HomeMy WebLinkAboutApplication.pdfGARFIELD 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 & 1 CD copy of Ihe completed application to Planning Department wlin 48 hours following
occupation (To be completed by the Small Facility Operator -e.g. well pad operator) Sectionrrownship/Range Location of Housing Site: Sec 35 -T6S -R94W Well Pad Number: RWF 11-35 Tax
Parcel Number for Parcel Containing Housing Site: 2175-264-00-177 GPS and/or Lat-Long Coordinates of Housing Facility Site (Often included in APD): Lat: 39.485788 Long: -107.860540 Maximum
Number of Occupants at Zone District: Rural Pennilted 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
Permitting Agency Overseeing Reclamation, Restoration and Revegetalion and Relevant Pennit Number: 0504521848 Date of Installation: 9/5/13 I Date of Removal: 1117113 Name of Landowner:
Savage, Joan L Street Address: PO Box 1926 City: Rifle Telephone: 970-625-1675 State: CO Email: Zip Code: 81650 lName of Opcmtol"s Compliancc Officer: WPX Energy Rocky MOllntain, LLC
Bryan S. Hotard Street Address: PO Box 370 City: Parachute Telephone: 970-285-9377 ext 2754 State: CO Email: Bryan.Hotard@wpxe nerQV.com Zip Code: 81635 Company 24-Hour Emergency Contact:
WPX Energy Rocky Mountain, LLC Phone Number: 970-265-9377 This Administrative Checklist must be received by the Garfield County Planning Department within 48 hours following occupancy
of the Small Facility. be delivered to A copy of this completed Administrative Checklist and all associated submittals shall . . the Garfield County Sheriffs Office and relevant Fire
Protection District (if wtfhm 48 hours applicable) . Office ~nd . following occupancy of the Small Facility. Additionally, the Garfield County Sheriffsrecelpt) or venfied 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 1
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: 500BBLl21 ,000 gallons 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. 1. 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. ----I---Ie;-Submittat-Requirements:-l'he-appli
cation-submittedioihe-Countyrshali contain-the-following'--I-----l 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) -All Requirements Applicant Planning Must be Satisfied
to be Eligible as a Small Facility Department Complies (yIN) Complies (yIN) 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 geriod, all structures,
foundations and associated infrastructure are completely removed; and, YES 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. 3
Building Information (Per Unit) Unit 1 Make: ATCO Structures (USA) Inc Serial Number or Unit 10 Number: 354085432 Manufacture Year: 2008 Size of Unit (Square Feet): 14X56 Unit 2 Make:
AmeriTech Building System Serial Number or Unit 10 Number: 11-100621 Manufacture Year: 2006 Size of Unit (Square Feet): 14X56 Unit 3 Make: Serial Number or Unit 10 Number: Manufacture
Year: Size of Unit (Square Feet): Unit 4 Make: Serial Number or Unit 10 Number: Manufacture Year: Size of Unit (Square Feet): Unit 5 Make: Serial Number or Unit 10 Number: Manufacture
Year: Size of Unit (Square Feet): ISOS Permit ISOS Permit Number SEPT -8-13-2962 ~ Signature of Operator's comp~ /" .f1/J Officer: .-~~~y ( By signing this form, /verify that t'ffI information
provided in this checklist is correct and accurate to the best of my know/edge) Print NamA' Brvan S, Hotard Title: Attorney-In-Fact 4
Eligibility, 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 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 (Le. 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 (0). 5
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, ---------+testect,-and-maintained-in-accordance-with1he-reqairements-of1he, elevantfire·---------j protection district(s)
and the Colorado Division of Housing. I. Single-station carbon monoxide alarms shall be placed in each Factory Built NonResidential Structure. J. 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. 6
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 (SectionfTownship/Range, relevant Tax Parcel Number, and GPS coordinates or Latitude/Longitude coordinates); relevant zone district;
maximum number of ---------occopants;-tomolative-amoont-oHimeiin-days}thaHhe-SmaII-Facilitywill-be-aHh~----------j 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 1994H-136.
