Handbook 2709.11, Chapter 30. The authorized
officer shall determine the single, additional annual land use fee for leasing fiber optic cable using the length of
the authorized linear right-of-way and a width of 10 feet. The authorized officer may request any information
from the holder deemed necessary for proper administration of the leased fiber optic cable.

3. Leases Involving Communications Uses and Other Third-Party Uses Involving Pipeline Facilities.

Leases involving communications uses that are owned by third parties (such as antennas or other
communications uses owned by third parties that are attached to any part of the pipeline facilities) must have
prior written approval from the authorized officer and must be authorized under a communications use
authorization issued to the holder. Other third-party uses involving the pipeline facilities, such as installation of
fiber optic cable on the pipeline facilities solely for use by third parties, must have prior written approval from
the authorized officer and must be authorized under a separate special use authorization issued to the third
party.

F. CUTTING, DISPOSAL, AND PLANTING OF VEGETATION. This permit does not authorize the
cutting of trees, brush, shrubs, and other plants (“vegetation”). Vegetation may be cut, destroyed, or
trimmed only after the authorized officer or the authorized officer's designated representative has
approved in writing and marked or otherwise identified what vegetation may be cut, disposed of, or
trimmed. The holder shall notify the authorized officer when approved felling, pruning, or destruction of
vegetation has been completed. The Forest Service shall determine in advance of felling the method of
disposal of trees felled in the permit area that meet utilization standards. Disposal may be by sale or
without charge per 36 CFR Part 223, as may be most advantageous to the United States. Debris from
felling that does not meet utilization standards shall also be disposed of according to methods determined
by the Forest Service. Planting of vegetation in the permit area must have prior written approval from the
authorized officer.
G. GROUND SURFACE PROTECTION AND RESTORATION. The holder shall prevent and control
soil erosion and gullying on National Forest System lands in and adjacent to the permit area resulting
from construction, operation, maintenance, and termination of the pipeline facilities. The holder shall
construct the pipeline facilities so as to avoid accumulation of excessive amounts of water in the permit
area and encroachment on streams. The holder shall revegetate or otherwise stabilize (for example, by
constructing a retaining wall) all ground where the soil has been exposed as a result of the holder’s
construction, maintenance, operation, or termination of the pipeline facilities.
H. MONITORING BY THE FOREST SERVICE. The Forest Service shall monitor the holder’s
operations and reserves the right to inspect the permit area and pipeline facilities at any time for
compliance with the terms of this permit. The holder shall comply with inspection requirements deemed
appropriate by the authorized officer. The holder’s obligations under this permit are not contingent upon
any duty of the Forest Service to inspect the permit area or pipeline facilities. A failure by the Forest
Service or other governmental officials to inspect is not a justification for noncompliance with any of the
terms of this permit.
I. PIPELINE INSPECTION REQUIREMENTS. The holder shall perform inspections annually to ensure
compliance with safety, environmental, and resource protection requirements in this permit, including but
not limited to the integrity of the pipeline facilities and linear right-of-way and leakage of hazardous
material into soil or water. Sixty days after the inspection, the holder shall provide to the Forest Service a
written inspection report that documents the locations and dates of inspection, any issues identified, and
any remedies performed and the dates they were performed and that includes videos or photographs.

Page 6 of 31

J. PIPELINE STANDARDS AND PRACTICES. All designs, materials, construction, operation,
maintenance, and termination practices employed in connection with the pipeline facilities shall be in
accordance with safe and proven engineering practices. In addition, all designs, materials, construction,
operation, maintenance, and termination practices employed in connection with the pipeline facilities shall
meet or exceed the requirements in 49 CFR Parts 191-196; Title 18, Chapter I, of the CFR, as applicable;
and the latest edition of [ASME B31.4, Pipeline Transportation System for Liquids and Slurries] [ASME
B31.8, Gas Transmission and Distribution Piping Systems]. Related mechanical facilities such as pumps,
pump stations, and tanks shall be designed, constructed, operated, and maintained in accordance with
applicable standard engineering practices and shall meet or exceed applicable engineering standards.

K. PIPELINE CERTIFICATION REQUIREMENTS. The pipeline facilities shall be designed,
constructed, operated and maintained under the supervision of, and certified by, a qualified PE licensed
in the state in which the pipeline facilities are located. The holder may not operate the pipeline facilities
until the holder has provided to the authorized officer written certification by the qualified PE who
inspected construction that the pipeline facilities have been constructed in accordance with the standards
specified in clause III.J and the authorized officer has provided written approval to the holder.

L. COMMON CARRIER OBLIGATIONS
1. The pipeline facilities shall be constructed, operated, and maintained as common carriers. The holder
shall accept, convey, transport, or purchase without discrimination all oil or gas delivered to the pipeline
facilities without regard to whether the oil or gas was produced from federal or non-federal lands. In the
case of oil or gas produced from federal lands or resources on federal lands near the pipeline facilities,
the Secretary of the Interior may, after giving notice to interested parties, conducting a hearing, and
making a proper finding of facts, determine the proportionate amounts of oil or gas to be accepted,
conveyed, transported, or purchased.

2. Where natural gas that is not subject to state regulatory or conservation laws governing its purchase
by the holder is offered for sale, the holder shall purchase without discrimination any such natural gas
produced in the vicinity of the pipeline facilities.
3. Whenever the Secretary of the Interior has reason to believe that the holder is not operating the
pipeline facilities in complete accord with its obligations as a common carrier, the Secretary of the Interior
may request the Attorney General to prosecute an appropriate proceeding before the Secretary of
Energy, Federal Energy Regulatory Committe (FERC), any appropriate state agency, or the United States
district court for the district in which all or part of the pipeline facilities are located to enforce the holder’s
common carrier obligations or to impose any penalty provided for noncompliance with those obligations,
or the Secretary of the Interior may suspend or revoke this permit pursuant to clause VII.A.

Page 7 of 31

M. AUTHORIZED ABANDONMENT OR DEACTIVATION OF THE PIPELINE FACILITIES.
Authorized abandonment or deactivation of the pipeline facilities, in whole or in part, shall be conducted in
accordance with 49 CFR 192.727. The holder shall give prior written notice to the authorized officer in
advance of authorized abandonment or deactivation of any of the pipeline facilities. The holder shall
submit to the authorized officer and the Pipeline and Hazardous Material Safety Administration a plan to
disconnect, purge, plug, and lock the pipeline facilities to be authorized abandoned or deactivated. The
authorized officer shall decide whether the pipeline facilities to be subject to authorized abandonment
must be removed and the permit area restored, or whether the pipeline facilities to be subject to
authorized abandonment may remain in place. Pipeline facilities that are deactivated, and not subject to
authorized abandonment, may be left in place for the purposes of future reactivation. The holder must
receive approval from FERC before authorized abandonment or deactivation of any FERC pipeline. This
permit shall terminate as to any pipeline facilities for which authorized abandonment or deactivation has
been completed.
N. PAID SICK LEAVE REQUIREMENT. Executive Order 13706, Establishing Paid Sick Leave for
Federal Contractors, and its implementing regulations, including the federal contractor paid sick leave
clause at 29 CFR Part 13, Appendix A, are incorporated by reference into this authorization as if fully set
forth in this authorization.

