HomeMy WebLinkAboutApplicationGARFIELD COUNTY
Building and Planning Department
108 8 th Street, Suite 401
Glenwood Springs, Colorado 81601
Telephone: (970) 945 -8212 Facsimile: (970) 384 -3470
www.garfield- county.com
Small Temporary Employee Housing
Administrative Checklist
GENERAL INFORMATION — Submit 1 paper 81 CD copy of the completed application to Planning Department wJin O hours following
occupation
(To be completed by the Small Facility Operator — e.g. well pad operator)
Sectionrrownship/Range Location of Housing Site: Sec 23 — T6S — R94W Well Pad Number: RWF 33 -2
Tax Parcel Number for Parcel Containing Housing Site: 2175- 23400 -029
GPS and/or Lat -Long Coordinates of Housing Facility Site (Often
included in APD): Lat: 39.507441168 Long: - 107.854348233
Maximum Number of Occupants at
Zone District: Rural
Permitted Site (e.g. well pad): less than 8
Cumulative Amount of Time (in Days) The Facility Will be
at Location: 32 days
State or Federal Pennitting Agency Overseeing Reclamation, Restoration
and Revegetation and Relevant Permit Number: 0504518252000
Date of Installation: 2118113 1 Date of Removal: 7130113
Name of Landowner: Youberg Beaver Creek Ranch
Street Address: 215 S 1 oth Street
Telephone:
Email:
712 662 -4212
City: Sac City
State: IA
Zip Code: 50583-
2137
Name of Operator's Compliance Officer: 'WPX Energy Rocky Mountain, LLC Bryan S. Hotard
Street Address: PO Box 370
Telephone: 970- 285.9377 ext
Email:
2754
Bryan. Hotard(ftPxe
nergy.com
City: Parachute
State: CO
Zip Code: 81635
Company 24 -Hour Emergency Contact: WPX Energy Rocky Mountain, LLC Phone Number: 970 - 285 -9377
7TnAdminisbafire Chedlist must bereceived by the Garfield County Planning Depait tent within 48
hours following occupancy of the Small Facility.
A copy of this completed Administrative Checklist and all associated submittals shall delivered to
w
the Garfield County Sheriffs Office and relevant Fire Protection District (if within 48 hours
applicable) Office and
following occupancy of the Small Facility. Additionally, the Garfield County Sherifi'sreceipt) or verired is
relevant Fire Protection District (if applicable) must be notified in writing (return the Operator's
email (return receipt) within 48 hours following removal of the Small Facility. It been received by
responsibility to confirm and obtain verification that the Administrative Checklist has
Fire Suppression Requirements (Per Performance Standard L)
'A water storage tank is required to provide water to the sprinkler system (if applicable) and initial
suppression activities. The size of the water tank shall be determined based on sprinkler
calculations and initial suppression demands. The relevant fire protection district shall be
responsible for determining the size of the water storage tank. If the Small Facility is not within a fire
protection district, the Operator shall provide at least 2500 gallons of water dedicated to initial fire
suppression which is accessible with a dry hydrant."
Required Size of water storage tank for sprinkler system and initial suppression
activities: 500 BBI_I 21,00Qgallons
A. Outline of Process. The Small Temporary Housing Facility(ies) Review process shall
consist of the following procedures as more fully outlined in Section 4 -109 of Article IV of the
Unified Land Use Resolution of 2008.
I. Application to relevant protection districts and the Garfield County Sheriff's Office.
2. Application to the County
B. Review Process. Prior to submittal of any forms to the Planning Department, the applicant
shall submit all documents to the relevant fire protection district(s) and the Garfield County
Sheriff's Office. All forms shall be accurately completed, signed, dated and submitted to the
Garfield County Planning Department within 48 hours following occupation of the Small
Facility.
C. Submittal Requirements. The application submitted to the County shall contain the following
information:
i. A vicinity map indicating the section, township, and range of the subject lot and the location
of Small Facility within the subject lot and the Permitted Site; general relation to surrounding
public roads, private roads, adjacent utility systems, residential development, other actively
permitted Small, Minor and Major Facilities, natural drainage courses and municipalities within
one (1) mile of the proposed Small Facility; north arrow and scale; GPS coordinates and current
surface ownership of the subject lot. The vicinity map shall be presented on a USGS 7.5
minute series quadrangle at a scale of 1" =2000' or equivalent, with a topography depicted at a
minimum of 40' intervals.
ii. Surveyed layout of the proposed Small Facility within the surveyed boundaries of the
Permitted Site, including at a minimum: sewage and wastewater disposal, trash receptacles,
potable water storage, all other associated infrastructure and all other equipment located within the
Permitted Site. (See Section 4 -502 (C )(3) for site plan definition)
iii. Identification of the private and public roadways accessing each Small Facility.
Roadways shall be marked as open, gated, and/or locked (include combinations). Detailed
directions, with mileage, shall be given from the nearest town within Garfield County, nearest Garfield
County Sheriff's Office dispatch location and responsible fire district headquarters to each Small
Facility, along each roadway.
iv. Name, address and phone number of surface owner of the subject lot.
v. Name, address and phone number, including a 24 -hour emergency response
number of at least two persons responsible for Operator's emergency field operations;
contact numbers for local hospitals, emergency response, fire protection
2
districts, Garfield County Sheriffs Office, Life /Care Flight, and applicable regulatory
agencies; site safety /evacuation plan; and any other written response plan for
potential emergencies at the Permitted Site.
vi. Identification of the anticipated dates of installation and removal of the Small Facility.
The site plan shall include a notation of the total cumulative length of time (number of
days) that the Small Facility will be installed at the Permitted Site.
ELIGIBILITY
Requirement (Section 7 -808 (D)(3) -- Requirements
Applicant
Planning
Planning
< Department
Must be Satisfied to be Eligible as a Small Facility
Complies /N
Complies /N
The Small Facility and any associated infrastructure must
be completely contained within a state or federally
permitted parcel (such as a Colorado Oil and Gas
Conservation Commission (COGCC) approved oil /gas
YES
well pad) in which reclamation and revegetation are
secured with the permitting agency (Permitted Site); and,
The Small Facility is located at the Permitted Site for less
than a cumulative of one (1) year and at the end of the
utilization period, all structures, foundations and
YES
associated infrastructure are completely removed; and,
The Small Facility shall have an occupancy of eight (8) or
fewer people within a Permitted Site (e.g. well pad) who
are employees, contractors or sub - contractors of the
operator of the small facility and are needed for onsite
safety of the related commercial, industrial, extraction or
highway operation.
YES
Temporary employee housing facilities that do not have
the three characteristics listed above, or consist wholly or
in part of Recreational Vehicles as defined above, are
subject to the administrative permit requirements or the
Major Impact Permit process, standards and
requirements contained in this document.
Building Information (Per Unit)
Unit 1
Make: ATCO Structures (USA) Inc
Serial Number or Unit ID Number:
354074502
Manufacture Year: 2007
Size of Unit (Square Feet):
14X56
Unit 2
Make: ATCO Structures (USA) Inc
Serial Number or Unit ID Number:
354062966
Manufacture Year: 2007
Size of Unit (Square Feet):
14X56
Unit 3
Make:
Serial Number or Unit ID Number:
Manufacture Year:
Size of Unit (Square Feet):
Unit 4
Make:
Serial Number or Unit ID Number:
Manufacture Year:
Size of Unit (Square Feet):
Unit 5
Make:
Serial Number or Unit ID Number:
Manufacture Year:
Size of Unit (Square Feet):
ISDS Permit
ISDS Permit Number SEPT -2 -13 -2750
Signature of Operator's Compliance
Officer:
_
(By signing this form, 1 verify that all inform6tion provided in
the hest of my knowledge)
Print a e: Bryan S. Hotard
Title: Attorney -In -Fact
this checklist is correct and accurate to
Eligibil► "ty, Submittal and Performance Standards Certification
Section 7- 808(D)(3) - Small Temporary Employee Housing Facilities (Small Facility(ies))
in Article VII -- Standards, requires the that the following performance standards be met
with each facility:
Small Facilities, in the nature of Factory Built Nonresidential Structures [as defined under
C.R.S. 24- 32- 3302(a)] but NOT recreational vehicles [as defined under C.R.S. 42 -1 -102
(61), including truck, truck tractor, motor home or camper trailer], may be utilized for
housing of workers on projects related to commercial, industrial, mineral extraction or
highway operations, pursuant to the standards for Small Facilities contained in sub-
section (2), below. Such facilities are not subject to Garfield County building and fire
codes (building code, fire code). However, Small Facilities are subject to all pertinent
state (i.e. electrical permits), federal permits and relevant fire protection district(s) code
requirements.