I hereby attest that I am the designated Compliance Officer for the aforementioned Small Temporary Employee Housing Facility(ies). I attest that I 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, I 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: P r i n t N a me: _-"B""rJ,y",a",n,--"S,,.-.!H.",o""t",a.!r.",d _ Title:
Attorney -In-Fact Phone Number: 970-285-9377 ext 2754 Email: Bryan.Hotard@wpxenergy.comScott.Brady@wpxenergy.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 (0) (3) of the Unified Land Use Resolution of 2008. PE Certification Number PE Stamp See Date
of Inspection See Summary Summary Print Name and Title: David Fox of Fox Engineering Solutions Signature See Form 8
..... 3 Fox Engineering Solutions, Inc. 670 Canyon Creek Drive, Grand Junction, CO 81507 Ph: (970) 250-5505/Fax: (626) 784-0667 Email: colorado(ox@bresnan.nel Inspection Report for:
Client: RWF 11-35 Small Temporary Employee Housing WPX Energy Rocky Mountain, LLC Location: Conducted By: NW 1/4 NW 1/4 of Section 35, T6S, R94W, 6th P.M. Garfield County David Fox,
P.E. Date Conducted: September 5, 2013 Garfield County Paragraph Article 7-808(0)(3) land Use Resolution 2008 Reference Characteristic or Standard Description Inspection Comments 3.a.
Small Facilities, in the nature of Factory Built Nonresidential Colorado Division of Housing certifications noted on Structures (as defined under CR.S. 24-32-3302(a)) but NOT recreational
vehicles (as defined under CR.S. 42-1-102 (61), including Company trailer, Unit 10.354085432 with truck, truck tractor, motor home or camper trailer]. may be utilized Certification No.
19195, manufactured by ArCO for housing of workers on proje.c.ts..r.elakdJo_c_o.mme(ciaLJndUitdaJ ____~S tr-uetures-in-2008 i and-Driller-'s-traile r,-t.:J ni t-l ();--l-~-~----1 mineral
extraction or highway operat ions, pursuant to the standards for Small Facili ties contained in subsection (2), below. Such facilities 100621 with Certification No. 22178, manufactured
are not subject to Garfield County building and fire codes (building by Ameritech Building Systems in 2006. All other code, fire code). However, Small Facilities are subject to all pertinent
aspects not subject to visual inspection and state (i.e. electrical permits), federal permits and relevant fire protection district(s) code requirements. certification by third party
Professional Engineer. 3.a.(1) The Small Facili ty and any associated infrastructure must be completely contained within a state or fede rally permitted parcel (such as a Colorado Oil
and Gas Conservation Commission (COGCe) approved oil/gas well pad) in which reclamation and revegetation are secured with the permitting agency (Permitted Site); and, 3,a.(2) The Small
Facility Is loca ted at the Permitted Site for less than a cumulative of one (1) year and at the end of the utili zation period, all struc tu res, 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·con tractors of the operator of the
small facility and are needed for onslte safety of the rela ted commercial, Industrial, extract ion or highway operation. 1 2 Small 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 (0). Page 1 of 5 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 11-35 Inspection WPX Energy Rocky Mountain, LLC 3 4 5 In no case shall unsafe water be used for drinking nor shall (aw sewage or contaminated water be discharged on the ground surface.
The operator shall condu ct monthly tests (or quarterlv if an on-site disinfection system is Installed) and maintain records of stored potable waler samples specific for call form bacteria.