IV. RIGHTS AND LIABILITIES

A. LEGAL EFFECT OF THE PERMIT. This permit, which is revocable and terminable, is not a contract
or a lease, but rather a federal license. The benefits and requirements conferred by this authorization are
reviewable solely under the procedures set forth in 36 CFR Part 214 and 5 U.S.C. 704. This permit does
not constitute a contract for purposes of the Contract Disputes Act, 41 U.S.C. 601. The permit is not real
property, does not convey any interest in real property, and may not be used as collateral for a loan.
B. VALID EXISTING RIGHTS. This permit is subject to all valid existing rights. Valid existing rights
include those derived under mining and mineral leasing laws of the United States. The United States is
not liable to the holder for the exercise of any such right.
C. ABSENCE OF THIRD-PARTY BENEFICIARY RIGHTS. The parties to this permit do not intend to
confer any rights on any third party as a beneficiary under this permit.
D. NO WARRANTY OF ACCESS, SITE SUITABILITY, OR SERVICES. This permit authorizes the use
and occupancy of National Forest System lands by the holder for the purposes identified in this permit.
The Forest Service does not make any express or implied warranty of access to the permit area, of the
suitability of the permit area for the authorized uses, or for the furnishing of road or trail maintenance,
water, fire protection services, search and rescue services, or any other services by a government
agency, utility, association, or individual.

E. RISK OF LOSS. The holder assumes all risk of loss to the pipeline facilities and all risk of loss of
use and occupancy of the permit area, in whole or in part, due to public health and safety or
environmental hazards. Loss to the pipeline facilities and of use and occupancy of the permit area may
result from but is not limited to theft, vandalism, fire and any fire-fighting activities (including prescribed
Page 8 of 31

burns), environmental contamination, avalanches, rising waters, winds, falling limbs or trees, and other
forces of nature. If all or part of the pipeline facilities are destroyed or substantially damaged, the
authorized officer shall conduct an analysis to determine whether the affected portions of the pipeline
facilities can be safely used in the future and whether rebuilding should be allowed. If rebuilding is not
allowed, this permit shall terminate as to those portions of the pipeline facilities. If the authorized officer
determines that all or part of the permit area cannot be safely occupied due to a public health or safety or
environmental hazard, this permit shall terminate as to those portions of the permit area. Termination
under this clause shall not give rise to any claim for damages, including lost profits and the value of the
pipeline facilities, by the holder against the Forest Service.
F. DAMAGE TO UNITED STATES PROPERTY. The holder has an affirmative duty to protect from
damage the land, property, and other interests of the United States that are associated with the use and
occupancy authorized by this permit. Damage includes but is not limited to destruction of or damage to
National Forest System lands, fire suppression costs, and destruction of or damage to federally owned
improvements.
1. The holder shall be liable for all injury, loss, or damage, including fire suppression costs, prevention
and control of the spread of invasive species, and the costs of rehabilitation or restoration of natural
resources, resulting from the holder’s use and occupancy of the permit area. Compensation shall include
but not be limited to the value of resources damaged or destroyed, the costs of restoration, cleanup, or
other mitigation, fire suppression or other types of abatement costs, and all associated administrative,
legal (including attorney’s fees), and other costs. Such costs may be deducted from a performance bond
required under clause IV.J.
2. The holder shall be liable for damage to all roads and trails of the United States caused by use of the
holder or the holder's heirs, assignees, agents, employees, contractors, or lessees to the same extent as
provided under clause IV.F.1, except that liability shall not include reasonable and ordinary wear and tear.
G. HEALTH AND SAFETY. The holder shall take all measures necessary to protect the health and
safety of all persons affected by the use and occupancy authorized by this permit. The holder shall
promptly abate as completely as possible and in compliance with all applicable laws and regulations any
physical or mechanical procedure, activity, event, or condition existing or occurring in connection with the
authorized use and occupancy during the term of this permit that causes or threatens to cause a hazard
to the health or safety of the public or the holder’s employees, agents, or contractors. The holder shall as
soon as practicable notify the authorized officer of all serious accidents that occur in connection with
these procedures, activities, events, or conditions. The Forest Service has no duty under the terms of
this permit to inspect the permit area or operations of the holder for hazardous conditions or compliance
with health and safety standards.
H. ENVIRONMENTAL PROTECTION
1. Compliance with Environmental Laws. The holder shall in connection with the use and occupancy
authorized by this permit comply with all applicable federal, state, and local environmental laws and
regulations, including but not limited to those established pursuant to the Comprehensive Environmental
Response, Compensation, and Liability Act (CERCLA), as amended, 42 U.S.C. 9601 et seq., the
Resource Conservation and Recovery Act, as amended, 42 U.S.C. 6901 et seq., the Federal Water
Pollution Control Act, as amended, 33 U.S.C. 1251 et seq., the Oil Pollution Act, as amended, 33 U.S.C.
2701 et seq., the Clean Air Act, as amended, 42 U.S.C. 7401 et seq., CERCLA, as amended, 42 U.S.C.
9601 et seq., the Toxic Substances Control Act, as amended, 15 U.S.C. 2601 et seq., the Federal
Insecticide, Fungicide, and Rodenticide Act, as amended, 7 U.S.C. 136 et seq., and the Safe Drinking
Water Act, as amended, 42 U.S.C. 300f et seq.
2. Definition of Hazardous Material. For purposes of clause IV.G and section V, “hazardous material”
shall mean (a) any hazardous substance under section 101(14) of CERCLA, 42 U.S.C. 9601(14); (b) any
pollutant or contaminant under section 101(33) of CERCLA, 42 U.S.C. 9601(33); (c) any petroleum
product or its derivative, including fuel oil, and waste oils; and (d) any hazardous substance, extremely
Page 9 of 31

hazardous substance, toxic substance, hazardous waste, ignitable, reactive or corrosive materials,
pollutant, contaminant, element, compound, mixture, solution or substance that may pose a present or
potential hazard to human health or the environment under any applicable environmental laws.
3. Environmental Site Assessment (SA). The holder shall conduct an initial SA prior to use and
occupancy of the permit area for any new authorized oil or gas pipeline facilities and a follow-up SA prior
to termination or upon revocation of this permit. The initial and follow-up SAs shall be incorporated into
this permit as Appendix F.
(a) Purposes. The purpose of the initial and follow-up SAs is to identify Recognized Environmental
Conditions in the permit area, that is, the presence or likely presence of any hazardous substances or
petroleum products in the permit area: (1) due to any release to the environment; (2) under conditions
indicative of a release to the environment; or (3) under conditions that pose a material threat of a future
release to the environment. A comparison of the initial and follow-up SAs shall assist the authorized
officer in determining whether any environmental cleanup or restoration is required as a result of the use
and occupancy. Any cleanup or restoration shall be completed promptly by the holder in accordance with
all applicable federal, state, and local laws and regulations, to the satisfaction of the authorized officer
and at no expense to the Forest Service.
(b) Standard. All SAs must be conducted by the holder’s environmental professional with the requisite
certification and experience and must meet the objectives and performance factors of 40 CFR Part 312,
Innocent Landowners, Standards for Conducting All Appropriate Inquiries. The holder may use the most
recent version of The American Society for Testing and Materials (ASTM) guideline referenced in 40 CFR
312.11(a), entitled Standard Practice for Environmental Site Assessments: Phase I Environmental Site
Assessment Process, or select an alternate practice that constitutes all appropriate inquiries consistent
with good commercial and customary practices.
(c) Exceptions. If a new permit will be issued to the same holder upon expiration of this permit, the
follow-up SA shall satisfy the requirement for an initial SA for the new permit. Initial and follow-up SAs
are not required when this permit is revoked at the request of the holder and a new permit is granted to
the holder for the balance of this permit’s term or when this permit is reissued for the balance of its term to
the holder due to a modification pursuant to 36 CFR 251.61(a), provided that an initial SA shall be
completed in either of these scenarios if one has not been done by the holder.
(d) Cleanup or Other Remedial Action Based on the Initial SA. If the initial SA shows that a hazardous
substance release is present in the permit area, the holder shall be responsible for any cleanup or other
remedial action that the Forest Service determines to be required in the permit area based on the initial
SA. The level of cleanup or other remedial action shall be commensurate with the holder’s intended use
and occupancy of the permit area for the new authorized pipeline facilities and shall be completed before
that use and occupancy commence.
4. Oil Discharges and Release of Hazardous Materials. The holder shall immediately notify all
appropriate response authorities, including the National Response Center and the authorized officer or
the authorized officer’s designated representative, of any oil discharge or of the release of a hazardous
material in the permit area in an amount greater than or equal to its reportable quantity, in accordance
with 33 CFR Part 153 and 40 CFR Part 302. For the purposes of this requirement, “oil” is defined by
section 311(a)(1) of the Clean Water Act, 33 U.S.C. 1321(a)(1). The holder shall immediately notify the
authorized officer or the authorized officer’s designated representative of any release or threatened
release of any hazardous material in or near the permit area which may be harmful to public health or
welfare or which may adversely affect natural resources on federal lands.
5. Remediation of Release of Hazardous Materials. The holder shall remediate any release, threat of
release, or discharge of hazardous materials that occurs in connection with the holder’s activities in the
permit area, including activities conducted by the holder’s agents, employees, contractors, or lessees and
regardless of whether those activities are authorized under this permit. The holder shall perform
remediation in accordance with applicable law immediately upon discovery of the release, threat of
Page 10 of 31