Small Facilities shall have all of the following basic characteristics:
A. The Small Facility and any associated infrastructure must be completely contained
within a state or federally permitted parcel (such as a Colorado Oil and Gas
Conservation Commission (COGCC) approved oil /gas well pad) in which reclamation
and revegetation are secured with the permitting agency (Permitted Site); and,
B. The Small Facility is located at the Permitted Site for less than a cumulative of one
(1) year and at the end of the utilization period, all structures, foundations and
associated infrastructure are completely removed; and,
C. The Small Facility shall have an occupancy of eight (8) or fewer people who are
employees, contractors or sub- contractors of the operator of the small facility and are
needed for onsite safety of the related commercial, industrial, extraction or highway
operation.
Temporary employee housing facilities that do not have the three characteristics listed
above, or consist wholly or in part of Recreational Vehicles as defined above, are subject
to the administrative permit requirements or the Major Impact permit process, standards
and requirements contained in this document.
The Small Facility shall adhere to the following Standards: All required submittals (as
outlined in (2), above) shall be submitted to the Planning Department within 48 hours
following occupation of the Small Facility. Enforcement shall be in accordance with this
Resolution. The Small Facility shall demonstrate and certify compliance with the following
standards:
A. Small Facility must comply with all applicable federal, state and local laws and
regulations.
B. The Small Facility shall NOT contain recreational vehicles as defined in Section 7-
808 (D).
E
C. In no case shall unsafe water be used for drinking nor shall raw sewage or
contaminated water be discharged on the ground surface. The operator shall
conduct monthly tests (or quarterly if an on -site disinfection system is installed) and
maintain records of stored potable water samples specific for coli form bacteria.
Any tests indicating coli form contamination must be disclosed to the Garfield
County Board of Health or designee within 72 hours from the time the
contaminated water was tested.
D. Each Small Facility shall be maintained in a clean, safe and sanitary condition, free
of weeds and refuse. Any hazardous or noxious materials that must be stored at
the Small Facility for operational or security reasons must be managed in
accordance with all applicable federal, state and local laws and regulations.
E. At least one thirty (30) gallon (4 cubic feet) wildlife -proof refuse container shall be
provided for each Factory Built Non - Residential Structure unit. Said container(s)
must be durable, washable, non - absorbent metal or plastic with tight - fitting lids.
F. Refuse shall be disposed of weekly, at a minimum. Operators must keep
appropriate records, to be provided to the County or any interested third party upon
request, to demonstrate that refuse is collected in a timely fashion and disposed of
at a licensed facility.
G. Outdoor food storage is prohibited.
H. Factory Built Non - Residential Structures equipped by the manufacturer with a fire
sprinkler system, fire detection system, and/or alarm system shall be inspected,
tested, and maintained in accordance with the requirements of the relevant fire
protection district(s) and the Colorado Division of Housing.
Single - station carbon monoxide alarms shall be placed in each Factory Built Non -
Residential Structure.
One (1) or more approved fire extinguisher(s) of a type suitable for flammable
liquids, combustible materials and electrical fires (Class ABC), or dry chemical,
shall be located in each Factory Built Non - Residential Structure and placed in
accordance with applicable fire protection district and /or Colorado Division of
Housing codes.
K. Domestic animals are prohibited at all Small Facilities.
L. A water storage tank is required to provide water to the sprinkler system (if
applicable) and initial suppression activities. The size of the water tank shall be
determined based on sprinkler calculations and initial suppression demands. The
relevant fire protection district shall be responsible for determining the size of the
water storage tank. If the Small Facility is not within a fire protection district, the
Operator shall provide at least 2500 gallons of water dedicated to initial fire
suppression which is accessible with a dry hydrant within each Permitted Site for a
Small Facility.
M. The operator shall document all emergency situations requiring action by any
government agency or fire protection district, in writing, and such documentation
shall be presented to the Planning Department within 24 hours of the occurrence.
N. All required Access Permits shall be obtained from the Garfield County Road and
Bridge Department or the Colorado Department of Transportation.
0
O. The Garfield County Sheriff's Office and relevant fire protection district(s) shall be
notified and provided with all documentation as outlined in these regulations, within
48 hours following occupation of each Small Facility. In addition, the Garfield
County Sheriff's Office and relevant fire protection district(s) shall be notified either
by hard -copy or electronically within 48 hours following removal of all Small
Facilities. The Planning Department shall be copied on all such notification,
whether hard copy or electronic.
P. The Operator shall maintain records identifying workers, whether employees,
contractors or sub - contractors, and document the dates that each worker is housed
at the Small Facility. Such records shall be provided to the County or any additional
third party upon request.
Q. The Operator shall obtain a certification inspection conducted by a third -party
Professional Engineer Licensed in the State of Colorado. The certification shall
verify that at the time of inspection the identified Small Facility meets or exceeds
the standards set forth in Article 7.808 D. 2. of the Garfield County Land Use Code
of 2008, as amended. This certification shall be on forms provided by the Garfield
County Planning Department. The certification shall be provided to the Garfield
County Planning Department within 48 hours following occupation of the Small
Facility.
R. The Operator shall accurately complete all required forms provided by the Garfield
County Planning Department identifying the location of the facility
(Section/Township /Range, relevant Tax Parcel Number, and GPS coordinates or
Latitude /Longitude coordinates); relevant zone district; maximum number of
occupants; cumulative amount of time (in days) that the Small Facility will be at the
specified location; identification of the State or Federal permitting agency
overseeing reclamation, rehabilitation and revegetation of the Permitted Site and
relevant permit number; date of installation; date of removal; name and contact
information of the landowner; name and contact information of the Operator's
Compliance Officer; 24 -hour emergency contact information for the Operator;
building information (make, manufacture year, serial number, size (square feet));
signature and contact information of the Operator's Compliance Officer.
S. Wastewater Disposal:
1) Vault System: All vault systems shall be designed and installed to
accommodate the maximum number of persons (eight or less
individuals), who will inhabit the Small Facility. In addition, all vault
systems shall be equipped with an overflow alarm device. Vault
systems shall be designed to accommodate a minimum of 75 gallons
of wastewater per person per day. If a vault system is proposed or has
been approved, the Operator must:
a. Demonstrate that year -round vehicular access is available and
maintained for safe and regular access for sewage hauling vehicles.
b. Maintain all sewage disposal records including but not limited to trip
logs /reports and landfill receipts as public records, available to the County
and/or any other interested third party upon request.
c. (b) Individual Sewage Disposal System (ISDS); If an ISDS is
proposed, then it shall be designed, installed and operated to
accommodate the maximum number of persons who will inhabit the Small
7
Facility (eight or less individuals) and shall otherwise be permitted and
operated in accordance with the Garfield County ISDS regulations as
contained in BOCC Resolution Number 19941-1-136.