Any tests Indicating (oli form contamination must be disclosed to the Garfield County Board of Hea lth or designee within 72 hours from the time the contaminated water was tested. Each
Small Facility shall be maintained in a dean, 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. At least one thirty (30) galion (4 cubic feet) wildlife·
proof refuse container shall be provided for each Factory Built Non-Residential Structure unit. Said containe r(s) must be durable, washable, nonabsorbent metal or plastic with tight·fitting
lids. Fox Engineering Solutions, Inc. September 5, 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. Individual refuse containers in each office/housing structure. 6 Refuse shall be disposed of weeklv, at a minimum. Operators must
Not subject to visual inspection and certification by keep appropriate records, to be provided to t he County or any ______-t'"h"i'r"d'-party. Professional Eng!!' lJlJe~rc---___________-t
________ lnte(e~ted-third.pa R:y.upon-fequestrto-de monst(ate-lhat-re fuse_Is -7 8 9 10 11 collected in a timely fashion and disposed of at a licensed facilitv· Outdoor food storage
is prohibited. 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 dlstrict(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 electrica l fires (Class
ABC), or dry chemical, shall be located In each Factory Built NonResidential Structure and placed in accordance with applicable fire protection district and/or Colorado Division of Housing
codes. Domestic animals are prohibited at all Small Fa cilities. Page 2 of 5 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 buiit nonresidential structures. Colorado Division of Housing (CDH) compliance tags on all factory built nonresidential
structures stating compliance with nonresidental construction standards of the State of Colorado. Carbon monoxide detectors located in all factory built non-residential structures. Fire
extinguishers, Ciass ABC, observed in all structures. No domestic animals observed on-site.
RWF 11-35 Inspection WPX Energy Rocky Mountain, llC 12 13 14 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 fjre 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. 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. All required Access Permits shall
be obtained from the Garfield County Road and Bridge Department or the Colorado Department of Transportation. Fox Engineering Solutions, Inc. September 5,2013 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. -----~lS---fhe·Garfiefd_eountyShertfrS"OfftcecmdTetevantflrellrotection'------,N""oT!-s"u"b"j"e"c!OT!o..-.V"I'S"U=arl" m"s"p"e"c"!'"lo""n'
a"n"d"'c"'e'"'rtiflcatlon y district(s) shall be notified and provided with all documentation as third party Professional Engineer. 16 17 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 dlstrict{s) shall be notified either by hardcopy 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. 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. 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. Page 3 of 5 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.S0S D. 3. of
the Garfield County land Use Code of 200S, as amended, that are subject to visual inspection.
RWF 11-35 Inspection WPX Energy Rocky MOllntain, llC 18 19(a) 19(a)(1) 19(a)(2) 19(b) The Operator shall 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 GP$ 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. 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 FaCil ity. In addition, all vault systems shall be equipped with an overflow alarm device. Vault systems shall be deSigned
to accommodate a minimum of 7S gallons of wastewater per person per day. If a vault system is proposed or has been approved, the Operator must: Demonstrate that year-round vehicular
access Is available and maintained for safe and regular access for sewage hauling vehicles. 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. Individual Sewage Disposal System (1505): If an 1505 Is Facility (eight or less
Individuals) and shall otherwise be permitted and operated in accordance with the Garfield County ISDS regulations as contained In BOeC Resolution Number 1994H-136. proposed, then it
shall be designed, installed 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 1505 regulations as contained in Boee Resolution Number 1994H-136. Page 4 of 5 Fox Engineering Solutions, Inc. September 5, 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 11-35 Inspection Fox Engineering Solutions, Inc. WPX Energy Rocky Mountain, LLC September 5, 2013 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, subject to and limited to visual inspections items as Identified above; set forth In Article 7-808 (0) (3) of the Unified Land Use
Resolution of 2008, for Garfield County, Colorado. PE Certification Number: No. 25420 (Colorado PE Stamp Date of Inspection: September 5, 2013 Print Name and Title: David J. Fox, Principal
Engineer Signature: ~.~ ( vi h Page 5 of 5
WPX Energy Rocky Mountain LLC RWF11-35 Well Pad Directions to Site' _.l~ 1: ~.~.A'IH'" Ill" ----cc -----. Or 1 --.0, ------l,0 /' -----... /! ~-=.-:.~.~~f_...(:-< k • '.---.o"~.::: ..