release, or discharge of hazardous materials. The holder shall perform the remediation to the satisfaction
of the authorized officer and at no expense to the United States. Upon revocation or termination of this
permit, the holder shall deliver the site to the Forest Service in compliance with all applicable laws and
regulations and free and clear of contamination.

I. INDEMNIFICATION OF THE UNITED STATES. The holder shall indemnify, defend, and hold
harmless the United States for any costs, damages, claims, liabilities, and judgments arising from past,
present, and future acts or omissions of the holder in connection with the use and occupancy authorized
by this permit. This indemnification and hold harmless provision includes but is not limited to acts and
omissions of the holder or the holder’s heirs, assignees, agents, employees, contractors, or lessees in
connection with the use and occupancy authorized by this permit which result in (1) violations of any laws
and regulations which are now or which may in the future become applicable; (2) judgments, claims,
demands, penalties, or fees assessed against the United States; (3) costs, expenses, and damages
incurred by the United States; or (4) the release or threatened release of any hazardous material into the
environment. The authorized officer may prescribe terms that allow the holder to replace, repair, restore,
or otherwise undertake necessary curative actions to mitigate damages in combination with or as an
alternative to monetary indemnification.
J. STRICT LIABILITY. The holder shall be strictly liable (liable without proof of negligence) to the United
States up to the limit specified in 36 CFR 251.56(d)(2), as amended, per occurrence for any injury, loss,
or damage arising in tort under this permit. Liability in tort for injury, loss, or damage to the United States
exceeding the prescribed amount of strict liability in tort shall be determined under the law of negligence.

K. INSURANCE. The holder shall furnish proof of insurance, such as a certificate of insurance, to the
authorized officer prior to issuance of this permit and each year thereafter that this permit is in effect. The
Forest Service reserves the right to review the insurance policy and require any changes needed to
ensure adequate coverage of the United States in connection with the authorized use and occupancy.
The holder shall send an authenticated copy of any insurance policy obtained pursuant to this clause to
the authorized officer immediately upon issuance of the policy. Any insurance policies obtained by the
holder pursuant to this clause shall include the United States as an additional insured in an endorsement
to the policy, and the additional insured provision shall provide for insurance coverage for the United
States as required under this clause and to the extent of the full limits of insurance available to the holder.
The holder shall give 30 days prior written notice to the authorized officer of cancellation of or any
modification to the insurance policy. The certificate of insurance, the authenticated copy of the insurance
policy, and written notice of cancellation or modification of insurance policies should be sent to [mailing
address of administering office]. Minimum amounts of coverage and other insurance requirements are
subject to change at the sole discretion of the authorized officer on the anniversary date of this permit.
1. The holder shall have in force liability insurance covering losses associated with the use and
occupancy authorized by this permit arising from personal injury or death and third-party property damage
in the minimum amount of $2 million as a combined single limit per occurrence and $5 million in the
aggregate for each of the pipeline facilities authorized by this permit.

Page 11 of 31

2. Depending on the holder’s operations, the Forest Service may require the holder to demonstrate the
availability of funds to address any release or threatened release of hazardous materials that may occur
in connection with the holder’s use and occupancy. Any requirements imposed would be established
case by case by the authorized officer based on the degree of environmental risk from the holder’s
operations. The use and storage of normal maintenance supplies in nominal amounts generally would
not trigger financial assurance requirements.

K. INSURANCE
1. Source of Funding for Insurance. The holder is required to obtain approval for the rates it charges the
public for oil or gas in a manner that ensures that the holder is provided the opportunity to recover its
costs, plus a fair return on capital investment. Included in the holder’s recovery of costs are liabilities that
the holder may incur under this permit, including indemnification and self-insurance requirements for
third-party liability claims and related claims and legal expenses incurred by the holder.

2. Self-Insurance and Procured Insurance. As part of its cost recovery, the holder self-insures for thirdparty liability for up to $#AMOUNT# million. The holder has a commercial general liability (CGL)
insurance policy for claims above $#AMOUNT# million. The holder shall self-insure for losses associated
with the use and occupancy authorized by this permit arising from personal injury or death and third-party
property damage in the minimum amount of $2 million as a combined single limit per occurrence and $5
million in the aggregate for each of the pipeline facilities authorized by this permit. The minimum amounts
of self-insurance specified in this clause do not limit or otherwise affect in any way the holder’s obligation
under this permit to indemnify the United States for injury, loss, or damage. The holder’s self-insurance
and CGL insurance policy above the minimum amounts of insurance specified in this clause may need to
be utilized to meet the holder’s indemnification obligation under this permit. Any insurance policies
obtained by the holder pursuant to this clause shall include the United States as an additional insured in
an endorsement to the policy, and the additional insured provision shall provide for insurance coverage
for the United States as required under this clause and to the extent of the full limits of insurance
available to the holder. Minimum amounts of insurance coverage and other insurance requirements are
subject to change at the sole discretion of the authorized officer on the anniversary date of this permit.
The holder shall furnish proof of its self-insurance and CGL insurance policy, such as a certificate of
insurance, to the authorized officer prior to issuance of this permit and each year thereafter that this
permit is in effect. The holder shall send an authenticated copy of its CGL insurance policy to the
authorized officer before issuance of this permit. The Forest Service reserves the right to review the selfinsurance and CGL insurance policy and require any changes needed to ensure adequate coverage of
the United States in connection with the authorized use and occupancy.