I hereby attest that 1 am the designated Compliance Officer for the aforementioned
Small Temporary Employee Housing Facility(ies). I attest that 1 have read and
understand the standards to which the Facility(ies) shall be installed and
operated. I attest that the Facility(ies) will be constructed and maintained in
accordance with all applicable Garfield County, State of Colorado and Federal
regulations and standards. In addition, I attest that I have read and understand the
enforcement provisions as described in Article 12 of the Garfield County Unified
Land Use Resolution of 2008. Further, l understand that non - compliance with any
of the provisions as outlined in Article 7 -808 (D) (3) of the Garfield County Unified
Land Use Resolution of 2008 shall be enforced in accordance with Article 12.
Signature of Operator's Compliance Officer:
Print Name: Bryan S. Hotard
Title: Attorney -in- Fact
Phone Number: 970 - 285 -9377 ext 2754
S
Email: Bryan.Hotard(a),wpxeneray.com Scott. Brady(a)wpxeneray.com
I hereby attest that I am a Licensed Professional Engineer in the State of
Colorado. I attest that I have conducted a visual inspection of the Small Facility
identified in this Administrative Checklist, as installed, and, based on information
from that inspection I certify that the Small Facility complies with the standards
set forth in Article 7 -808 (D) (3) of the Unified Land Use Resolution of 2008.
PE Certification Number
PE Stamp
See
Summary
Date of Inspection See Summary
Print Name and Title: David Fox of Fox
Engineering Solutions
Signature See Form
Fox Engineering Solutions, Inc.
670 Canyon Creek Drive, Grand Junction, CO 81507
Ph: (970) 250.5505 /Fax: (626) 784 -0667
Email: coloradofox@,bresnan.net
Inspection Report for: RWF 33 -23 Small Temporary Employee Housing
Client: WPX Energy Rocky Mountain, LLC
Location: NW1 /4 SE 1/4 of Section 23, T6S, R94W, 6th P.M. Garfield County
Conducted By: David Fox, P.E.
Date Conducted: February 18, 2013
Garfield County
Paragraph Article 7- 808(D)(3) Land Use Resolution 2008
Reference Characteristic or Standard Description
3.a. Small Facilities, In the nature of Factory Built Nonresidential
Structures [as defined under C.R.S. 24- 32- 3302(a)] but NOT
recreational vehicles [as defined under C.R.S. 42 -1 -102 (61), including
truck, truck tractor, motor home or camper trailer), may be utilized
for housing of workers on projects related to commercial, industrial,
mineral extraction or highway operations, pursuant to the standards
for Small Facilities contained in subsection (2), below. Such facilities
are not subject to Garfield County building and fire codes (building
code, fire code). However, Small Facilities are subject to all pertinent
state (i.e. electrical permits), federal permits and relevant fire
protection district(s) code requirements.
3.a.(1) The Small Facility and any associated Infrastructure must be
completely contained within a state or federally permitted parcel
(such as a Colorado Oil and Gas Conservation Commission (COGCC)
approved all /gas well pad) in which reclamation and revegetation
are secured with the permitting agency (Permitted Site); and,
3.a. (2) The Small Facility is located at the Permitted Site for less than a
cumulative of one (1) year and at the end of the utilization period, all
structures, foundations and associated infrastructure are completely
removed; and,
3.a.(3) The Small Facility shall have an occupancy of eight (8) or fewer
people who are employees, contractors or sub- contractors of the
operator of the small facility and are needed for onsite safety of the
related commercial, Industrial, extraction or highway operation.
$mall Facility must comply with all applicable federal, state and local
laws and regulations.
The Small Facility shall NOT contain recreational vehicles as defined
In Section 7 -808 (D).
Page 1 of 5
Inspection Comments
Colorado Division of Housing certifications noted on
Company trailer, ATCO Structures USA,Unit ID.
354074502 with Certification No. 21525
manufactured in 2007; and Driller's trailer, ATCO
Structures USA, Unit ID. 354062966 with
Certification No. 21941 manufactured in 2007. All
other aspects not subject to visual inspection and
certification by third party Professional Engineer.
Not subject to visual inspection and certification by
third party Professional Engineer.
Not subject to visual inspection and certification by
third party Professional Engineer.
Not subject to visual inspection and certification by
third party Professional Engineer.
Not subject to visual inspection and certification by
third party Professional Engineer.
No recreational vehicles observed on site.
RWF 33 -23 Inspection
WPX Energy Rocky Mountain, LLC
3 In no case shall unsafe water be used ford rin king nor shall raw
sewage or contaminated water be discharged on the ground surface.
The operator shall conduct monthly tests (or quarterly if an on -site
disinfection system is installed) and maintain records of stored
potable water samples specific for coli form bacteria. Any tests
indicating coh form contamination must be disclosed to the Garfield
County Board of Health or designee within 72 hours from the time
the contaminated water was tested.
4 Each Small Facility shall be maintained in a clean, safe and sanitary
condition, free of weeds and refuse. Any hazardous or noxious
materials that must be stored at the Small Facility for operational or
security reasons must be managed in accordance with all applicable
federal, state and local laws and regulations.
5 At least one thirty (30) gallon (4 cubic feet) wildlife -proof refuse
container shall be provided for each Factory Built Non - Residential
Structure unit. Said containers) must be durable, washable, non-
absorbent metal or plastic with tight-fitting lids.
6 Refuse shall be disposed of weekly, at a minimum. Operators must
keep appropriate records, to be provided to the County or any
interested third party upon request, to demonstrate that refuse is
collected in a timely fashion and disposed of at a licensed facility.
7 Outdoor food storage is prohibited.
8 Factory Built Non - Residential Structures equipped by the
manufacturer with a fire sprinkler system, fire detection system,
and /or alarm system shall be inspected, tested, and maintained in
accordance with the requirements of the relevant fire protection
district(s) and the Colorado Division of Housing.
9 Single- station carbon monoxide alarms shall he placed in each
Factory Built Non- Residential Structure.
10 One (1) or more approved fire extinguisher(s) of a type suitable for
flammable liquids, combustible materials and electrical fires (Class
ABC), or dry chemical, shall be located in each Factory Built Non -
Residential Structure and placed in accordance with applicable fire
protection district and /or Colorado Division of Housing codes.
Page 2 of 5
Fox Engineering Solutions, Inc,
February 18, 2013
One potable water tanks of approximately 4000
gallons and one 4000 - gallon sewage holding tank
onsite. All tanks and piping located above ground.
No on -site disinfection systems installed.
Site appeared to be maintained in clean, safe and
sanitary condition, free of weeds and refuse.
One wildlife -proof trash recepacle with a capacity of
approximately 20 cubic yards onsite to be located
onsite. Individual refuse containers in each
office /housing structure.
Not subject to visual inspection and certification by
third party Professional Engineer.
No outdoor food storage observed on -site.
No active fire sprinkler systems observed in any of
the factory built non - residential structures. Smoke
detectors observed in all factory built non-
residential structures. Colorado Division of Housing
(CDH) compliance tags on all factory built non-
residential structures stating compliance with
nonresidental construction standards of the State of
Colorado.
Carbon monoxide detector was located in Company
trailer. Carbon monoxide detector could not be
located in the driller's trailer at the time of
inspection. WPX Energy has provided written
confirmation that a carbon monoxide detector was
installed in the driller's trailer - factory built non-
residential structure.
Fire extinguishers observed in all structures.
RWF 33 -23 Inspection
WPX Energy Rocky Mountain, LLC
11 Domestic animals are prohibited at all Small Facilities.
12 A water storage tank is required to provide water to the sprinkler
system (if applicable} and initial suppression activities. The size of the
water tank shall be determined based on sprinkler calculations and
initial suppression demands. The relevant fire protection district shall
be responsible for determining the size of the water storage tank. If
the Small Facility is not within a fire protection district, the Operator
shall provide at least 2500 gallons of water dedicated to initial fire
suppression which is accessible with a dry hydrant within each
Permitted Site for a Small Facility.