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970-285-93n Doug McAd:Im. WPX Drilling 910-61 8-1340 con Soott Brody-WPX OrIIIIf'log Sup. 970-271).9187 Cell KovIn Mr;Oormon·WPX SIIloty-97Q.309.11!1S COli lQI'kMumby-Spil Contr:1C1Of-910-260-1576
Con Onll Rig& 1. WO~lowotor Abovoground Tonk (4000 gol.) 2 .?otnblo Wnler AlxwCl'Oll'OUnd Took (4000 gol) 3. Portoblo Toilet=. 4.W!klltlo.prool dump"..tor S.Coinp<Iny M:m otfocolHOldng
6.0rIfI0(,Onh:c/HOu:llng 7."" • SubiO'd to ro~!loo fOf eo<I$truetk)n (lCllvI\io" W&P,X.,E..N ERGY. ,j.... N<lles.: Tho well p:!d sito is .0C3tcd In tho NW 1/4 NW 114 of Section 35, T65
. R94W. 6th P .M . (NA083N39.48S8° W107.860SO) The slle wliliomporarily office ond house on 3ver.Jge of four Indlvldu.:lls dunng nntural gns dnlling nctlvlUos nnd I~ expected to bo completed
In one ye:lr or loss. Tho Indlvldu:lls will occupy Ihroo Indlvldunl tr:lllor officos/houses located on tho well p3d. Offlcc/housos htNO COIOr.ldo Oivislon of Housing complinncc bgs.
Ono nboveground stNr.Igo holding bnk with 4~nllon C3p:lclty OI"I-sllo. Sewage n~ estlmatod to be 300 g:lllonslday (4 Ir'ldMdU:lls x 75 gpccl). Scwngo holding bnk noeds to bo omptled
approximately overy 13.3 dnys (4000 g:lllons 1300 90110ns por day). Wastewator voult oqulppod with ovorflow olnrm dovlco. WPXEnorgy utilizes the services of :llleonscd contrnctor to
removo .:::and h.:::aul the IY:lstOW:ltor to:l St:llo certified lte.:::atmontidispoS:l1 f:lcility. One pobble aboveground IY:lter I3nk of .:::approxlmatoly 4000 g.:::alLons eop,xlty
on·slto. Pobble water demand Is cstlmated 10 be 300 gallons/day (4 Individuals x 75 gpcd). Roquirod minimum fire suppression demand is 2500 gallons. TObl pebblo :lnd fire suppression
voIumo required Is estimated to be 4000 gnllons. Wnter supply npponfS :ldoqu.:::ato with 4000 g.:::allons of stor.lge with refills scheduled at 5 d:lY InteNnls. Ory hydronts observed
on wnter t.lnk. Rood nccoss to the slto Is m:llnblnod yellr-round through the services of priv.:::ato road maintonnnco .:::and construction contr.:::actofS . B3se mapping by BookclitTSurvey
Services, Inc. Silo fe:ltures including hoUSing trollers, IY:lter and wastewater t:mks, portablo lollets 3nd dumpst« were field located. Plense note th.:lt this Is a construcllon site
and thot thO locations of dnll equlpmont:lnd other Itoms are subJoct to chonge. F .. ctory-6uilt Nonresidential Structures (OfficclHeuslng) havo 0 minimum scp.:::arotion diSbnce of 40
ft . RWF11-35 Site Plan Garfield County, Colorado Small Temporary Employee Housing and SeptiC Permit Application ApplicantWPXEnergy Rocky Mountain LLC 0~10: 5eptOmbor S. 2013 Cneeked:
DJF Fox Engineering Solutions, tnc. 670 C:l1l'fOII Clock Orlvo. Gr.l1>d J\lf'CIlon. co 81507 Ph: (970) 250-5505 I F:tx; (G2G) 184-0667 Ema~ eoiOttldQfox€t brot M n.1'IO!. ver-.Jo...:
001
GARFIELD COUNTY BUILDING AND PLANNING DEPARTMENT FEE SCHEDULE Garfield County, pursuant to Board of County Commissioners ("Board") Resolution No. 98-09, 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. l\ctualSlaff Ime 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 /Conservation Subdivision 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 Preliminary Plan Amendment
