FS-2700-31a Oil or Gas Pipeline Facility Easement

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

FS-2700-31a (XX/202X)
OMB No. 0596-0082

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

This oil or gas pipeline facility easement (the easement), dated #DATE#, is granted by the United States,
acting through the United States Department of Agriculture, Forest Service (hereinafter “the grantor”), to
#GRANTEE_NAME# of #GRANTEE_ADD_LINE_1#, #GRANTEE_ADD_LINE_2#,
#GRANTEE_ADD_LINE_3#, #GRANTEE_CITY#, #GRANTEE_STATE# #GRANTEE_ZIP# (hereinafter
“the grantee”).

This easement 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 grantor, in consideration of an annual land use fee paid by the grantee, grants to the grantee, subject
to existing easements and other valid existing rights, a non-exclusive linear right-of-way for one or more
oil or gas pipeline facilities. The linear right-of-way and access roads and trails for each oil or gas
pipeline facility authorized by this easement shall be referred to collectively as “the easement area.” A
legal description and a map of the easement area for each oil or gas pipeline facility authorized by this
easement are contained in Appendix B, and the access roads and trails for each oil or gas pipeline facility
authorized by this easement are listed and identified on the map in Appendix C. The oil or gas pipeline
facility or facilities authorized by this easement shall be referred to collectively as “the pipeline facilities.”
The grantor further grants to the grantee:
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 the access
roads and trails, in accordance with the following provisions:

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(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
have written approval from the authorized officer before they are implemented. The authorized officer
may require the grantee to furnish as-built drawings, maps, or surveys upon completion of the work.
(b) The grantor does not have an obligation to maintain the 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 grantee shall continue to have access to that right-of-way to operate and maintain the pipeline
facilities and to address concerns of public safety in connection with the pipeline facilities.
2. The right to install, maintain, and use gates and fences in the easement 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 easement:
APPENDIX A: Definitions
APPENDIX B: Maps, Legal Description, Surveys, Plats, Site Plans, and Engineering Drawings of the
Easement Area
APPENDIX C: List and Location of Access Roads and Trails and National Forest System Roads and
National Forest System Trails Used by the Grantee
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 easement is issued pursuant to the Mineral Leasing Act 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 pursuant to Forest
Service Manual 2700.

C. TERM. This easement shall expire at midnight on #EXPIRATION_DATE#. Expiration of this
easement 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 easement for the pipeline
facilities must be submitted at least 6 months before expiration of this easement. Prior to issuing a new
easement for the pipeline facilities, the authorized officer shall require that the grantee submit all plans,
contracts and other agreements, and other information or material deemed necessary by the authorized
officer to determine whether a new easement shall be issued and the terms that should be included in the
new easement. 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

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shipment or purchase tenders. Upon expiration of this easement, the authorized officer shall issue a new
easement for the pipeline facilities, provided that (1) the grantee desires to renew the use and occupancy;
(2) the use and occupancy are consistent with the direction in the applicable land management plan and
applicable laws and regulations; (3) the pipeline facilities are still being used for the purposes previously
authorized; and (4) the grantee is in compliance with all the terms of this easement. The authorized
officer may prescribe new terms when a new easement is granted.
E. AMENDMENT. The terms of this easement may be amended by the grantor every 10 years from the
date of issuance of this easement 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
easement made by the grantor must be in writing and must be signed and dated by the grantor. This
easement also may be amended at any time by written agreement of the grantor and the grantee.
Amendments to this easement made by the grantor and the grantee must be in writing and must be
signed and dated by the grantor and the grantee.
F. COMPLIANCE WITH LAWS, REGULATIONS, AND OTHER LEGAL REQUIREMENTS. In
exercising the rights and privileges granted by this easement, the grantee 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 easement area, to the extent they do not
conflict with federal law, regulation, or policy. The grantor 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 grantee are reserved to
the grantor, including:
1. The right of access to the easement area, including a continuing right of physical entry to the
easement 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 easement
area other than the pipeline facilities, including the right to use roads and trails and authorize rights-of-way
and other uses in the easement area in any way that is not inconsistent with the grantee’s rights and
privileges under this easement, after consultation with all parties involved. Except for any restrictions that
the grantee and the grantor agree are necessary to protect public health and safety, property, and the
installation and operation of the pipeline facilities, the easement area shall remain open to the public for
all lawful purposes.
H. ASSIGNABILITY. This easement is fully assignable, subject to the following conditions:
1. The grantee must be in compliance with all the terms of this easement.
2. Assignments must have prior written approval of the authorized officer.
3. The authorized officer may modify the terms of this easement and the assignee must agree in writing
to comply with the terms of the easement as modified.
4. Upon change in ownership of the pipeline facilities or change in control of the business entity that
holds this easement, this easement may be assigned to the new owner or to the party acquiring control,
provided that the conditions in clause I.H.1 through I.H.3 are met. Any transfer of title to the pipeline
facilities without an approved assignment of this easement shall result in termination of this easement.
(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.