13 The operator shall document all emergency situations requiring
action by any government agency or fire protection district, in
writing, and such documentation shall be presented to the Planning
Department within 24 hours of the occurrence.
14 All required Access Permits shall be obtained from the Garfield
County Road and Bridge Department or the Colorado Department of
Transportation.
15 The Garfield County Sheriff's Office and relevant fire protection
district(s) shall be notified and provided with all documentation as
outlined in these regulations, within 48 hours following occupation of
each Small Facility- In addition, the Garfield County Sheriff's Office
and relevant fire protection distri(:ts) shall be notified either by hard -
copy or electronically within 48 hours following removal of all Small
Facilities. The Planning Department shall be copied on all such
notification, whether hard copy or electronic.
16 The Operator shall maintain records identifying workers, whether
employees, contractors or subcontractors, and document the dates
that each worker Is housed at the Small Facility. Such records shall be
provided to the County or any additional third party upon request.
17 The Operator shall obtain a certification inspection conducted by a
third -party Professional Engineer Licensed in the State of Colorado.
The certification shall verify that at the time of inspection the
identified Small Facility meets or exceeds the standards set forth in
Article 7.808 D. 2, of the Garfield County land Use Code of 2008, as
amended. This certification shall be on forms provided by the
Garfield County Planning Department. The certification shalt be
provided to the Garfield County Planning Department within 48
hours following occupation of the Small Facility.
Page 3 of 5
Fox Engineering Solutions, Inc.
February 18, 2613
No domestic animals observed on -site.
One potable aboveground water tank of
approximately 4000 gallons capacity on -site. Potable
water demand is estimated to be 300 gallons /day
gallons (4 individuals x 75 gpcd). Required fire
suppression demand is 2500 gallons. Total potable
and fire suppression volume required is estimated
to be 4000 gallons. Water supply appears adequate
with 4000 gallons of storage with refills scheduled at
5 -day intervals. Dry hydrant observed on water
tank.
Not subject to visual inspection and certification by
third party Professional Engineer.
Not subject to visual inspection and certification by
third party Professional Engineer.
Not subject to visual inspection and certification by
third party Professional Engineer.
Not subject to visual inspection and certification by
third party Professional Engineer.
This inspection was conducted by a third -party
Professional Engineer licensed in Colorado and
certifies compliance only with applicable standards
set forth in Article 7.808 D. 3. of the Garfield County
Land Use Code of 2008, as amended, that are
subject to visual inspection.
RWF 33 -23 Inspection
WPX Energy Rocky Mountain, LLC
18 The Operator shaII accurately complete all required forms provided
by the Garfield County Planning Department identifying he location
of the facility (Section /Township /Range, relevant Tax Parcel Number,
and GPS coordinates or Latitude /Longitude coordinates); relevant
zone district; maximum number of occupants; cumulative amount of
time {in days) that the Small facility will be at the specified location;
identification of the State or Federal permitting agency overseeing
reclamation, rehabilitation and revegetation of the Permitted Site
and relevant permit number; date of installation; date of removal;
name and contact information of the landowner; name and contact
information of the Operator's Compliance Officer; 24 -hour
emergency contact information for the Operator; building
information (make, manufacture year, serial number, size (square
feet)); signature and contact information of the Operator's
Compliance Officer.
19(a) Vault System: AI! vault systems shall be designed and installed to
accommodate the maximum number of persons (eight or less
individuals), who wifl inhabit the Small Facility. In addition, all vault
systems shall be equipped with an overflow alarm device. Vault
systems shall be designed to accommodate a minimum of 75 galions
of wastewater per person per day. If a vault system is proposed or
has been approved, the Operator must:
19(a)(1) Demonstrate that year -round vehicular access is available and
maintained for safe and regular access for sewage hauling vehicles.
19(a)(2) Maintain all sewage disposal records including but not limited to trip
logs /reports and landfill receipts as public records, available to the
County and /or any other interested third party upon request.
19(b) Individual Sewage Disposal System (1505): If an ISDS is Facility {eight
or less individuals) and shall otherwise be permitted and operated in
accordance with the Garfield County ISDS regulations as contained in
BOCC Resolution Number 1994H -136. proposed, then it shall be
designed, insta #led and operated to accommodate the maximum
number of persons who will inhabit the Small Facility {eight or less
individuals) and shall otherwise be permitted and operated in
accordance with the Garfield County ISDS regulations as contained in
BOCC Resolution Number 1994H -136,
Page 4 of 5
Fox Engineering Solutions, Inc.
February 18, 2013
Not subject to visual inspection and certification by
third party Professional Engineer.
One aboveground sewage holding tank with 4000 -
gallon capacity on -site. Sewage flows estimated to
be 300 gallons /day (4 individuals x 75 gpcd).
Sewage holding tanks need to be emptied
approximately every 13.3 days (4000 gallons / 300
gallons per day). Wastewater vault equipped with
overflow alarm device.
Not subject to visual inspection and certification by
third party Professional Engineer.
Not subject to visual inspection and certification by
third party Professional Engineer.
Not subject to visual inspection and certification by
third party Professional Engineer.
RWF 33 -23 Inspection
WPX Energy Rocky Mountain, LLC
Fox Engineering Solutions, Inc.
February 18, 2013
1 hereby attest that 1 am a Licensed Professional Engineer in the State of Colorado. l attest that I have conducted a
visual inspection of the Small Facility identified in this Administrative Checklist, as installed, and, based on
information from that inspection I certify that the Small Facility complies with the standards, subject to and
limited to visual inspections items as identified above; set forth in Article 7 -808 (D) (3) of the Unified Land Use
Resolution of 2008, for Garfield County, Colorado.
PE Certification Number: No. 25420 (coforadol
Date of Inspection: February 18, 2013
Print Name and Title: avid J. Fox, Principal Engineer
Signature: —G
Page 5 of 5
WPX Eneargy Rocky Mountain,LLC
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err DRn1, RIG I-1 YOUT
Ident9ncntlon & Location KW
Directions to Site: Emergency Contact List 1. Wastewater Abovoground Toe( (4000 gal.)
WPX OM. (24 Hrn) 970. 285.9377 2. Potable Wator Abovugrovnd Tank (4009 gal)
Doug McAdam- WPX Ddlling 970 -618 -7340 Cull 3. ild4loo r of
Scan Brady- WPX Drilling Sup- 970 - 270.9.187 Coll 4•WIIdpa-prof Officator
Kovin McDom,ott- WPXSall 970309 -1195 Call 5- Cemars 0Man OfO:;1np alnq
Mork Mumby- Spill Contractor- 970 - 260.1575 Coll 7.Shaar'o OlficoMausing
7.Shotl
Subject to rolocotion for conotrucllan astivltlos.
WPXENERGY.
1►CSi
The well pad site Is located In the NW 114 SE. 114 of Section 23,T6S, R94W,
61h P.M. (NAMN39,5975" W17,8544 °)
The site will tamporariiy otflco and house up to a maximum of four Individuals
during natural gas drilling activities and Is expected to be Completed in one
year or less. The Individuals will occupy two Individual trailer officals/houses
located on the wall pad. Office/houses have Colorado Dlvislon of Housing
compiianco tags,
Ono abovaground sawago holding tank with 4000- gallon capacity on -sito.
Sewage flows estimated to be 309 gallons/day (4 Individuals x 75 gpcd).
Sewage holding tank needs to be emptied approximately every 13.3 days
(4000 gallons 1300 gallons per day). Wastewater vault equipped with overffow
alarm device. Williams utlll--os the sorvlcos of a llconsod contractor to
remove and haul the wastewater to a State Certified troatmonNdupocal
facility.