$325 Final Plat $200 Final Plat Amendment! Correction Plat $100 Combined Preliminary Plan and Final Plat $1,075 Minor Exemption /Amendment $300 /$300 Major Exemption /Amendment $400
/$300 Rural Land Development Option Exemption /Amendment $400 /$300 ----·GeAefal~AemiAistriltiv~Perfflit ~2-§l}---------------1 Floodplain Development Permit $400 Pipeline Development
Plan /Amendment $400/$300 Small Temporary Employee Housing $50 Minor Temporary Employee Housing $250 Limited Impact Review /Amendment $400 /$300 Major Impact Review /Amendment $525 /$400
Rezoning: Text Amendment $300 Rezoning: Zone District Amendment $450 Planned Unit Development (PUD) /Amendment $500/$300 Comprehensive Plan Amendment $450 Variance $250 Interpretation
$250 Takings Determination NO FEE Planning Staff Hourly Rate • Planning Director • Senior Planner • Planning Technician • Secretary $50.50 $40.50 $33.75 $30.00 County Surveyor Review
Fee (includes review of Amended Determined by Surveyor$ Plats, Final Plats, Exemption Plats) $ 1 1 M y I a r R e cor din g Fee sl $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 -------appliGati0n, SUGR-G0sts-will-be--b0rne-by-the-applicant-and-paid
-priof_to_tbe_finalI-_ ____ 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 11-35 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 Ibe-Base-£ee.-shall-be-it'l-8dditiot'l-to
-8t'1d-exclysive-Qf-any-cQsl-fer-publiGatioA-oF'------i 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. ORIZED REPRESENTATIVE) Date Bl'yan S. Hotal'd Print Name WPX Enel'gy Rocky Mountain, LLC Mailing Address: PO Box 370, Pal'achute, CO 81635 Page
4
From: To: Cc: Subject: Oate: Attachments: t>1eil, Kris "ljm Sears" Reed Gary RWF 11-35 Rig '·love On Notification Friday, September 06, 2013 1: 15:00 Pt.l BWf 11 -35 Sheriff pdf I am
notifying you on the attached pad locations we will be commencing drill ing operations in the next few days and these operations will continue for approximately 32 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 loca ted in Sec 35 -T6S R94W. Attached please find a map with directions
to the pad layout and emergency contact information. Should you have any questions please let me know. Thanks, Kris Meil ------------~WPX-E"n'e~~~y.---------------------------------------------------
--------------------------+ Planning FDA III 1058 County Road 215 Parachute, CO 81635 (970) 285-9377 , 2209 (970) 623-6583 ce ll krjs mejl@WpXFnergycom WPXENERGY
WPX WPX Energy 1058 County Road 215 P.O. Box 370 Parachute, Colorado 81635 (970) 285-9377 9/6/13 Garfield County Sheriffs Office Emergency Operations Attn: Jim Sears 108 8'h Street Glenwood
Springs, CO 8160 I Ph: 970-945-0453 RE: Emergency Response Notification RWF 11-35 pad Dear Jim: This letter is to inform the Garfield County Sheriffs 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