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(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 authorize 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.

I. PARTNERSHIP STATUS NOTIFICATION. The holder shall notify the authorized officer within fifteen
(15) days of the following changes:
1. Names of the individuals involved.
2. Partnership makeup changes due to the death, withdrawal, or addition of a partner.
3. Party or parties assigned financed interest in the partnership by existing partner(s).
4. Termination, reformation, or revision of the partnership agreement.
5. The acquisition of partnership interest, either through purchase of an interest from an
existing partner or partners, or contribution of assets, that exceeds 50 percent of the
partnership permanent investment.
OR
I. CORPORATION STATUS NOTIFICATION. The holder may furnish the authorized officer with the
names and addresses of shareholders owning 3 percent or more of the shares, and number and
percentage of any class of voting shares of the entity which such shareholder is authorized to vote. In
addition, the holder shall notify the authorized officer within 15 days of the following changes:
1. Names of officers appointed or terminated.
2. Names of stockholders who acquire stock shares causing their ownership to exceed 50 percent of
shares issued or who otherwise acquire controlling interest in the corporation.
3. A copy of the articles of incorporation and bylaws.
4. An authenticated copy of a resolution of the board of directors specifically authorizing a certain
individual or individuals to represent the holder in dealing with the Forest Service.
5. A list of officers and directors of the corporation and their addresses.
6. Upon request, a certified list of stockholders and amount of stock owned by each.
7. The authorized officer may, when necessary, require the holder to furnish additional information as set
forth in 36 CFR 251.54(d)(2)(ii)(D).
II. IMPROVEMENTS
A. LIMITATIONS ON USE. Nothing in this easement gives or implies permission to build or maintain
any structure or facility or to conduct any activity unless specifically provided by this easement. Any use
not specifically authorized by this easement must be proposed in accordance with 36 CFR 251.54 or

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251.61. Approval of such a proposed use through issuance of a new easement or easement 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 easement 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 grantee to furnish as-built
drawings, maps, or surveys upon completion of the work.

C. CONSTRUCTION OR RECONSTRUCTION. Any construction or reconstruction authorized by this
easement 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 easement 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 easement is [number] feet.
E. RELOCATION. This easement is granted 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 grantee within a reasonable period specified by
the authorized officer.
III. OPERATIONS
A. PERIOD OF USE. Use and occupancy of the easement area shall be exercised at least 240 days
each year.
B. CONDITION OF OPERATIONS. The grantee shall maintain the pipeline facilities and easement area
to standards of repair, orderliness, neatness, sanitation, and safety acceptable to the authorized officer
and consistent with other provisions of this easement. 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
grantee’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 grantee 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
easement. The operating plan shall outline steps the grantee will take to protect public health and safety

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and the environment and shall include sufficient detail and standards to enable the Forest Service to
monitor the grantee’s operations for compliance with the terms of this easement. The operating plan shall
be submitted by the grantee 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 easement
as Appendix D. At least every 10 years from the approval date of the operating plan in Appendix D, the
grantee 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 grantee for
review and approval by the authorized officer. Proposed updates that are deemed non-significant by the
authorized officer may be made by written agreement of the grantee and the authorized officer.
E. RESERVATION OF EXCESS FIBER OPTIC CABLE CAPACITY AND LEASING
1. Reservation of Excess Capacity. The grantee may reserve fiber optic cable for the grantee’s
expansion and may utilize the reserved fiber optic cable during the term of this easement without
additional approval from the authorized officer. Leasing of fiber optic cable by third parties is not
authorized by this easement, except as provided in clause III.E.2.
2. Leasing of the Grantee’s Fiber Optic Cable. Leasing of the grantee’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 grantee’s requests to lease fiber optic cable. The grantee shall remain
responsible for any third party’s compliance with all the terms of this easement. The grantee 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 grantee’s fiber optic cable that includes the United States as an additional insured
under the policy. The grantee shall pay in advance a single, additional annual land use fee for leasing
fiber optic cable, regardless of the grantee’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 grantee deemed
necessary for proper administration of the leased fiber optic cable.
3. Leases Involving Communications Uses and Other Third-Party Uses Involving the 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 grantee. 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 easement 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 grantee 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 easement 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 easement area must have prior written approval from
the authorized officer.
G. GROUND SURFACE PROTECTION AND RESTORATION. The grantee shall prevent and control
soil erosion and gullying on National Forest System lands in and adjacent to the easement area resulting
from construction, operation, maintenance, and termination of the pipeline facilities. The grantee shall

