Address Location Form for Underground Mining Information · Starter Portal

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Address Location Form for Underground Mining Information

THIS IS AN INFORMAL REQUEST FOR INFORMATION AND NOT A REQUEST FOR INFORMATION UNDER THE RIGHT TO KNOW LAW. USE THE FOLLOWING E-MAIL ADDRESS TO REQUEST INFORMATION FROM DEP UNDER THE RIGHT TO KNOW LAW: EP-DEP-RTK@pa.gov If you have problems with this form, please call 888-357-2674 or email questions to ra-epmsi@pa.gov

First Name

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MI

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Last Name

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Email

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Confirm Email

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Address

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City

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State

Zip Code

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Municipality

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County

Daytime Phone Type

Daytime Phone Number (XXX-XXX-XXXX)

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Nearest Street Intersection

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Rural Route Address

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Additional Comments

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