60 days. In accordance with Garfield County Plalming and Zoning Regulations, the attached documentation provides emergency response information and driving directions for the WPX RWF
11-35 pad. Should you have any further questions or concerns regarding this notification, feel free to contact me at (970)263-6583. Sincerely, ~A~~ Kris Meil Planning Coordinator -Piceance
District Kris.meil@wpxenergy.com
WPX Energy Rocky Mountain LLC RWF11-35 Well Pad 0ifN'H'C J/ICA<.I' IN"" ,1HQ/_2<I(1IJ'Ur N::ct~~~ '_THC~ellONor~"Tt_"V'NilJcotJII(TO'NW)~ (~IIOAOI_Tlror~....oetl:O llCIVn<JU.y III,.ONQCOUHTY
MC;W) = (M.V)OH l00000) .'.t IM.C TO THC t<I~C'11OH ""'" OOI.tIT'I' NW) JOIIlfOI,A.ItO!< ~ ~~O\.UT "»I~TDa.Y_eTlD"I.UIoll..l:~lOT>C NI't~CIIOOI""""t:D.IKfT_:a:o ~, ou..o<I 1IICWI!.1"IIOXtP'f)_
.. _rI&rtN.V_CIIOOI., ... ..-n '00 nc ~CTIOH """" a:ucTY1IC\OO :In.~_,,,",..,.,,...: .... Ytal<l:C. ..:: . . tO"""lL~""""Q!fI_Vl:~MOoII,~u;I'l""" CIoITC .... y~eTIOO< -e, • ....uTOl'IC_
'Io3/JDllUt'K)~oa.1lON,MJIHO\MoI"'M_ Directions to Site: _. l~ r.1I,'f:. IIHI>' Ct: __ -e;: -1 <>: -c<_ ...-r ,;.-.-=~~-~~--~~:;:..~ //! .=:-::::~-,-, .' ~-<o~S~:,,::..\~ __ ; '-"-...
<:y-", ~----::-,< . .... =~3..; .y. \..."lo: ~ ___ y =-"-i... ~=::", t \ ~ h... _~ ' .... d""""-';"-.J //I J -.......... ..::-t-. I. J ( Emergency Contact L ist' WP'X0ffic.0 (24 Hili)
970-285-9377 Doug Mc!Idnm-WPX DrlIHng 97().618-7:w<l CIlII Scott emd~·WPX Orlilino Sup-970·271).9181 Coil KIMn McOorrno!t·WPX Snroty-97O.J09-1195 Coli 101:1'" Mumby-Spill COnItXtOr·
97(}'260-1576 CoIl A~xi{n.lte Orin Rig & ; /• W3~CW:llor ~ Tonk (4000 QOI.) Pot:IbJeW,.M ..O.r. Abovoground T3fIIc (-4000",,1) OOeoJHouillrlg roloe:ltlGn for oon:olNdlon J)Imes; WPXENERGY,
t5 Tho well p::.d slto Is I~tod In tho NW 1/4 NW 1/4 of Section 35, T6S, R94W, 6th P.M. (NA,D83N39.4858" W107.860se) The site will temporarily office:.'lnd house:.'ln 3~rage of four
Individu:.'lls during natural gas drilling actlvilies and Is expecled to be completed In one year or loss. Tho Individuals will occupy threo Indlvldu:l1 tmllor offices/housos loc.:Iled
on the well iXId. OffiColhousos havo Colomdo Division of Housing compliance tog,. One aboveground sewage holding bnk with 40Q0..g:.'llion C:lpaclty on-silO. Sowage flom estimated 10
be 300 gallonsld<ly (4 Individuals x 75 gptd) . Sow.lge holding bnk needs to be emptied o.pproxlm::IIOIy every 13.3 dClYS (4000 9:.'10ons 1300 93110ns per d:.'lY). WtlSICW3!er v,:)ult
~Ipped with overllow 31.;:lrm devico. WPXEncrgy utitlzeslt!o $Crvices of 3 licensed conlrxtor 10 romovo and haul the wastowater to a SUlto ccrtified tr03tmcnVdispos.:ll fadtity. One
pot:lble :::Iboveground water tank of :.'IpproxlmCltely 4000 g:.'liions c:lpaeity on-slto. Pottlbio water dorrond Is ostim:.'lled to be 300 gallonsidClY (4 IndlvidU:Jls x 75 gped). Roqulred
minimum nro suppression demand Is 2500 g:.'liions. TOI3I pebble '::lOd fire suppression volumo roc;uired is estim:::lted to be 4000 g:::lllons. W:ltcr supply :lPPO:::lrs :::Idoquate