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construct the pipeline facilities so as to avoid accumulation of excessive amounts of water in the
easement area and encroachment on streams. The grantee 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
grantee’s construction, maintenance, operation, or termination of the pipeline facilities.
H. MONITORING BY THE FOREST SERVICE. The Forest Service shall monitor the grantee’s
operations and reserves the right to inspect the easement area and pipeline facilities at any time for
compliance with the terms of this easement. The grantee shall comply with inspection requirements
deemed appropriate by the authorized officer. The grantee’s obligations under this easement are not
contingent upon any duty of the Forest Service to inspect the easement 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 easement.
I. PIPELINE INSPECTION REQUIREMENTS. The grantee shall perform inspections annually to ensure
compliance with safety, environmental, and resource protection requirements in this easement, 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 grantee 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.

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 grantee may not operate the pipeline facilities
until the grantee 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 grantee.

L. COMMON CARRIER OBLIGATIONS
1. The pipeline facilities shall be constructed, operated, and maintained as common carriers. The

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grantee 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 grantee is offered for sale, the grantee 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 grantee 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, the Federal Energy Regulatory Commission (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
grantee’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 easement pursuant to VII.A.
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 grantee shall give prior written notice to the authorized officer in
advance of authorized abandonment or deactivation of any of the pipeline facilities. The grantee 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 easement 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 grantee must
receive approval from FERC before authorized abandonment or deactivation of any FERC pipeline. This
easement 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. VALID EXISTING RIGHTS. This easement is subject to all valid existing rights. Valid existing rights
include those derived from mining and mineral leasing laws of the United States. The grantor is not
liable to the grantee for the exercise of any such right.

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B. ABSENCE OF THIRD-PARTY BENEFICIARY RIGHTS. The parties to this easement do not intend
to confer any rights on any third party as a beneficiary under this easement.
C. NO WARRANTY OF ACCESS, SITE SUITABILITY, OR SERVICES. This easement authorizes the
use and occupancy of National Forest System lands by the grantee for the purposes identified in this
easement. The Forest Service does not make any express or implied warranty of access to the
easement area, of the suitability of the easement 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.
D. RISK OF LOSS. The grantee assumes all risk of loss to the pipeline facilities and all risk of loss of
use and occupancy of this easement 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 this easement 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 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 easement shall terminate as to those portions of the pipeline facilities. If the authorized
officer determines that all or part of this easement area cannot be safely occupied due to a public health
or safety or environmental hazard, this easement shall terminate as to those portions of this easement
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 grantee against the Forest Service.
E. DAMAGE TO UNITED STATES PROPERTY. The grantee 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 easement. 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 grantee 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 grantee’s use and occupancy of the easement area. Compensation shall
include but is not 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.L.
2. The grantee shall be liable for damage to all roads and trails of the United States caused by use of the
grantee or the grantee’s heirs, assignees, agents, employees, contractors, or lessees to the same extent
as provided under clause IV.E.1, except that liability shall not include reasonable and ordinary wear and
tear.
F. HEALTH AND SAFETY. The grantee shall take all measures necessary to protect the health and
safety of all persons affected by the use and occupancy authorized by this easement. The grantee 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 easement that causes or threatens to cause a
hazard to the health or safety of the public or the grantee’s employees. agents, or contractors. The
grantee 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 grantor has no duty under the
terms of this easement to inspect the easement area or operations of the grantee for hazardous
conditions or compliance with health and safety standards.
G. ENVIRONMENTAL PROTECTION