One potable aboveground water tank of approximately 4000 gallons capacity
cn -sito. Petablo water demand Is ostlmatod to be 300 gollonslday (4
Individuals x 75 gpcd). Required minimum fire suppression demand Is 2500
gallons. Total potabto and fire suppression volume required ks estimated to bo
4000 gallons. Water supply appears adequate with 4000 gallons of storage
with refills scheduled at 5 -day Intervals. Dry hydrants observed on water
tank.
Road access to the site Is maintained year -round through the services of
private road malntonance and construction tontractcrs.
Factory•Bullt Nonresidential Structures (OfhcelHousing) have a minimum
separation distance of 21ft
Base mapping by BookcliffSunroying Sorvices, Inc, Please note that this ks a
construction site and that the locations of drITI oqulpmont and other Items are
subject to change.
RWF33 -23 Site Plan
Garfield County, Colorado
Small Temporary Employee Housing and
Septic Permit Application
Applicant: WPX Energy Rocky Mountain,LLC
Data: Fapmary 18, 2013 Checked: DJF V-1l 001
Fox Engineering Solutions, Inc.
670 Cnnyon Creok Drlve, Grand Junction. CO 81507 - t
Ph: (970) 250.5505 f Foxy (626) 784 -0667
Emad coloradotaxabrosrwn.not
9ZGARFIELD COUNTY
BUILDING AND PLANNING DEPARTMENT
FEE SCHEDULE
1W
Garfield County, pursuant to Board of County Commissioners ('Board ") Resolution No.
98 -49, has established a fee structure ( "Base Fee ") for the processing of each type of
subdivision and land use applications.
The Base Fee is an estimate of the average number of hours of staff time devoted to
an application, multiplied by an hourly rate for the personnel involved. The Board
recognized that the subdivision and land use application processing time will vary and
that an applicant should pay for the total cost of the review which may require
additional billing. Hourly rates based on the hourly salary, and fringe benefits costs of
the respective positions combined with an hourly overhead cost for the office will be
used to establish the actual cost of County staff time devoted to the review of a
particular project.
Actual staff time spent will be charged against the Base Fee. After the Base Fee has
been expended, the applicant will be billed based on actual staff hours accrued. Any
billing shall be paid in full prior to final consideration of any land use permit, zoning
amendment or subdivision plan. If an applicant has previously failed to pay application
fees as required, no new or additional applications will be accepted for processing until
the outstanding fees are paid.
Checks, including the appropriate Base Fee set forth below, must be submitted with
each land use application, and made payable to the Garfield County Treasurer.
Applications will not be accepted without the required application fee. Base Fees are
non- refundable in full, unless a written request for withdraw from the applicant is
submitted prior the initial review of the application materials.
Applications must include a Payment Agreement Form ( "Agreement ") set forth below.
The Agreement establishes the applicant as being responsible for payment of all costs
associated with processing the application. The Agreement must be signed by the
party responsible for payment and submitted with the application in order for it to be
accepted.
The following Base Fees shall be received by the County at the time of submittal of
any procedural application to which such fees relate. Such Base Fees shall be in
addition to and exclusive of any cost for publication or cost of consulting service
determined necessary by the Board for the consideration of any application or
additional County staff time or expense not covered by the Base Fee, which have not
otherwise been paid by the applicant to the County prior to final action upon the
application tendered to the County.
GARFIELD COUNTY BUILDING AND PLANNING DEPARTMENT
BASE FEES
TYPE OF LAND USE ACTION
Vacating Public Roads & Rights-of-Way
Sketch Plan
Preliminary Plan 1 Conservation Subdivision
Preliminary Plan Amendment
Final Plat
Final Plat Amendment I Correction Plat
Combined Preliminary Plan and Final Plat
BASE FEE
$400
$325
$675 + application agency
review fees and outside
consultant review fees, as
authorized pursuant to the
Regulations, such as the
Colorado Geologic Survey
$325
$200
$100
$1,075
Minor Exemption 1 Amendment
$3001$300
Major Exemption 1 Amendment
$4001$300
Rural Land Development Option Exemption 1 Amendment $4001$300
General Administrative Permit
$250
Floodplain Development Permit
$400
Pipeline Development Plan 1 Amendment
$4001$300
Small Temporary Employee Housing
$50
Minor Temporary Employee Housing
$250
Limited Impact Review 1 Amendment
$400/$300
Major Impact Review 1 Amendment
$5251$400
Rezoning: Text Amendment
$300
Rezoning: Zone District Amendment
$450
Planned Unit Development (PUD)1 Amendment
$5001$300
Comprehensive Plan Amendment
$450
Variance
$250
Interpretation
$250
Takings Determination
NO FEE
Planning Staff Hourly Rate
• Planning Director
$50.50
• Senior Planner
$40.50
• Planning Technician
$33.75
• Secretary
$30.00
County Surveyor Review Fee (includes review of Amended Determined by Surveyor$
Plats, Final Plats, Exemption Plats)
$ 1 1 — M y I a r R e c o r d i n g F e e St
$10 each additional page
Page 2
The following guidelines shall be used for the administration of the fee structure set
forth above:
1. All applications shall be submitted with a signed Agreement for Payment form set
forth below.
2. County staff shall keep accurate record of actual time required for the processing
of each land use application, zoning amendment, or subdivision application. Any
additional billing will occur commensurate with the additional costs incurred by
the County as a result of having to take more time that that covered by the base
fee.
3. Any billings shall be paid prior to final consideration of any land use permit,
zoning amendment, or subdivision plan. All additional costs shall be paid to the
execution of the written resolution confirming action on the application.
4. Final Plats, Amended or Corrected Plats, Exemption Plats or Permits will not be
recorded or issued until all fees have been paid.
5. In the event that the Board determines that special expertise is needed to assist
them in the review of a land use permit, zoning amendment, or subdivision
application, such costs will be borne by the applicant and paid prior to the final
consideration of the application. All additional costs shall be paid prior to the
execution of the written resolution confirming action on the application.
6. If an application involves multiple reviews, the Applicant shall be charged the
highest Base Fee listed above.
7. Types of "Procedures" not listed in the above chart will be charged at an hourly
rate based on the pertinent planning staff rate listed above.
8. The Planning Director shall establish appropriate guidelines for the collection of
Additional Billings as required.
Page 3
GARFIELD COUNTY BUILDING AND PLANNING DEPARTMENT
PAYMENT AGREEMENT FORM
(Shall be submitted with application)
GARFIELD COUNTY (hereinafter COUNTY) and WPX Energy Rocky Mountain, LLC
Property Owner (hereinafter OWNER) agree as follows;
1. OWNER has submitted to COUNTY an application for
RWF 33 -23 pad location STEH &ISDS (hereinafter, THE PROJECT).
2. OWNER understands and agrees that Garfield County Resolution No. 98 -09, as
amended, establishes a fee schedule for each type of subdivision or land use review
applications, and the guidelines for the administration of the fee structure.
3. OWNER and COUNTY agree that because of the size, nature or scope of the
proposed project, it is not possible at this time to ascertain the full extent of the costs
involved in processing the application. OWNER agrees to make payment of the Base Fee,
established for the PROJECT, and to thereafter permit additional costs to be billed to
OWNER. OWNER agrees to make additional payments upon notification by the COUNTY
when they are necessary as costs are incurred.
4. The Base Fee shall be in addition to and exclusive of any cost for publication or
cost of consulting service determined necessary by the Board of County Commissioners for
the consideration of an application or additional COUNTY staff time or expense not covered
by the Base Fee. If actual recorded costs exceed the initial Base Fee, OWNER shall pay
additional billings to COUNTY to reimburse the COUNTY for the processing of the
PROJECT mentioned above. OWNER acknowledges that all billing shall be paid prior to
the final consideration by the COUNTY of any land use permit, zoning amendment, or
subdivision plan.