with 4000 gallons of storage with refills scheduled :.'It 5 d:::lY Inlerv3ls. Dry hydmnts observed on w3ter bnk. Road access to tho silo Is m3lnblncd year-round through Inc services
of privato ro:::ld m.:llntenance cnd construction contractors. B:.'lSfl m:.'lpplng by BookcliffSurvey Services, Inc. Site features Including housing trailers, W:ltor and wostew:lter
t:.'lnks, portable toilets and dumpslCf' wore flOid loc.:ltod. P1e3SO note th:.'lt this Is 3. construction site and thot the locations of drill equlpmont :lOd other Items :::Iro subJcct
to chango. F:::Ictory-Bulit Nonrosldentl:::ll Structures (OfficelHouslngl havo:.'l minimum 5eP')mtion dist:.'loce of 40: ft . RWF 11-35 Site Plan Garfield County, Colorado Small Temporary
Employee Housing and Septic Permit Application Applicant:WPXEnergy Rocky Mountain LLC O~to: ~:;,201 3 Chedced: OJF Fox Engineering Solutions, Inc. 610 c..nyotI Crook 0rtY0. GrIme! J~I'IdIon.
CO 111501 Ph: (970) 25Q.5S051 F3lC (6$) 784-0667 EmtlH eolor:lclofox@btoul3n.not V~n: 001
From: To: Cc: Subject: Date: Attachments: Meil, Kris "kevin whelan@crfr us" Reed Gary RWF 11·35 Rig t>1ove On Notification· Fire District & County Friday, September 06,2013 1:14:00 Pt>1
BWF 11· 3S Fire pdf I am notifying you on the attached pad locations we will be commencing drilling operations in the next few days and these operations wi ll con tinue for approximately
32 days. At which time I wi ll notify you of the removal of the employee housing. This notification is per the GARCO regulations for our pad located in Sec 35 -T6S R94W. Attached please
find a map with directions to the pad layout and emergency contact information. Should you have any questions please let me know. Thanks, Krls Mell --------jWPX-En-erw--------------------------------
---------1' Planning FDA III 1058 County Road 215 Parachute, CO 81635 1970) 285-9377 x2209 (970) 623·6583 cell krjs mejl@WPXEnergy com WPXENERGY
WPX WPX Energy 1058 County Road 215 P.O. Box 370 Parachute, Colorado 81635 (970) 285-9377 9/6/13 Colorado River Fire Rescue Emergency Operations Attn: Kevin Whelan 1850 Railroad Ave
Rifle, CO 81650 Ph: 970-625-1243 RE: Emergency Response Notification RWF 11-35 pad Dear Kevin: This letter is to inform the Colorado River Fire Rescue 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 60 days. In accordance
with Garfield County Planning and Zoning Regulations, the attached documentation provides emergency response information and driving directions for the WPX RWF 11-35 pad. Should you
have any further questions or concerns regarding this notification, feel free to contact me at (970)263-6583. Sincerely, ~A~~ Kris Meil Planning Coordinator -Piceance District Kris.meil@wpxenergy.com
WPX Energy Rocky Mountain LLC RWF 11-35 Well Pad ..ccc:;:;~ _1CI'If",,"n flNO< .. ;!fI()C~r ~TIC..m:ot:;Co;T1ONor:iT"'1"t_ ... _COUNT'fI'llCWl,);,)~IW)ooo\lI~'Ot'~..-oc:a: o ~Y~ODI.OI
... ~:w~JIOtoOl , '. '''''TOTICNT~ION '''''''a:'IUNlVAC)oD lIII(JIUU!;ON ~ ~~ ~tO LD'T .. N' !W;T[IIL Y OftCCTII:)OIou....c; ~o T>C ~e1Dl wm< C:Q.NT'Y I!QOoO ~ IIII'\~ IU.moN MloOD).