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1. Compliance with Environmental Laws. The grantee shall in connection with the use and occupancy
authorized by this easement 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
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 grantee shall conduct an initial SA prior to use and
occupancy of the easement area for any new authorized oil or gas pipeline facilities and a follow-up SA
prior to termination or upon revocation of this easement. The initial and follow-up SAs shall be
incorporated into this easement as Appendix F.
(a) Purposes. The purpose of the initial and follow-up SAs is to identify Recognized Environmental
Conditions in the easement area, that is, the presence or likely presence of any hazardous substances or
petroleum products in the easement 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 grantee 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 grantee’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 grantee 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 easement will be issued to the same grantee upon expiration of this easement,
the follow-up SA shall satisfy the requirement for an initial SA for the new easement. Initial and follow-up
SAs are not required when this easement is revoked at the request of the grantee and a new easement is
granted to the grantee for the balance of this easement’s term or when this easement is reissued for the
balance of its term to the grantee 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 grantee.
(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 easement area, the grantee shall be responsible for any cleanup or
other remedial action that the Forest Service determines to be required in the easement area based on
the initial SA. The level of cleanup or other remedial action shall be commensurate with the grantee’s
intended use and occupancy of the easement area for the new authorized pipeline facilities and shall be
completed before that use and occupancy commence.

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4. Oil Discharges and Release of Hazardous Materials. The grantee 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 easement 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 grantee 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 easement 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 grantee shall remediate any release, threat of
release, or discharge of hazardous materials that occurs in connection with the grantee’s activities in the
easement area, including activities conducted by the grantee’s agents, employees, contractors, or
lessees and regardless of whether those activities are authorized under this easement. The grantee
shall perform remediation in accordance with applicable law immediately upon discovery of the release,
threat of release, or discharge of hazardous materials. The grantee 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 easement, the grantee shall deliver the site to the Forest Service in compliance with all
applicable laws and regulations and free and clear of contamination.

H. INDEMNIFICATION OF THE UNITED STATES. The grantee 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 grantee in connection with the use and occupancy authorized
by this easement. This indemnification and hold harmless provision includes but is not limited to acts
and omissions of the grantee or the grantee’s heirs, assignees, agents, employees, contractors, or
lessees in connection with the use and occupancy authorized by this easement 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 grantee to
replace, repair, restore, or otherwise undertake necessary curative actions to mitigate damages in
combination with or as an alternative to monetary indemnification.
I. STRICT LIABILITY. The grantee 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 easement. 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.

J. INSURANCE. The grantee shall furnish proof of insurance, such as a certificate of insurance, to the
authorized officer prior to issuance of this easement and each year thereafter that this easement 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 grantee 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 grantee pursuant to this clause shall include the United States as an additional insured in

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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 grantee. The grantee 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 easement.
1. The grantee shall have in force liability insurance covering losses associated with the use and
occupancy authorized by this easement 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 easement.
2. Depending on the grantee’s operations, the Forest Service may require the grantee to demonstrate
the availability of funds to address any release or threatened release of hazardous materials that may
occur in connection with the grantee’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
grantee’s operations. The use and storage of normal maintenance supplies in nominal amounts
generally would not trigger financial assurance requirements.

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

2. Self-Insurance and Procured Insurance. As part of its cost recovery, the grantee self-insures for
third-party liability for up to $#AMOUNT# million. The grantee has a commercial general liability (CGL)
insurance policy for claims above $#AMOUNT# million. The grantee shall self-insure for losses
associated with the use and occupancy authorized by this easement 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 easement.
The minimum amounts of self-insurance specified in this clause do not limit or otherwise affect in any way
the grantee’s obligation under this easement to indemnify the United States for injury, loss, or damage.
The grantee’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 grantee’s indemnification obligation under this
easement. Any insurance policies obtained by the grantee 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 grantee. 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 easement. The grantee 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
easement and each year thereafter that this easement is in effect. The grantee shall send an

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authenticated copy of its CGL insurance policy to the authorized officer before issuance of this easement.
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.