PROPERTY OWNER (OR IX ORIZED REPRESENTATIVE)
Sigma re Date
Bi-yan S. Hotard
Print Name
Mailing Address:
WPX Energy Rocky Mountain, LLC
PO Box 370, Parachute, CO 81635
Page 4
Front: Meil, Kris
To: "Jim Sears ": "R1jie— TavlUL; Vgla Mercer
Cc: Reed. Gary
Subject: RWF 33 -23 Rig Move On Notification
Date:. Monday, February 18, 2013 2:11:00 PM
Attachments: RWF 33 -23 GARCO Sheriff Utter"
RWF 33 -23 Maa,odf
am notifying you on the attached pad locations we will be commencing drilling operations
in the next few days and these operations will continue for approximately 132 days. At
which time I will notify you of the removal of the employee housing.
This notification is per the GARCO regulations for our pad located in Sec 23 - TES R94W.
Attached please find a map with directions to the pad lay out and emergency contact
information.
Should you have any questions please let me know.
Thanks,
Kris Meil
wPX Energy
Planning FOA ill
IOS8 County Road 215
Parachute, CO 81635
(970) 28S -9377 x2209
(970) 623 -6583 cell
krls.me'I@WPXEnera.com
W PXENERGY
WPXENERGY,,
WPX Energy
1058 County Road 215
P.O. Box 370
Parachute, Colorado 81635
(970) 285 -9377
2/18/13
Garfield County Sheriff's Office
Emergency Operations
Attn.: Jim Sears
108 8"' Street
Glenwood Springs, CO 81601
Ph: 970 -945 -0453
RE: Emergency Response Notification
RWF 33 -23 pad
Dear Jim:
This letter is to inform the Garfield County Sheriff's Department that WPX Energy will soon
commence drilling operations on the above mentioned drilling location. WPX will provide rig
site housing accommodations for the duration of the drilling operation approximately 160 days.
In accordance with Garfield County Planning and Zoning Regulations, the attached
documentation provides emergency response information and driving directions for the WPX
RWF 33 -23 pad.
Should you have any further questions or concerns regarding this notification, feel free to contact
me at (970)263 -6583.
Sincerely,
Kris Meil
Planning Coordinator — Piceance District
Kris.meil Owwpxenergy.com
'X Energy Rocky Mountain,LLC
RW]F 33 -23 Well Pad
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Emergency Contact List
t, WaRCrpoorASoaprourd TOrYi (GaSri ON.)
vNX oft. ON HM) 37D•.'AS9377 =. Pet"e w,:o nsor. ,rd,ea Tana (4000 qoG
Doug n5c4dam• wPXDri:Mq D7CLG' -7p4a— 1.1'�°�ToPo�
,ragaomdy,wN Srining ''270-91a7Gan 4.wtldLtaCarets Q�tmlptcr
5.Cempany M1bnoM *A feuJ -Jma
Kavin MCDamwtl•WPX Sata[y 97GA07 -7 t35 Gott g.Ddllet, olleamm"Ap
IuUrk alkiaMy. Spin coavociv' 970.260.1; -mco9 7.Shed
- Subject to mlocolton Tor cort auelon acts dam
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The well pad -site L- looted In tho NW 114 SE 114 of Section 23,76S. €Z94W
6th P.M. 04AOW N39.507s W17.3S A-)
The uto will tompertrly office and house up to a maximum of four IndNkluaL^
during natural gaa drilling aetMlias and Is expected to be eompfoted In one
yearor lea. The Indvkkkd-- will occupy two Individual trailer olnccslhotcr
located on the won pad. CV1ce.rt:ou„r_ have Colorado Divlslon of Mousing
compliance tags.
One aboveground sawago holding tank with 4000-gancn wpacdy on-slto.
Sewage now. esttmotod to be 100 gatlonsJday (4 lndlviduals x 75 gprtl),
Sewage hoiding rank nods to be empted approximately evary 73.3 day:
(4000 gallon; / 300 gallon par day). Wastewater moult equipped wnh oveR3vw
alarm device. Winlaira utilizzC the sorvIcos of a Ilconaod contractor to
rernovo and hour fie wa-stowa /or to a Stoto certified treat7%entfd1Zperal
todnity.
Ono potable aboveground water tank of apprexlmatey 4000 gallem capacity
on Cite. Potable water demand I¢ asilmafad k+ ba 300 gallonJday (G
Individuals x 75 Sped). Roquined minimum tiro suppression demand a 2500
gallons. Total potabto and fire =pprosson vohrrric mqulrod Is ostrnotod to be
4000 gallons. Water supply appears adequate with 4900 talons of storage
wdth roflno zebodured at $day lnterva:s. Dry hydrants observed on water
rant.
Road aoeo= to the site r rnaitltainod year-round through the = arweov or
pdvato rood malntonanco and co=irllctico aonlrzid= -.
FDCtory-Bunt raonrosid"6al Structures (Off+cerMouaMg) have a minimum
soparation distance of 211t
BA:B mapping by BaokCtltrSUMMykag SOMCo -, Inc, Pieaoa note that this 15 a
construction site and thol the kxadws of drill equipment and other Items are
subject to change.
RWF33 -23 Site Plan
Garfield County, Colorado
Small Temporary Employee Housing and
Septic Permit Application
A pKcznt:WPXEncrgy Rocky MOuntnin.LLC
Dole: February tea 2ata Chocked: WF Ver.fch:001
Fox Engineering Solutions. Inc.
670 carryon Creak Onw. Grind Jwrx1k n, CO WSO7
Pn7 (m) 2565505 1 Fax: (Q6) rs"XZ7
Front; Meil, Kris
Tor Kevin Whelan -Rifle FPD ( gul -Riff )_(kLe - ohelan(@riFlefirede to ora?: "Julie Taylor'; Vofa Mercer
Cc: Reed. Gary
Subject: RWF 33 -23 Rig Move On Notification - Fire District & County
Date; Monday, February 18, 2013 2:08:00 PM
Attachments: RWF 33 -23 Rifle Fire Letter.doc
RWF 33 -23 Mao.odf
I am notifying you on the attached pad locations we will be commencing drilling operations
in the next few days and these operations will continue for approximately 132 days. At
which time I will notify you of the removal of the employee housing.
This notification is per the GARCO regulations for our pad located in Sec 23 - T6S R94W.
Attached please find a map with directions to the pad lay out and emergency contact
information.
Should you have any questions please let me know.
Thanks,
Iris Meil
wPX Energy
Planning FOA III
1058 County Road 215
Parachute, CO 81635
(970) 285 -9377 x2209
(970) 623 -6583 cell
kris.nieil(@WPXEnera.com
WPXENERGY
WPXENERGY...
WPX Energy
1058 County Road 215
P.O. Box 370
Parachute, Colorado 81635
(970) 285 -9377
2118/13
Rifle Fire Protection District
Emergency Operations
Attn: Kevin Whelan
1850 Railroad Ave
Rifle, CO 81650
Pli: 970 - 625 -1213
RE: Emergency Response Notification
RWF 33 -23 pad
Dear Kevin:
This letter is to inform the Rifle Fire Protection District that WPX Energy will soon commence
drilling operations on the above mentioned drilling location. WPX will provide rig site housing
accommodations for the duration of the drilling operation approximately 160 days.
In accordance with Garfield County Planning and Zoning Regulations, the attached
documentation provides emergency response information and driving directions for the WPX
RWF 33 -23 pad.
Should you have any further questions or concerns regarding this notification, feel flee to contact
me at (970)263 -6583.