2. Self-Insurance and Procured Insurance. As part of its cost recovery, the holder self-insures for thirdparty liability for up to $#AMOUNT# million for non-wildfire claims and up to $#AMOUNT# million for
wildfire claims. The holder has a commercial general liability (CGL) insurance policy for non-wildfire
claims above $#AMOUNT# million and wildfire claims above $#AMOUNT# million. The holder shall selfinsure for losses associated with the use and occupancy authorized by this permit arising from personal
Page 12 of 31

injury or death and third-party property damage in the minimum amount of $2 million as a combined
single limit per occurrence and $5 million in the aggregate for each of the pipeline facilities authorized by
this permit. The minimum amounts of self-insurance specified in this clause do not limit or otherwise
affect in any way the holder’s obligation under this permit to indemnify the United States for injury, loss, or
damage. The holder’s self-insurance and CGL insurance policy above the minimum amounts of
insurance specified in this clause may need to be utilized to meet the holder’s indemnification obligation
under this permit. Any insurance policies obtained by the holder pursuant to this clause shall include the
United States as an additional insured in an endorsement to the policy, and the additional insured
provision shall provide for insurance coverage for the United States as required under this clause and to
the extent of the full limits of insurance available to the holder Minimum amounts of insurance coverage
and other insurance requirements are subject to change at the sole discretion of the authorized officer on
the anniversary date of this permit. The holder shall furnish proof of its self-insurance and CGL insurance
policy, such as a certificate of insurance, to the authorized officer prior to issuance of this permit and each
year thereafter that this permit is in effect. The holder shall send an authenticated copy of its CGL
insurance policy to the authorized officer before issuance of this permit. The Forest Service reserves the
right to review the self-insurance and CGL insurance policy and require any changes needed to ensure
adequate coverage of the United States in connection with the authorized use and occupancy.
3. Notice of Cancellation or Modification. The holder shall give 30 days prior written notice to the
authorized officer of cancellation or modification of the holder’s self-insurance or CGL insurance policy.
Written notice of cancellation or modification of the self-insurance or CGL insurance policy should be sent
to [mailing address of administering office].
4. Release of Hazardous Materials. Depending on the holder’s operations, the Forest Service may
require the holder to demonstrate the availability of funds to address any release or threatened release of
hazardous materials that may occur in connection with the holder’s use and occupancy. Any
requirements imposed would be established case by case by the authorized officer based on the degree
of environmental risk from the holder’s operations. The use and storage of normal maintenance supplies
in nominal amounts generally would not trigger financial assurance requirements.
L. BONDING. The authorized officer shall require the holder to furnish a surety bond or other security
for any of the obligations imposed by the terms of this permit or any applicable law, regulation, or order.

1. As a further guarantee of compliance with the terms of this permit, the holder shall deliver and
maintain a surety bond or other acceptable security, such as cash deposited and maintained in a federal
depository or negotiable securities of the United States, in the amount of #AMOUNT# to secure the
holder’s obligation to restore the permit area [after construction or reconstruction and] upon abandonment
or deactivation of the pipeline facilities and revocation or termination of this permit without issuance of a
new permit. The holder shall submit to the authorized officer an estimate of the cost of removal of the
pipeline facilities from National Forest System lands and restoration of the permit area for purposes of the
authorized officer’s determination of the amount of the bond.’’
2. The authorized officer may periodically evaluate the adequacy of the bond or other security and
increase or decrease the amount as appropriate. If the bond or other security becomes unsatisfactory to
the authorized officer, the holder shall within 30 days of demand furnish a new bond or other security
issued by a surety that is solvent and satisfactory to the authorized officer. If the holder fails to meet any
of the requirements secured under this clause, money deposited pursuant to this clause shall be retained
by the United States to the extent necessary to satisfy the obligations secured under this clause, without
prejudice to any other rights and remedies of the United States.
3. The bond shall be released or other security returned 30 days after (a) the authorized officer certifies
that the obligations covered by the bond or other security are met and (b) the holder establishes to the
Page 13 of 31

satisfaction of the authorized officer that all claims for labor and material for the secured obligations have
been paid or released.
4. The holder may be required to obtain additional bonding or security prior to undertaking additional
construction or alteration not covered by the bond or other security or when the pipeline facilities are to be
removed and the permit area restored.

E. RISK OF LOSS. The holder assumes all risk of loss to the authorized improvements and all risk of
loss of use and occupancy of the permit area, in whole or in part, due to public health and safety or
environmental hazards. Loss to the authorized improvements and of use and occupancy of the permit
area may result from but is not limited to theft, vandalism, fire and any fire-fighting activities (including
prescribed burns), environmental contamination, avalanches, rising waters, winds, falling limbs or trees,
and other forces of nature. If any authorized improvements are destroyed or substantially damaged, the
authorized officer shall conduct an analysis to determine whether the authorized improvements can be
safely occupied in the future and whether rebuilding should be allowed. If rebuilding is not allowed, this
permit shall terminate. If the authorized officer determines that the permit area cannot be safely occupied
due to a public health or safety or environmental hazard, this permit shall terminate. Termination under
this clause shall not give rise to any claim for damages, including lost profits and the value of the
improvements, by the holder against the Forest Service.
F. HEALTH AND SAFETY. The holder shall take all measures necessary to protect the health and
safety of all persons affected by the use and occupancy authorized by this permit. The holder shall
promptly abate as completely as possible and in compliance with all applicable laws and regulations any
physical or mechanical procedure, activity, event, or condition existing or occurring in connection with the
authorized use and occupancy during the term of this permit that causes or threatens to cause a hazard
to the health or safety of the public or the holder’s employees, agents, or contractors. The holder shall as
soon as practicable notify the authorized officer of all serious accidents that occur in connection with
these procedures, activities, events, or conditions. The Forest Service has no duty under the terms of
this permit to inspect the permit area or operations of the holder for hazardous conditions or compliance
with health and safety standards.
G. ENVIRONMENTAL PROTECTION
1. Compliance with Environmental Laws. The holder shall in connection with the use and occupancy
authorized by this permit comply with all applicable federal, state, and local environmental laws and
regulations, including but not limited to those established pursuant to the Comprehensive Environmental
Response, Compensation, and Liability Act (CERCLA), as amended, 42 U.S.C. 9601 et seq., the
Resource Conservation and Recovery Act, as amended, 42 U.S.C. 6901 et seq., the Federal Water
Pollution Control Act, as amended, 33 U.S.C. 1251 et seq., the Oil Pollution Act, as amended, 33 U.S.C.
2701 et seq., the Clean Air Act, as amended, 42 U.S.C. 7401 et seq., the Toxic Substances Control Act,
as amended, 15 U.S.C. 2601 et seq., the Federal Insecticide, Fungicide, and Rodenticide Act, as
amended, 7 U.S.C. 136 et seq., and the Safe Drinking Water Act, as amended, 42 U.S.C. 300f et seq.
2. Definition of Hazardous Material. For purposes of clause IV.G and section V, “hazardous material”
shall mean (a) any hazardous substance under section 101(14) of the Comprehensive Environmental
Response, Compensation, and Liability Act (CERCLA), 42 U.S.C. 9601(14); (b) any pollutant or
contaminant under section 101(33) of CERCLA, 42 U.S.C. 9601(33); (c) any petroleum product or its
derivative, including fuel oil, and waste oils; and (d) any hazardous substance, extremely hazardous
substance, toxic substance, hazardous waste, ignitable, reactive or corrosive materials, pollutant,
contaminant, element, compound, mixture, solution or substance that may pose a present or potential
hazard to human health or the environment under any applicable environmental laws.
Page 14 of 31