2. Self-Insurance and Procured Insurance. As part of its cost recovery, the grantee self-insures for thirdparty liability for up to $#AMOUNT# million for non-wildfire claims and up to $#AMOUNT# million for
wildfire claims. The grantee has a commercial general liability (CGL) insurance policy for non-wildfire
claims above $#AMOUNT# million and wildfire claims above $#AMOUNT# million. The grantee shall
self-insure for losses associated with the use and occupancy authorized by this easement 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 easement. The minimum amounts of self-insurance specified in this clause do not limit
or otherwise affect in any way the grantee’s obligation under this easement to indemnify the United States
for injury, loss, or damage. The grantee’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 grantee’s
indemnification obligation under this easement. Any insurance policies obtained by the grantee 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 grantee 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 easement. The grantee 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 easement and each year thereafter that this easement is in effect. The
grantee shall send an authenticated copy of its CGL insurance policy to the authorized officer before
issuance of this easement. 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 grantee shall give 30 days prior written notice to the
authorized officer of cancellation or modification of the grantee’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 grantee’s operations, the Forest Service may
require the grantee to demonstrate the availability of funds to address any release or threatened release
of hazardous materials that may occur in connection with the grantee’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 grantee’s operations. The use and storage of normal maintenance
supplies in nominal amounts generally would not trigger financial assurance requirements.
K. BONDING. The authorized officer shall require the grantee to furnish a surety bond or other security
for any of the obligations imposed by the terms of this easement or any applicable law, regulation, or
order.

1. As a further guarantee of compliance with the terms of this easement, the grantee shall deliver and
maintain a surety bond or other acceptable security, such as cash deposited and maintained in a federal

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depository or negotiable securities of the United States, in the amount of #AMOUNT# to secure the
grantee’s obligation to restore the easement area [after construction or reconstruction and] upon
abandonment or deactivation of the pipeline facilities and revocation or termination of this easement
without issuance of a new easement. The grantee 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
easement 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 grantee 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 grantee 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 grantee establishes to the
satisfaction of the authorized officer that all claims for labor and material for the secured obligations have
been paid or released.
4. The grantee 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 easement area restored.
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 easement 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 grantee shall protect the scenic values of the easement area and the
adjacent land to the greatest extent possible during construction, operation, and maintenance of the
pipeline facilities.
C. VANDALISM. The grantee shall take reasonable measures to prevent and discourage vandalism or
disorderly conduct and, when necessary, shall contact the appropriate law enforcement officer to address
these problems.
D. PESTICIDE USE
1. Authorized Officer Concurrence. Pesticides may not be used outside of buildings in the easement
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 grantee 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

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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.
3. Safety Plan. Before applying pesticides in the easement area, the grantee 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 easement; 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 grantee 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 grantee 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 easement. The grantee 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 grantee inadvertently discovers human
remains, funerary objects, sacred objects, or objects of cultural patrimony on National Forest System
lands, the grantee shall immediately cease work in the area of the discovery and shall leave the
discoveries intact and in place. The grantee 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 grantee 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, 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 easement
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 easement and may be shown on the
ground. The grantee 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 grantee or the grantor of other
sites within the easement 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.

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2. Sensitive Species and Species of Conservation Concern and Their Habitat. The location of sites
within the easement 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 easement and may be shown on the ground. The grantee
shall take any protective and mitigation measures specified by the authorized officer as necessary and
appropriate 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 grantee or the Forest Service of
other sites within the easement 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 grantee shall not store any hazardous
materials in the easement area without prior written approval from the authorized officer. This approval
shall not be unreasonably withheld. If the authorized officer provides approval, this easement shall
include or, in the case of approval provided after this easement 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 grantee and are subject to approval by the authorized officer.

1. The grantee shall identify to the authorized officer any hazardous material to be stored in the
easement area. 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 grantee 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 grantee 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 grantee as the
generator of the hazardous waste.
2. If hazardous materials are used or stored at the site, the authorized officer may require the grantee to
deliver and maintain a surety bond in accordance with clause IV.K.
3. The grantee shall not release any hazardous materials onto land or into rivers, streams,
impoundments, or into natural or artificial channels leading thereto. All prudent and safe attempts must
be made to contain any release of these materials. The authorized officer may specify conditions that
must be met, including conditions more stringent than those in applicable federal, state, and local laws
and regulations, to prevent releases and protect natural resources.
4. If the grantee uses or stores hazardous materials at the site, upon revocation or termination of this
easement the grantee shall provide the Forest Service with a report certified by a professional or
professionals acceptable to the Forest Service that the easement area is uncontaminated by the
presence of hazardous materials and that there has not been a release or discharge of hazardous
materials upon the easement area, into surface water at or near the easement area, or into groundwater
below the easement area during the term of the easement. 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 easement area is in compliance with all applicable federal, state, and local laws
and regulations.
I. FEDERAL SURVEY MONUMENTS, CORNERS, and BOUNDARY MARKERS. The grantee 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,