Sincerely,
Kris Meil
Planning Coordinator --- Piceance District
Kris.meil(@wpxeneW.com
WPXEner<,ry Rocky Mountaiin,lLLC
RNAT 33 -23 Well Pad
i -
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nw 4 -um'OT � aO�o.,^ r•uvsov soar r r warorw� rvr+RM1+erwtrr. morn rret7 aeeeh+.ukorr:
wwp.un.'ea'•al.-0 LLr+IN M1M rrno�r alMClanr le+aL: •a'�L n'rt%4cc'Iw+ArNCawrvnone %�.
i.0it MIr .a.4, IMA 1e6arex>rrl C Lns1a60n.-M tft, e+ac.a�nrn= ^LOCAT wr7rn swr��V.vS
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Scat Lindy- wPX0eMr Su;- 77a„744tCTtan
Xa.ln bACOOnapoa�-�wPX Safety 97(,303.7 135 Cc7
kwk AiWmey- W.+Ca+V=G 9%7,—'62.1',:75 CeA
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wager Abwogrwrd Torte (4044 got.)
. PoShro watw Ab —found Tarok (4000 420j)
Poeuok Togo
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.Gom ny+tan OTtaMoer.Jng
.Shad
rule llw Sex eo Wmotlon aetivItIm
Na^ -s::
The won pad site Is located In the NW 114 SE 114 of section 23.765. R94W.
6.,b P.M. ¢ A033hF'9.SAT;+ W17..$5
Tho sits win Iamporarlly oRicO and hou,= up to a maximum of four InCriduats
during nonrral gas drininq acfNtuca and 1: expactod to bar completed rn are
year or loss. Tho Indlvlduars will occupy two Individual trallor oftkosihousas
located on the wan pad. Otnca!hou -ses have Colorado Division of Rousing
comptlanco tags.
one aboveground **w.igo holding tank with 4000-gallon capacity on .I;c.
Sewage Eows estimated to be 500 gallonarday (4 lndlvldual: x 75 gpcd).
Sewage holding tank Hood: to be amptaed approXlrr3ie4y ovary 13.3 day:
(4000 ganons! 300 gallons per day). wastewater vault equipped with overflow,
s'.am davko. Williams udlLcs (he sorvleos of a Ileensod contractor to
romove and hour tho+wstowator to a stoto comllod trc*trnanJdlcpo -.al
focinzy.
One potable aboveground water tank of approxlmotety 4000 gancrr capacity
oh -silo. Potable w=or domard Is cclm3tad to be 300 ganonlday (4
Irdiwdua&^ x 75 gpcd). RgWirod minifnurn fuo suppreszlan demand a 2500
gallons. Totat potable and lira suppros:.ion valumo requlmd Is esbmOtcd to be
4000 gallon✓. Water supply appears =W:uate with 4000 gluons of worsge
wth ragns sc adurad at 5-day tnter•vats. Dry hydrard; observed on water
tan1L
Rood access to the site �- maintained year -round through the =%mcG or
private road maintonanao and construction conampaors.
Fodory-Eunt Nonresidential Struauros (OMeeniousing) have a minhtlum
separation deznca of 21ft
Hasa mapping by Sookc1inurvoying Servkas, Inc. Please note that thin I-- a
constructIon sire and that the 10CAons of drill aqulpnwnt and ONar Items are
=bloc: to change.
RWF33 -23 Site Plan
Garfield County, Colorado
Small Temporary Employee Housing and
Septic Permit Application
Apps caret WPXEnorgy Rocky Mountain.=
Cam: Fnbm=y ib, 2013 Grockod: DIP 00'
Fox Engineering Solutions. Inc.,
Go carryon Creak Dorm, trim lur bM. Co 9170'
Pit (370) 250.5505 f Faee (6X6) 7044457 '�'`�
Sectim? 23
T. 6S., R94 IV Exist. Ditch
� 1
y y 1 yy y k 1 D'pyltghf Line
IfREF PNTI 11�OdliQpfLE i 11 I� I w i tt y1 1
SI . y� I A 1y I 1, °1
� I y �
NE #7B .i I yI i 'I yl , SE #1 1A \ `�
cnA HICSCALEINPEET F 4.1' ! 35' I � ' )5Dy y i y/ C 19.2'
rrw- Fn FET I. I . r I R l I 1
rr �l i r i F
0.2' i I y1 ty 1y 1y
r I I I w l i i I
Edge of
Drill Pad
NE VA
1--
I
F 11.8'!
LL LL l
o
I I I I I I
LL' u.u. revccv
I 150'R I i I $$a "ou°c a.
I f I i I I I a as aILf�a 1 1 i y
N #6 +: I II I + NI A100,,00 W a a a C Ui 6' y ! i yy } r S` #2 j
B I ! °115D" C$ 6' B BJ J
I 1 I x 19D' '4 1 1 J
F 14.1' i +- -+125 —i i # ## �!�
l y 1
3LL1
a a 0 �a a s 'N
I I o a a !o -- &
a22 k�lL l� J
�/Daylllghf Lind r1
60"1 ly 11 1 1
�` �
! SW #3
0. W li #4 i r y C 9.7' J 1
NW 45' 450' / / C 1.2'; 10' I5 J
— F 6.9' f /' JI� C
J
a80'x5d'
Exist. Ditch—/ � _ r/ Praduclipn Equipment Pa� J
Proposed
Access Road
ESTIMATED DIRT QUANTITIES (cy)
ITEM CUT FILL TOPSOIL EXCESS
PAD 21519 12041 5177 4301
PIT 6200 6200
DTALSI 27719 12041 5177 10501
' 4
t
C 2.9' 1 0 9.5'
' � I
50'
REF. PNT. } I
yl 1
° 1
•1 1 \
y t ° 'MOTE•
u
1) TOPSOIL VOLUME BASED ON 12"
SOIL DEPTH.
2) TOTAL DISTURBED AREA = ±3.99 ac
tion Plan Preparea for:
Williams Production, RMT
RWF 33 -23 Dnll Pad - Plat 2
C O NS Tl 2 U C TI O N L A YC 7 U T
y y
1 °
4
1
°
1
REVISED.-
514110
C'
SCALE:
I" = 80'
W
DATE:
1113108
PLAT.
2 of 9
PROJECT:
Iyillrn rns
DFT.
DPM
u
1) TOPSOIL VOLUME BASED ON 12"
SOIL DEPTH.
2) TOTAL DISTURBED AREA = ±3.99 ac
tion Plan Preparea for:
Williams Production, RMT
RWF 33 -23 Dnll Pad - Plat 2
C O NS Tl 2 U C TI O N L A YC 7 U T
•F
'r
c
i
_y
ill
9�i l_4 13
1
.ti i� I '� ��f • 4�f"° � T ` 1 r ' a' ',�s�"'�
ti� 4
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of -•'.��
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ry
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,- 1 ...f°� izAC,11 r �a11..�y!'k 'Ci:::,� f�•,s
RWF 33 -23 DRILL
r PAD .LOCATION
its
�!.'( 1 i` � �r� ..•M 41 i �. —. _..t �ti•..,,,�� .( 1,4 _ �_ a _�
44qq {{1 p
24
A ,GrH'EMBAUt�
COUNTY 1,=
�; �•;:�.� o
26 ROAD 320
i i +f ai i '� 1 !1f ..- �,:ti .��crrn ;�ti.. •.�ti
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a V LL
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a1
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r �-
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1' 11! i 44caa
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1�
GRAPHC SCALE N FEET
ACCESS DESCRIPTION: 1 IW_I -''»' _-T
FROM THE INTERSECTION OF STATE HIGHWAY 6 AND COUNTY ROAD 323 (RULISON ROAD) NORTH OF RULISON, PROCEED
SOUTHERLY ALONG COUNTY ROAD 323 (RULISON ROAD) t1.1 MILES TO THE INTERSECTION WITH COUNTY ROAD 309 (RULISON
PARACHUTE ROAD), PROCEED LEFT IN AN EASTERLY DIRECTION +2.3 MILES TO THE INTERSECTION WITH COUNTY ROAD 320
(RIFLE RULISON ROAD), PROCEED RIGHT IN AN EASTERLY DIRECTION t3.6 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL
ROAD, PROCEED LEFT IN A NORTHERLY DIRECTION 1400 FEET TO THE RWF 33 -23 DRILL PAD LOCATION, AS SHOWN HEREON.