3. Oil Discharges and Release of Hazardous Materials. The holder shall immediately notify all
appropriate response authorities, including the National Response Center and the authorized officer or
the authorized officer’s designated representative, of any oil discharge or of the release of a hazardous
material in the permit area in an amount greater than or equal to its reportable quantity, in accordance
with 33 CFR Part 153 and 40 CFR Part 302. For the purposes of this requirement, “oil” is as defined by
section 311(a)(1) of the Clean Water Act, 33 U.S.C. 1321(a)(1). The holder shall immediately notify the
authorized officer or the authorized officer’s designated representative of any release or threatened
release of any hazardous material in or near the permit area which may be harmful to public health or
welfare or which may adversely affect natural resources on federal lands.
4. Remediation of Release of Hazardous Materials. The holder shall remediate any release, threat of
release, or discharge of hazardous materials that occurs in connection with the holder’s activities in the
permit area, including activities conducted by the holder’s agents, employees, or contractors and
regardless of whether those activities are authorized under this permit. The holder shall perform
remediation in accordance with applicable law immediately upon discovery of the release, threat of
release, or discharge of hazardous materials. The holder shall perform the remediation to the satisfaction
of the authorized officer and at no expense to the Forest Service. Upon revocation or termination of this
permit, the holder shall deliver the site to the Forest Service in compliance with all applicable laws and
regulations and free and clear of contamination.
V. RESOURCE PROTECTION
A. WATER POLLUTION. No waste or by-product shall be discharged into water in connection with the
use and occupancy authorized by this permit except in full compliance with all applicable federal, state,
and local environmental and other laws. Storage facilities for materials capable of causing water
pollution, if accidentally discharged, shall be located so as to prevent any spillage into waters or channels
leading into water except in full compliance with all applicable federal, state, and local environmental and
other laws.
B. SCENIC VALUES. The holder shall protect the scenic values of the permit area and the adjacent
land to the greatest extent possible during construction, operation, and maintenance of the authorized
improvements.
C. VANDALISM. The holder shall take reasonable measures to prevent and discourage vandalism and
disorderly conduct and, when necessary, shall contact the appropriate law enforcement officer.
D. PESTICIDE USE
1. Authorized Officer Concurrence. Pesticides may not be used outside of buildings in the permit area to
control pests, including undesirable woody and herbaceous vegetation (including aquatic plants), insects,
birds, rodents, or fish without prior written concurrence of the authorized officer. Only those products
registered or otherwise authorized by the U.S. Environmental Protection Agency and appropriate state
authority for the specific purpose planned shall be authorized for use within areas on National Forest
System lands.
2. Pesticide-Use Proposal. Requests for concurrence of any planned uses of pesticides shall be
provided in advance using the Pesticide-Use Proposal (form FS-2100-2). Annually the holder shall, on
the due date established by the authorized officer, submit requests for any new, or continued, pesticide
usage. The Pesticide-Use Proposal shall cover a 12-month period of planned use. The Pesticide-Use
Proposal shall be submitted at least 60 days in advance of pesticide application. Information essential for
review shall be provided in the form specified. Exceptions to this schedule may be allowed, subject to
emergency request and approval, only when unexpected outbreaks of pests require control measures
which were not anticipated at the time a Pesticide-Use Proposal was submitted.

Page 15 of 31

3. Safety Plan. Before applying pesticides in the permit area, the holder shall submit to the authorized
officer a safety plan that includes, at a minimum, a precise statement of the treatment objectives; a
description of the equipment, materials, and supplies to be used, including pesticide formulation,
quantities, and application methods; a description of the lines of responsibility for project planning, project
monitoring, and after-action review; a description of any necessary interagency coordination; a copy of
the current Pesticide-Use Proposal for the permit; a description of the process by which treatment
effectiveness will be determined; and a spill plan, communications plan, security plan, and when required
by applicable local requirements, a provision for prior notification to sensitive individuals.
4. Reporting. By September 30th annually, the holder shall submit to the authorized officer a written
report of each pesticide application project completed during the previous 12-month period. The report
shall contain information pertaining to the pesticide application projects as requested by the authorized
officer.
5. Labeling, Laws, and Regulations. Label instructions and all applicable laws and regulations shall be
strictly followed in the application of pesticides and disposal of excess materials and containers. No
pesticide waste, excess materials, or containers shall be disposed of in any area administered by the
Forest Service.
E. ARCHAEOLOGICAL AND PALEONTOLOGICAL DISCOVERIES. The holder shall immediately
notify the authorized officer of any antiquities or other objects of historic or scientific interest, including but
not limited to historic or prehistoric ruins, fossils, or artifacts discovered in connection with the use and
occupancy authorized by this permit. The holder shall leave these discoveries intact and in place until
otherwise directed by the authorized officer.
F. NATIVE AMERICAN GRAVES PROTECTION AND REPATRIATION ACT (NAGPRA). In
accordance with 25 U.S.C. 3002(d) and 43 CFR 10.4, if the holder inadvertently discovers human
remains, funerary objects, sacred objects, or objects of cultural patrimony on National Forest System
lands, the holder shall immediately cease work in the area of the discovery and shall leave the
discoveries intact and in place. The holder shall follow the applicable NAGPRA protocols for the
undertaking provided in the NAGPRA plan of action or the NAGPRA comprehensive agreement; if there
are no such agreed-upon protocols, the holder shall as soon as practicable notify the authorized officer of
the discovery and shall follow up with written confirmation of the discovery. The activity that resulted in
the inadvertent discovery may not resume until 30 days after the authorized officer certifies receipt of the
written confirmation, if resumption of the activity is otherwise lawful, or at any time if a NAGPRA plan of
action has been executed by the Forest Service following tribal consultation and any preconditions have
been met.
G. PROTECTION OF THREATENED AND ENDANGERED SPECIES, SENSITIVE SPECIES, AND
SPECIES OF CONSERVATION CONCERN AND THEIR HABITAT
1. Threatened and Endangered Species and Their Habitat. The location of sites within the permit area
needing special measures for protection of plants or animals listed as threatened or endangered under
the Endangered Species Act of 1973, 16 U.S.C. 1531 et seq., as amended, or within designated critical
habitat shall be shown on a map in an appendix to this permit and may be shown on the ground. The
holder shall take any protective and mitigation measures specified by the authorized officer as necessary
and appropriate to avoid or reduce effects on listed species or designated critical habitat affected by the
authorized use and occupancy. Discovery by the holder or the Forest Service of other sites within the
permit area containing threatened or endangered species or designated critical habitat not shown on the
map in the appendix shall be promptly reported to the other party and shall be added to the map.
2. Sensitive Species and Species of Conservation Concern and Their Habitat. The location of sites
within the permit area needing special measures for protection of plants or animals designated by the
Regional Forester as sensitive species or as species of conservation concern pursuant to FSM 2670 shall
be shown on a map in an appendix to this permit and may be shown on the ground. The holder shall take
any protective and mitigation measures specified by the authorized officer as necessary and appropriate
Page 16 of 31

to avoid or reduce effects on sensitive species or species of conservation concern or their habitat affected
by the authorized use and occupancy. Discovery by the holder or the Forest Service of other sites within
the permit area containing sensitive species or species of conservation concern or their habitat not shown
on the map in the appendix shall be promptly reported to the other party and shall be added to the map.
H. CONSENT TO STORE HAZARDOUS MATERIALS. The holder shall not store any hazardous
materials at the site without prior written approval from the authorized officer. This approval shall not be
unreasonably withheld. If the authorized officer provides approval, this permit shall include or, in the case
of approval provided after this permit is issued, shall be amended to include specific terms addressing the
storage of hazardous materials, including the specific type of materials to be stored, the volume, the type
of storage, and a spill or release prevention and control plan. Such terms shall be proposed by the holder
and are subject to approval by the authorized officer.