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the grantee 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 grantee 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 grantee 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.
VI. LAND USE FEE AND DEBT COLLECTION

A. LAND USE FEE FOR GRANTEE’S USE AND OCCUPANCY. The grantee 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 GRANTEE’S USE AND OCCUPANCY. The grantee’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 GRANTEE’S USE AND OCCUPANCY. Per 42 U.S.C. 15925, the grantee
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 easement is issued. Otherwise, the grantee 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

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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.
(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 easement shall terminate if the grantee fails to pay any land use
fee, interest, or any other charges within 90 calendar days of the due date. The grantee shall remain
responsible for the delinquent charges.
4. Administrative Offset and Credit Reporting. Delinquent land use fees and other charges associated
with this easement 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 grantee from the grantor.
(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 grantee, 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 easement in whole or in part:
(a) For noncompliance with applicable federal, state, or local laws and regulations, other than 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 easement, other than common carrier provisions in
clause III.L, which are enforced by the Secretary of the Interior.
(c) For unauthorized abandonment of this easement. Failure of the grantee to use the right-of-way for a
continuous 2-year period shall constitute a rebuttable presumption of unauthorized abandonment of this
easement. Authorized abandonment under clause III.M 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 easement at the request of the grantee. Revocation at the
request of the grantee must be agreed to in writing by the authorized officer. As a condition of revocation
of this easement at the request of the grantee, the authorized officer has discretion to impose any terms
deemed appropriate as provided for in this easement.

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B. PREREQUISITES FOR REVOCATION AND SUSPENSION. Except for revocation at the request of
the grantee under clause VII.A.2 and immediate suspension under clause VII.C, the authorized officer
may not revoke or suspend this easement unless:
1. The authorized officer has given the grantee 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 easement if a rebuttable presumption of abandonment of this easement arises due to circumstances
that are not within the grantee’s control.
C. REVOCATION FOR SPECIFIC AND COMPELLING REASONS IN THE PUBLIC INTEREST. The
authorized officer may revoke this easement during its term if the Forest Service determines based on a
land management planning decision that the use and occupancy authorized by this easement should be
changed for specific and compelling reasons in the public interest, other than a determination under
clause IV.D that the pipeline facilities or the easement area cannot be safely occupied. Prior to revoking
the easement under this clause, the authorized officer shall give the grantee 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 pipeline facilities, to require the
grantee to remove or relocate them, or to purchase them. Removal or relocation by the Forest Service of
the pipeline facilities shall be accepted by the grantee in full satisfaction of all claims against the United
States under this clause. If the Forest Service requires the grantee to remove or relocate the pipeline
facilities or purchases them, the Forest Service shall be obligated to pay the lesser of (1) the cost of
removal or relocation of the pipeline facilities or (2) the value of the pipeline 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 grantee, that amount
shall be accepted by the grantee 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 easement implies that Congress will appropriate funds to
cover a deficiency in appropriations.
D. IMMEDIATE SUSPENSION. The authorized officer may immediately suspend this authorization in
whole or in part when necessary to protect public health or safety or the environment. The suspension
decision shall be in writing. The grantee 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 authorization, 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 easement if a
rebuttable presumption of abandonment of this easement arises due to circumstances that are not within
the grantee’s control. Revocation or suspension of this easement shall not give rise to any claim for
damages by the grantee against the Forest Service or the Secretary of the Interior.
F. TERMINATION. This easement 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 easement

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terminates upon expiration or upon the written agreement of the grantor and the grantee. Termination of
this easement shall not require notice, a decision document, or any environmental analysis or other
documentation. Termination of this easement is not subject to administrative appeal and shall not give
rise to any claim for damages by the grantee against the grantor. This easement shall terminate upon the
written agreement of the grantor and the grantee.
G. RIGHTS AND RESPONSIBILITIES UPON REVOCATION OR TERMINATION WITHOUT
ISSUANCE OF A NEW EASEMENT. Upon revocation of this easement or termination of this easement
without issuance of a new easement, the grantee shall remove all structures and improvements in the
easement area, except those owned by the United States, within a reasonable period prescribed by the
authorized officer and shall restore the easement area to the satisfaction of the authorized officer.
Before removing the pipeline facilities, the grantee 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
grantee fails to remove all structures or improvements in the easement 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 grantee shall remain liable for all costs associated with
their removal, including costs of sale and impoundment, cleanup, and restoration of the easement area.
H. CONTINUATION OF OBLIGATIONS AND LIABILITIES BEYOND TERMINATION OR
REVOCATION. Notwithstanding the termination or revocation of this easement, its terms shall remain in
effect and shall be binding on the grantee and the grantee’s personal representative, successors, and
assignees until all the grantee’s obligations and liabilities accruing before or as a result of termination or
revocation of this easement have been satisfied.