REVISED.- 3129/10 %.9J dLruGLlUU r1aU rrcpk1XeEL LUE;
se.�� a • - '�11ma Williams Production, RMT
1-1; of y RWF 33 -23 Drill Pad - Plat 5
PRIG ICP M711an,s
DFT.• MAJ ACCESS ROAD j1fAP
STATEMM OF AUTHOI:
Q
Pursuant to G.R.S. §38 --30 -172, the undersigned executer this
ME Q
Statement of Authority on behalf of David Youb-erg, General Partner. Deaver
Creek f►neh Limited Partnership, an Iowa Limited Partnership re&tered and doing
--
husinm ion. Colorado as Youbere Beaver Creek Ranch Limited Partnership
W
a LimtedPartnershin (corporation, limited liability Company,
general partnership, registered limited liability partnership,
registered limited liability limited partnership, limited partnership
n
association, government agency, trust or other), an entity other than
�.o
F a
an individual, capable of holding title to real property (the
.
ALL
"Entity „), and states as follows:
”' a
The name of the Entity is David YonheM_Cweneral Partner, Beaver Creek Ranch
Limited Partners, an Iowa United Partnership, registered and doing bu &em in
r N
Colorado_ asYouberj Beaver C mek Ranch Limited and is formed under
0 L
_Pnrtnemh!
the laws of Colorado
' o2
The mailing address for the Entity is c% David Youberu, 215 S. 10
NE
treet Sag i IA- 5M
o
MIX—
The name and /or position of the person authorized to execute
instruments conveying, encumbering, or otherwise affecting title to
real property on behalf of the Entity is David Youbers
The limitations upon the authority of the person named above or
holding the position descr:LbeA above to bind the Entity are as
follows: Iudewndent Sewaae DisnogAl Swstems and Small Temuorarvv EmWovee Rousing
for the SR X12 RU 23-5 RU 34-6 RU 13-7 RU 12-7 RU 22 -7 RU 11 -7 RU 21 -7 RU 1"
RU 13-6 Pads,
(if no limitations, insert Oyone ")
Other matters concerning the manner in which the Entity deals with
any interest in zeal property are:
(if no other matte. -, •Heave this section blank)
EXECUP: is day of j�ija� , 2010.
Signature:
Name typed: David You
Title (if any):
STATE OF
SS.
COUNTY OF -GARFIB= )
Sa �-'
The pregoing instrument was a knosiledged before me this ()'T!I�day of
I �IIC�1 2010 by - L �' A �f C u �� � � c, , on behalf of
. a
t
Witn s My • fund
After Recordation Please Return To:
Williams Production RMT Co.
Attn: Land Dept.
P.O. Box 370
Parachute, CO 81635
Official Seal
JAMMI, tPl LL. -N
Cnmrnlss'c ?c' : riar t25 7
26, . 1�
Mill NI III
Rec 2t0lo2 n f1{2; x15906
Jfan l%loo 62/2
1 / Rip F Feei0
GWIELO CWRiTY co
LIMITED POWER OF ATTORNEY
WPX ENERCx' ROCKY MOUNTAIN, LLC ("Compxny ") a Delaware limited
liability company, having its principal place of business in the City of Tulsa, County of Tulsa,
State of Oklahoma, does hereby make, constitute and appoint Bryan S. Dotard with the fill]
authority hereinafter provided, the true and lawful Attorney -in -Fact of the Company, authorized
and empowered on behalf of the Company and in the Company's name, and for the sole and
exclusive benefit of the Company and not on behalf of any other person, corporation or
association, in whole or in part, to enter into, execute, deliver, file and accept all instruments and
documents affecting the real property or real estate rights ofthe Company as more specifically
set forth below: ;
1. Applications and documentation associated with Garfield County or Rio Blanco
permitting requirements for including, but not limited to, Independent Sewage Disposal
Systems, Small Temporary Employee Housing, Major Impact Reviews, Limited Impact
Reviews, Oil and Gas well permitting, Driveway Access, County Road Maintenance,
Temporary Living Quarters, Temporary Use Permits, Surface Use Permits, Surface Use
Licenses, Utilities, Snow Removal and Private Construction of County Roads;
2. Agreements and other documentation that grant easements, rights of way, licenses; or
permits to Company and also instruments where the Company grants such rights to
others;
3. Agreements that assign easements, rigbts of way, licenses, permits or surface leases in
connection with the Company's operations;
4. Releases and Partial Releases of easements and rights of way;
5. Agreements allowing encroachments onto easements and rights of way owned by
Company and landowner instruments and conveyances on others easements;
6. Agreements subordinating mortgage rights to easement or lease;
7. .Agreements relating to the modification and relocation of Company facilities;
8. Rental or lease agreements far surface use or other surface use agreements and all notices
related to the pipeline agreements;
9. Agreements for the purohnse or sale of real property and for the lease of real property for
residential or commercial purposes or otherwise in connection with the Company's
operations;
10. Agreements to obtain water services, electrical, gas or oil services or the provision of
other utilily services utilized by Company's facilities;
1 L Agreements modifying, amending, renewing, extending, ratifying forfeiting, canceling
and terminating any and all of the aforementioned types of instruments and documents.
WPX ENERGY ROCKY MOUNTAIN, LLC hereby declares that each and every
act, matter and tiling which shall be given, made and done by Bryan S. Hotard in connection with
the exercise of any or all of the aforesaid powers shall be as good, valid and effectual to all
intents nud purposes as if the same had been given, made and done by WPX Energy Rocky
Mounlain, LLC in its limited liability company presence and it hereby ratifies whatsoever
Attorney -in -Fact shall lawfully do or cause to be done by virtue hereof. This Limited Power of
Attorney shall remain in full force and effect until terminated by Company.
VTA
Bill K1' AAMINIMMW . ruglmw 1401 NJ III
Re" 1 ' RDT": I16004
0212p2 12 2e1Bi10 R9
loan Alherkea 2 f rz a
Fae :'16.00 Dan Fea:0.60 GARFIELD COUNTY CO
IN NVITNESS WHEREOF, WPX Energy Rocky Mountain, LLC has c ?.used this
Limited Power of Attorney to be signed by one of its Vice Presidents, duly authorized by ils
Management Committee to grant powers of attorney this 1" day of January, 2012.
WPX RO FAIN, LLC
By.
D. Ines
Its ice Pr id
ACKNOWLEDGMENT
STATE OF OKLAHOMA )
ss.
COUNTY OF TULSA )
BEFORE ME, the undersigned authority, a Notary Public in and for said County and State,
on this day personally appeared, Jerry D. Barnes personally known tome to be the Vice President of
WPX Energy Rocky Mountain, LLC a Delaware limited liability company, who acknowledged tome
that he has executed the above LIMITED POWER OF ATTORNEY authorized by Company's
Management Committee. �/
IN WIT NESS WHEREOF, I have hereunto set my hand and aff xed my notary seal, the&, 1
day ofaey; 2012,
Notary Publio
� 1
My Commission Expires: 2 2 5.— o 124
110A YJ.UE111
1ML �1r1, Na�►� i s.+
U W o.matibn r/Y+�> �71i
After Recordation Please Return To:
WPX Energy Rocky Mountian, LLC
Attn: Land Dept.
PO Box 370
Parachute, CO 81635