1. If the holder receives consent to store hazardous material, the holder shall identify to the Forest
Service any hazardous material to be stored at the site. This identifying information shall be consistent
with column (1) of the table of hazardous materials and special provisions enumerated at 49 CFR
172.101 whenever the hazardous material appears in that table. For hazard communication purposes,
the holder shall maintain Material Safety Data Sheets for any stored hazardous chemicals, consistent with
29 CFR 1910.1200(c) and (g). In addition, all hazardous materials stored by the holder shall be used,
labeled, stored, transported, and disposed of in accordance with all applicable federal, state, and local
laws and regulations. Any hazardous material transportation and disposal manifests shall clearly identify
the holder as the generator of the hazardous waste.
2. If hazardous materials are used or stored at the site, the authorized officer may require the holder to
deliver and maintain a surety bond in accordance with clause IV.J.
3. The holder shall not release any hazardous material onto land or into rivers, streams, impoundments,
or natural or artificial channels leading to them. All prudent and safe attempts must be made to contain
any release of these materials. The authorized officer in charge may specify specific conditions that must
be met, including conditions more stringent than federal, state, and local regulations, to prevent releases
and protect natural resources.
4. If the holder uses or stores hazardous materials at the site, upon revocation or termination of this
permit the holder shall provide the Forest Service with a report certified by a professional or professionals
acceptable to the Forest Service that the permit area is uncontaminated by the presence of hazardous
materials and that there has not been a release or discharge of hazardous materials upon the permit
area, into surface water at or near the permit area, or into groundwater below the permit area during the
term of the permit. If a release or discharge has occurred, the professional or professionals shall
document and certify that the release or discharge has been fully remediated and that the permit area is
in compliance with all applicable federal, state, and local laws and regulations.
J. FEDERAL SURVEY MONUMENTS, CORNERS, and BOUNDARY MARKERS. The holder shall
protect in place all federal survey monuments, corners, and boundary markers in the permit area. If any
federal survey monuments, corners, or boundary markers in the permit area are destroyed or modified,
the holder shall ensure that they are reestablished or corrected in accordance with (1) the Manual of
Instructions for the Survey of the Public Land of the United States; (2) the applicable county surveyor’s
specifications; and (3) the specifications of the Forest Service, as applicable. The holder shall ensure
that any official survey records that were affected due to the destruction or modification of any federal
survey monuments, corners, or boundary markers are amended in accordance with applicable law.
Nothing in this clause shall relieve the holder of liability for the willful destruction or modification of any
federal survey monuments, corners, or boundary markers as provided in 18 U.S.C. 1858.

Page 17 of 31

VI. LAND USE FEE AND DEBT COLLECTION

A. LAND USE FEE FOR HOLDER’S USE AND OCCUPANCY. The holder is exempt from a land use
fee pursuant to 36 CFR 251.57 and Forest Service Handbook 2709.11, Chapter 30.

A. LAND USE FEE FOR HOLDER’S USE AND OCCUPANCY. The holder’s land use fee has been
waived pursuant to 36 CFR 251.57 and Forest Service Handbook 2709.11, Chapter 30. The authorized
officer reserves the right to review the land use fee waiver determination periodically and to charge all or
part of the land use fee if the waiver is no longer appropriate.

A. LAND USE FEE FOR HOLDER’S USE AND OCCUPANCY. Per 42 U.S.C. 15925, the holder shall
pay in advance an annual land use fee as determined in accordance with the Per Acre Rent Schedule
established by 43 CFR 2806.20. The initial annual land use fee shall be prorated if less than 6 months in
the calendar year remain on the date this permit is issued. Otherwise, the holder shall pay the entire
initial annual land use fee.
B. MODIFICATION OF THE LAND USE FEE. The land use fee may be revised whenever necessary to
reflect the market value of the authorized use or occupancy or when the fee system used to calculate the
land use fee is modified or replaced.
C. LAND USE FEE PAYMENTS
1. Crediting of Payments. Payments shall be credited on the date received by the deposit facility, except
that if a payment is received on a non-workday, the payment shall not be credited until the next workday.
2. Disputed Land Use Fees. Land use fees are due and payable by the due date. Disputed land use
fees, other than land use fees recalculated pursuant to an audit, must be paid in full. Adjustments will be
made if dictated by an administrative appeal decision, a court decision, or settlement terms.
3. Late Payments
(a) Interest. Pursuant to 31 U.S.C. 3717 et seq., interest shall be charged on any land use fee not paid
within 30 days from the date it became due. The rate of interest assessed shall be the higher of the
Prompt Payment Act rate or the rate of the current value of funds to the United States Treasury (i.e., the
Treasury tax and loan account rate), as prescribed and published annually or quarterly by the Secretary
of the Treasury in the Federal Register and the Treasury Fiscal Requirements Manual Bulletins. Interest
on the principal shall accrue from the date the land use fee is due.
(b) Administrative Costs. If the account becomes delinquent, administrative costs to cover processing
and handling the delinquency shall be assessed.

Page 18 of 31

(c) Penalties. Pursuant to 31 U.S.C. 3717(e)(2), a penalty of 6% per year shall be assessed on the total
amount of any debt, including interest and administrative costs, that is more than 90 days delinquent.
The penalty shall accrue from the same date on which interest charges begin to accrue.
(d) Termination for Nonpayment. This permit shall terminate if the holder fails to pay any land use fee,
interest, or any other charges within 90 calendar days of the due date. The holder shall remain
responsible for the delinquent charges.
4. Administrative Offset and Credit Reporting. Delinquent land use fees and other charges associated
with this permit shall be subject to all rights and remedies afforded the United States pursuant to 31
U.S.C. 3711 et seq. and its implementing regulations. Delinquencies are subject to any or all of the
following:
(a) Administrative offset of payments due the holder from the Forest Service.
(b) If in excess of 120 days, referral to the United States Department of the Treasury for appropriate
collection action as provided by 31 U.S.C. 3711(g)(1) and its implementing regulations.
(c) Offset by the Secretary of the Treasury of any amount due the holder, as provided by 31 U.S.C.
3720A et seq.
(d) Disclosure to consumer or commercial credit reporting agencies.
VII. REVOCATION, SUSPENSION, AND TERMINATION
A. REVOCATION AND SUSPENSION
1. The authorized officer may revoke or suspend this permit in whole or in part:
(a) For noncompliance with applicable federal, state, or local laws and regulations, other than the
common carrier provisions in 30 U.S.C. 185(r), which are enforced by the Secretary of the Interior.
(b) For noncompliance with the terms of this permit, other than the common carrier provisions in clause
III.L, which are enforced by the Secretary of the Interior.
(c) For unauthorized abandonment of this permit. Failure of the holder to use the permit area for a
continuous 2-year period shall constitute a rebuttable presumption of abandonment of this permit.
Authorized abandonment under clause III.N is not subject to revocation or suspension under clause
VII.A.1(c)
(d) At the discretion of the authorized officer, for specific and compelling reasons in the public interest.
2.

The authorized officer may revoke this permit at the request of the holder. Revocation at the request of
the holder must be agreed to in writing by the authorized officer. As a condition of revocation of this permit at
the request of the holder, the authorized officer has discretion to impose any terms deemed appropriate as
provided for in this permit.

3. Prior to revocation or suspension, other than revocation at the request of the holder under clause
VII.A.2 or immediate suspension under clause VII.B, the authorized officer or, for common carrier
provisions, the Secretary of the Interior shall give the holder written notice of the grounds for revocation or
suspension and a reasonable period, not to exceed 120 days, to cure any noncompliance.
B. PREREQUISITES FOR REVOCATION AND SUSPENSION. Except for revocation at the request of
the holder under clause VII.A.2 and immediate suspension under clause VII.C, the authorized officer may
not revoke or suspend this permit unless:
Page 19 of 31