I. TERMINATION FOR THE DEVELOPMENT OF HYDROELECTRIC POWER OR RECLAMATION
PURPOSES. Any lands covered by this easement 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 easement which have been withdrawn under the
Reclamation Act of June 17, 1902, are subject at any time to use for reclamation purposes. This
easement is granted with the specific understanding that (1) the use and occupancy authorized by this
easement shall not interfere with such development of hydroelectric power or reclamation and that (2) this
easement shall terminate after 90 days written notice as to any lands covered by this easement when, in
the judgment of the Federal Power Commission, those lands are needed for the development of
hydroelectric power or, in the judgment of the Bureau of Reclamation, those lands are needed for
reclamation purposes. The grantee shall have 90 days to remove or realign segments of the pipeline
facilities located on those lands. Termination under this clause shall not give rise to any claim by the
grantee against the Federal Power Commission, the Bureau of Reclamation, the Forest Service, or
hydroelectric power licensees for damages, including lost profits and damage to the pipeline facilities, 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 easement either directly or indirectly, except to the extent the authorized use and
occupancy provides a general benefit to a corporation.
B. CURRENT ADDRESSES. The grantor and the grantee shall keep each other informed of current
mailing addresses, including those necessary for payment of land use fees.

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C. SUPERSEDED AUTHORIZATION. This easement supersedes an authorization designated [name
or authorization ID], dated #DATE#.

D. MERGER CLAUSE. This easement, and any appendices incorporated into this easement by

reference, constitute the complete understanding of the parties to this easement as to the rights, duties
and obligations of each party as of the date of issuance of this easement. If there are any inconsistencies
between any of the preceding printed clauses and any of the subsequent clauses or any appendices to
this easement, the preceding printed clauses shall govern.

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THIS EASEMENT IS GRANTED SUBJECT TO ALL ITS TERMS.
BEFORE THIS EASEMENT IS GRANTED 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 EASEMENT.
On #DATE#, I, the grantee, have read, understood, and accepted the terms of this easement.
____________________________________________________________________________________
[NAME AND TITLE OF PERSON SIGNING ON BEHALF OF GRANTEE,
DATE
IF GRANTEE IS AN ENTITY]
#GRANTEE_NAME#
STATE OF [
]
[
] COUNTY
On #DATE#, before me, a notary public in the State of [
], personally appeared [name and title
of person signing on behalf of grantee, if grantee is an entity], known to me to be the person who signed
this easement on behalf of the grantee.
On #DATE#, the United States, through the United States Department of Agriculture, Forest Service, has
executed this easement pursuant to delegations of authority in 7 CFR 2.60(a)(2), 36 CFR 251.52, and
FSM.2733.04a and 2733.04b, paragraph 1.
____________________________________________________________________________________
UNITED STATES OF AMERICA
DATE
#AUTHORIZED OFFICER NAME#
#TITLE#
__________________National Forest
USDA Forest Service
STATE OF [
]
[
] COUNTY
On #DATE#, before me, a notary public in the State of [
], personally appeared
#AUTHORIZED OFFICER NAME#, #TITLE#, known to me to be the person who signed this easement on
behalf of the grantor.
____________________________________________________________________________________
Notary Public for the State of [
]
My commission expires [
]

PAPERWORK REDUCTION ACT STATEMENT

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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 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.

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APPENDIX A
DEFINITIONS
The following definitions apply to this easement 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 grantee; 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.

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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 easement, a road or trail constructed, operated, and
maintained by the grantee 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.

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APPENDIX B
MAPS AND LEGAL DESCRIPTION, SURVEYS, PLATS, SITE PLANS, AND
ENGINEERING DRAWINGS OF THE EASEMENT AREA

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

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APPENDIX D
OPERATING PLAN

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

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APPENDIX F
INITIAL AND FOLLOW-UP ENVIRONMENTAL SITE ASSESSMENTS

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APPENDIX G
BONDING

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