11. Surface impact

Enter the following surface impact information:

The AER water body setback requirements have been met
Required

Select Yes to show that the well will meet the water body setback requirements (Directive 056, Section 7.10.12.1), or that there is no water body within 100 m of the well centre.

Select No to show that due to exceptional circumstances, the requirements have not been met. You must include the following Water Body Protection attachment.

If the proposed well is a Category E well and is located within 100 m of a water body, you must also include this attachment.

Required Attachment	Description	Type
Water Body Protection	If the well centre is less than 100m from a water body, submit an explanation that outlines acceptable methods to prevent pollution of the water, addressing both the drilling and future production operations and considering the consequences of a spill	.doc, .jpg, .pdf

1a.

All other AER setback requirements have been met
Required

Select Yes to show that the proposed well will meet all applicable surface improvement setback requirements outlined in Directive 056, Sections 7.10.12.2 to 7.10.12.5.

Select No if

due to exceptional circumstances, all applicable requirements as cited above have not been met, or
the surface improvement is not a pipeline/utility right-of-way, a gas co-op right-of-way, or a private access, or
you are not able to acquire the consent of the surface improvement owner.

You must include the following Other Setbacks attachment.

If the proposed well is a Category E well and is located within 100 m of a surface improvement, you must also include this attachment:

Required Attachment	Description	Type
Other Setbacks	If the well centre is located less than 100 m from a surface improvement, documentation confirming that consent from the surface improvement owner was received prior to application or an explanation of why you are not able to acquire consent	.doc, .jpg, .pdf

The proposed well site and/or access road will meet AER environmental requirements
Required

Select Yes to show that the proposed well site or access road will meet all applicable environmental requirements stated in Directive 056, Section 7.9.13.

Select No if the well will be located within the Eastern Slopes Area defined by IL93-09, or if due to exceptional circumstances, all applicable requirements as cited above have not been met. You must attach:

Required Attachment	Description	Type
Environmental Requirements Exemption	If you cannot meet the environmental requirements, submit a detailed explanation outlining why you cannot meet the requirements and the alternative mitigative measures proposed to protect the environment	.doc, .jpg, .pdf

For Category E wells, you must attach:

Required Attachment	Description	Type
Environmental Requirements	If mitigation measures are necessary to protect the environment, you must submit documentation outlining the steps that will be taken to ensure the protection of the environment and that all AER requirements are met	.doc

The proposed well site requires Historical Resources Act clearance
(Freehold land only)

Select Yes to show that proposed well site requires clearance by Alberta Community Development (ACD), in accordance with the Historical Resources Act.

Select No to show that the proposed well site does not require clearance by ACD.

3a.

If Yes, Alberta Community Development has granted clearance for the well site
(Freehold land only)

Select Yes to show that Alberta Community Development has granted clearance for the proposed well site.

Select No if the clearance has not been granted. You must attach:

Required Attachment	Description	Type
ACD Explanation	Explanation of why ACD has not provided clearance	.doc, .jpg, .pdf

For both Yes and No answers for Category E wells, you must attach:

Required Attachment	Description	Type
ACD Clearance	Documentation granting clearance from ACD	.doc, .jpg, .pdf