1. The authorized officer has given the holder written notice of the grounds for revocation or suspension
and a reasonable period, not to exceed 90 days, to cure any noncompliance; and
2. After an administrative appeal conducted pursuant to 7 CFR Part 1, Subpart H, as amended, or
regulations promulgated by the U.S. Department of the Interior, as applicable, the authorized officer
makes a finding that grounds for revocation or suspension exist and that revocation or suspension is
justified, provided that a formal adjudicatory proceeding is not required for revocation or suspension of
this permit if a rebuttable presumption of abandonment of this permit arises due to circumstances that are
not within the holder’s control.
C. REVOCATION FOR SPECIFIC AND COMPELLING REASONS IN THE PUBLIC INTEREST. The
authorized officer may revoke this permit during its term if the Forest Service determines based on a land
management planning decision that the use and occupancy authorized by this permit should be changed
for specific and compelling reasons in the public interest, other than a determination under clause IV.E
that the powerline facilities or the permit area cannot be safely occupied. Prior to revoking the permit
under this clause, the authorized officer shall give the holder 90 days written notice, provided that the
authorized officer may prescribe a shorter notice period if justified by the public interest. The Forest
Service shall then have the right to remove or relocate the powerline facilities, to require the holder to
remove or relocate them, or to purchase them. Removal or relocation by the Forest Service of the
powerline facilities shall be accepted by the holder in full satisfaction of all claims against the United
States under this clause. If the Forest Service requires the holder to remove or relocate the powerline
facilities or purchases them, the Forest Service shall be obligated to pay the lesser of (1) the cost of
removal or relocation of the powerline facilities or (2) the value of the powerline facilities as determined by
the Forest Service through an appraisal of their replacement cost, less an allowance for depreciation of all
types. If that amount is fixed by agreement between the authorized officer and the holder, that amount
shall be accepted by the holder in full satisfaction of all claims against the United States under this
clause. If agreement is not reached, the authorized officer shall determine the amount to be paid, which
shall be set forth in the revocation decision. A payment made pursuant to this clause is subject to the
availability of appropriations. Nothing in this permit implies that Congress will appropriate funds to cover
a deficiency in appropriations.
D. IMMEDIATE SUSPENSION. The authorized officer may immediately suspend this permit in whole or
in part when necessary to protect public health or safety or the environment. The suspension decision
shall be in writing. The holder may request an on-site review with the authorized officer’s supervisor of
the adverse conditions prompting the suspension. The authorized officer’s supervisor shall grant this
request within 48 hours. Following the on-site review, the authorized officer’s supervisor shall promptly
affirm, modify, or cancel the suspension.
E. APPEALS AND REMEDIES. Written decisions by the authorized officer relating to administration of
this permit, other than revocation or suspension decisions, are subject to administrative appeal pursuant
to 36 CFR Part 214, as amended. Revocation and suspension of this authorization by the authorized
officer are subject to administrative proceedings pursuant to 7 CFR Part 1, Subpart H, as amended.
Revocation and suspension of this authorization by the Secretary of the Interior are subject to
administrative proceedings pursuant to regulations promulgated by the U.S. Department of the Interior. A
formal adjudicatory proceeding is not required for revocation or suspension of this permit if a rebuttable
presumption of abandonment of this permit arises due to circumstances that are not within the holder’s
control. Revocation or suspension of this permit shall not give rise to any claim for damages by the
holder against the Forest Service or the Secretary of the Interior.
F. TERMINATION. This permit shall terminate when by its terms a fixed or agreed upon condition,
event, or time occurs without any action by the authorized officer. For example, this permit terminates
upon expiration or upon the written agreement of the Forest Service and the holder. Termination of this
permit shall not require notice, a decision document, or any environmental analysis or other
documentation. Termination of this permit is not subject to administrative appeal and shall not give rise to

Page 20 of 31

any claim for damages by the holder against the Forest Service. This permit shall terminate upon the
written agreement of the Forest Service and the holder.

G. RIGHTS AND RESPONSIBILITIES UPON REVOCATION OR TERMINATION WITHOUT
ISSUANCE OF A NEW PERMIT. Upon revocation of this permit or termination of this permit without
issuance of a new permit, the holder shall remove all structures and improvements in the permit area,
except those owned by the United States, within a reasonable period prescribed by the authorized officer
and shall restore the permit area to the satisfaction of the authorized officer. Before removing the pipeline
facilities, the holder shall submit to the authorized officer a proposed rehabilitation plan, and the
rehabilitation plan must be approved in writing by the authorized officer. If the holder fails to remove all
structures or improvements in the permit area within the prescribed period, they shall become the
property of the United States and may be sold, destroyed, or otherwise disposed of without any liability to
the United States. The holder shall remain liable for all costs associated with their removal, including
costs of sale and impoundment, cleanup, and restoration of the permit area. The holder is obligated to
satisfy requirements

H. RIGHTS AND RESPONSIBILITIES UPON REVOCATION OR TERMINATION WITHOUT
ISSUANCE OF A NEW PERMIT. Upon revocation or termination of this permit without issuance of a new
permit, the holder shall remove within a reasonable period prescribed by the authorized officer all the
pipeline facilities and shall restore the permit area to the satisfaction of the authorized officer. Before
removing the pipeline facilities, the holder shall submit to the authorized officer a proposed rehabilitation
plan, and the rehabilitation plan must be approved in writing by the authorized officer.
I. CONTINUATION OF OBLIGATIONS AND LIABILITIES BEYOND TERMINATION OR
REVOCATION. Notwithstanding the termination or revocation of this permit, its terms shall remain in
effect and shall be binding on the holder and the holder’s personal representative, successors, and
assignees until all the holder’s obligations and liabilities accruing before or as a result of termination or
revocation of this permit have been satisfied.

J. TERMINATION FOR THE DEVELOPMENT OF HYDROELECTRIC POWER OR RECLAMATION
PURPOSES. Any lands covered by this permit which have been withdrawn for hydroelectric power under
the act of March 3, 1879, or the act of June 25, 1910, or are covered by an application or license
governed by the Federal Power Act of June 10, 1920, are subject at any time to use for the development
of hydroelectric power. Any lands covered by this permit which have been withdrawn under the
Reclamation Act of June 17, 1902, are subject at any time to use for reclamation purposes. This permit is
issued with the specific understanding that (1) the use and occupancy authorized by this permit shall not
interfere with such development of hydroelectric power or reclamation and that (2) this permit shall
terminate after 90 days written notice when, in the judgment of the Federal Power Commission, the lands
in question are needed for the development of hydroelectric power or, in the judgment of the Bureau of
Reclamation, the lands in question are needed for reclamation purposes. The holder shall have 90 days
to remove the pipeline facilities. [Termination under this clause shall not give rise to any claim by the
holder against the Federal Power Commission, the Bureau of Reclamation, the Forest Service, or

Page 21 of 31

hydroelectric power licensees for damages, including lost profits and damage to improvements, due to
such development of hydroelectric power or reclamation.]
VIII. MISCELLANEOUS PROVISIONS
A. MEMBERS OF CONGRESS. No member of or delegate to Congress or resident commissioner shall
benefit from this permit either directly or indirectly, except to the extent the authorized use provides a
general benefit to a corporation.
B. CURRENT ADDRESSES. The holder and the Forest Service shall keep each other informed of
current mailing addresses, including those necessary for billing and payment of land use fees.
C. SUPERSEDED AUTHORIZATION. This permit supersedes a special use authorization designated
#PREV_REISSUE_HOLDER#, #PREV_AUTH_ID#, dated #PREV_REIS_ISSUE_DATE#.
D. MERGER CLAUSE. This permit, and any appendices incorporated into this permit by reference,
constitute the complete understanding of the parties to this permit as to the rights, duties and obligations
of each party as of the date of issuance of this permit. If there are any inconsistencies between any of
the preceding printed clauses and any of the subsequent clauses or any appendices to this permit, the
preceding printed clauses shall govern.
THIS PERMIT IS ACCEPTED SUBJECT TO ALL ITS TERMS.
BEFORE THIS PERMIT IS ISSUED TO AN ENTITY, DOCUMENTATION MUST BE PROVIDED TO
THE AUTHORIZED OFFICER OF THE AUTHORITY OF THE SIGNATORY FOR THE ENTITY TO BIND
IT TO THE TERMS OF THIS PERMIT.
ACCEPTED:
___________________________________________________________________________________
[NAME AND TITLE OF PERSON SIGNING ON BEHALF OF HOLDER,
DATE
IF HOLDER IS AN ENTITY]
#HOLDER_NAME#
APPROVED:
___________________________________________________________________________________
#AUTHORIZED OFFICER NAME#
DATE
#TITLE#
National Forest
USDA Forest Service

Page 22 of 31

PAPERWORK REDUCTION ACT STATEMENT
According to the Paperwork Reduction Act of 1995, a Federal agency may not conduct or sponsor, and a person is not required to
respond to, an information collection request unless it displays a valid Office of Management and Budget (OMB) control number.
The valid OMB control number for this information collection request is 0596-0082. Response to this information collection request
is required to obtain or retain benefits, specifically, a special use authorization. The authority for this information collection request is
Section 28 of the Mineral Leasing Act of 1920, as amended, 30 U.S.C. 185. The time required to complete this information
collection request is estimated to average 2 hours per response, including the time for reviewing instructions, searching existing
data sources, collecting and maintaining the data needed, and completing and reviewing the information collection request. Send
comments regarding this burden estimate or any other aspect of this information collection request, including suggestions for
reducing the burden, to Forest Service Information Collections Officer, SM.FS.InfoCollect@usda.gov, with OMB control number
0596-0082 in the subject line.
PRIVACY ACT STATEMENT
Pursuant to 5 U.S.C. § 552a(e)(3), this Privacy Act statement serves to inform you of the following concerning the collection of the
information on this form.
Purpose: The Privacy Act of 1974 requires that the Director of Recreation, Heritage, and Volunteer Resources staff and the
Director of Lands, Minerals, and Geology Management staff provide the following statements to individuals from whom they request
information.
Authority: Collection of this information solicited on this form is authorized by Section 28 of the Mineral Leasing Act of 1920, as
amended, 30 U.S.C. 185.
Routine Uses: The information collected will be used by Forest Service officials to ensure that your use of National Forest System
lands is administered in accordance with applicable statutes, regulations, and directives. The information collected from you is
retained in the Special Uses Data System (SUDS) and is retrieved by the Forest Service create reports for the Agency’s Special
Uses Program, generate bills for collection of land use fees for your authorization, monitor compliance with your special use
authorization, and other matters pertaining to administration of your special use authorization. SUDS is a component of the Forest
Service’s Natural Resources Manager database (NRM). A complete list of the routine uses of NRM can be found in the system of
records notice associated with this form, FS-24.
Disclosure: The submission of this information is required to obtain or retain benefits, specifically, a special use authorization.
NONDISCRIMINATION STATEMENT
In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the
USDA, its agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from
discriminating based on race, color, national origin, religion, sex, disability, age, marital status, family/parental status, income
derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or
activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by
program or incident.
Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print,
audiotape, American Sign Language, etc.) should contact the the State or local Agency that administers the program or contact
USDA through the Telecommunications Relay Service at 711 (voice and TTY). Additionally, program information may be made
available in languages other than English.
To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at
How to File a Program Discrimination Complaint and at any USDA office or write a letter addressed to USDA and provide in the
letter all the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit the completed
form or letter to USDA by (1) mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400
Independence Avenue, SW, Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: program.intake@usda.gov.
USDA is an equal opportunity provider, employer, and lender.

Page 23 of 31

APPENDIX A
DEFINITIONS
The following definitions apply to this permit and all its appendices.
A. Oil or Gas Pipeline Infrastructure
1. Abandonment
(a) Authorized Abandonment. When a pipeline facility is permanently taken out of service in compliance
with 49 CFR 192.727 and is either removed or left in place as determined by the authorized officer.
(b) Unauthorized Abandonment. Failure of the grantee to use the right-of-way authorized by this
easement without meeting the criteria for authorized abandonment.
2. Certificate of Public Convenience and Necessity. A certificate issued by FERC that allows the
recipient to engage in the transportation and sale for resale of natural gas in interstate commerce or to
acquire and operate facilities needed for that purpose.
3. Compressor Station. A facility that is used to compress natural gas to increase the amount of natural
gas a pipeline can hold, help move natural gas through a pipeline, or transport natural gas to or from a
storage facility.
4. Deactivation. When a pipeline facility is taken out of service in accordance with 49 CFR 192.727 and
is left in place for future use.
5. Distribution Line. A small oil or gas pipeline that represents the final link in the production chain by
transporting oil or gas from the final transportation point to end users.
6. Lease Area. The extraction or production area for oil or gas that is authorized on National Forest
System lands under a lease issued by the Bureau of Land Management.
7. Linear Right-of-Way. An authorized right-of-way for a linear facility such as a road, trail, pipeline,
powerline facility, fence, water transmission facility, or fiber optic cable, whose linear boundary is
delineated by its legal description.
8. FERC Pipeline. An interstate natural gas pipeline operated by a private entity that requires a
certificate of public convenience and necessity issued by FERC.
9. Gathering Line. An oil or gas pipeline that is generally small in diameter, is located within a lease
area, and is used to transport oil or gas from a well or other production facility to a processing facility or a
transmission pipeline.
10. Pipeline Facility. An oil or gas pipeline authorized by a special use authorization, and any ancillary
facilities supporting that pipeline, including but not limited to access roads and trails, valves, pump
stations, supporting structures, bridges, monitoring devices, powerline facilities, fiber optic cable, surge
and storage tanks, terminals, and communications equipment that is owned by the holder; that solely
supports operation and maintenance of the oil or gas pipeline; and that is not leased to other parties for
communications uses that serve other purposes.
11. Pump Station. A large, industrial facility that maintains the flow and pressure of oil by receiving it
from a pipeline, repressurizing the oil, and sending it back into the pipeline.

Page 24 of 31

12. Transmission Pipeline. A larger-diameter oil or gas pipeline, other than a gathering line, that is used
in the delivery of oil or gas from a gathering pipeline or storage facility to a distribution center, storage
facility, or large-volume customer.
B. Roads and Trails
1. Access Road or Trail. For purposes of this permit, a road or trail constructed, operated, and
maintained by the holder that is necessary to access a pipeline facility or its linear right-of-way.
2. Road or Trail Construction. Building a road or trail where no road or trail has previously existed.
3. Road or Trail Reconstruction. Rebuilding an existing road or trail to increase its capacity, upgrade
drainage crossings, or provide improved access, which may involve increasing the road or trail prism.
4. Road or Trail Maintenance. The upkeep of an entire road or trail within the existing road or trail prism,
including surface and shoulders, parking and side areas, structures, and traffic control devices, that is
necessary to maintain or restore the road or trail in accordance with its original design standards.

Page 25 of 31

APPENDIX B
MAPS, LEGAL DESCRIPTIONS, SURVEYS, PLATS, SITE PLANS, AND
ENGINEERING DRAWINGS OF THE PERMIT AREA

Page 26 of 31

APPENDIX C
LIST AND LOCATION OF ACCESS ROADS AND TRAILS AND
NATIONAL FOREST SYSTEM ROADS AND NATIONAL FOREST SYSTEM TRAILS
USED BY THE HOLDER

Page 27 of 31

APPENDIX D
OPERATING PLAN

Page 28 of 31

APPENDIX E
LIST AND LOCATION OF PIPELINE FACILITIES OTHER THAN ACCESS ROADS AND TRAILS

Page 29 of 31

APPENDIX F
INITIAL AND FOLLOW-UP ENVIRONMENTAL SITE ASSESSMENTS

Page 30 of 31

APPENDIX G
BONDING

Page 31 of 31