P'IIOI;I':rD_ ...... rM'TD'l. ... IIIVCTlOOI ., .. .....,;s 'r'O 'rHI: """"~eT1()N _ CXlUNT't JI(I,o,I) ~ ~_t"A:K>Utlll: ....... o.a.:C1 _ 10,.,. .. tUI:.4~ ... , .. ~g,I'''-''~~MOoIoU
• .....o<;:uD~T''''''' a.=n:IILY_CCTliON -C,. IAUTOTlCrtNI' .\o3/lOlllU. r~Loco.TION.A:I ~ >tC~(ON. Directions to Site · ~."" 7.".~.Il'H'" //' \...--=-"--. t L ~=:"" ",. ---", --. ,
\ l 1""--'0, r ! ~~.~;U' "-.... ~ I ( ! ... =>.J /--. ...:1-~---1----' ) /( Emergency Contact List' WPX Offlco {24 Hr:I) 970-285-93n 00ugMeAd:m. WPX Drilling 970-616-1340 Cell Scott
Brody.. WPX OrllIIng Suj)-970-27()'91 81 ColI Kovin McOonnoI!. WPX Solof'(. 970-309-1195 Coli M.-.orlt Murroy. Spill Contr:ldOO'-970-2GO-1576 Coli ltl ... nl lfl" ,,'inn ,. I ..... "'1""
K ....... 1. W4~lowDtor AtXlVogroood TOnk (4000 got) 2 .?Obbk! WOIOt Aboveground Tonk {4000 1l~1) 3 . Portoblo Tollcl5 4 . Wlkjljlo-ptOOl durnpG!O< 5.~ny 1.1.:1" OtrICOlHOIdng G.OtIIk!t'!I
omcc/Houslr>g 7."'" • SubjO'Ct to roToell!lot1 lor eon=tn.Idlon 4C1[1'It1o~. Nates; WP.X-E NERGY• Tho woll pad silO is located In tho NW 1/4 NW 1/4 of Scetion 35. T6S. R94W. 6th P.M.
(NA083N39.48S8° W107.860S") Tho site will tempornrily office :md house an avcrtlgo of four Individuals during natural gas drilling :lctlvlties and Is expected to be comploted In one
year or loss. Tho IndiVIduals will occupy throo Indlvlduol Imllor offico5lhouses locoted on tho wall ~d . Officclhouscs h::\vo CoIor:ldo DiviSion of Housing complklnco t::lgs. One aboVeground
5eW:lgo holding t.:)nk with 4000-gn11on C:Jp::Iclty on-sito. Sowago flows estim;:ltod to be 300 gallon~d3y (4 Indlvldu.:lls x 75 gpcd). Sewago holding tonk noeds to be omptied approxlmatoly
ovory 13.3 days (4000 gallons 1300 gallons per day). Wastew.:'lter v:lU lt equipped with overflow al .. rm dovico. WPXEnorgy utllizos tho sOlViccs of 03 llconsod contr:lctor 10 removo
;:Ind h:lul tho W:lstew;:ltor to;:l St::lto ccrtlficd treotmcntJdisposal facility. Orle potable oboveground W:lter t.:)nk of approxlm:ltoly 4000 gallons C:Jpacity on-site. Potoble walor
dOlMnd Is estimated 10 be 300 gatlonslt13y (4 Indivlduols x 7S gpcd). Required minimum fore suppressiOn domond is 2500 g03"ons. Totol potable and firc ~pprcsslon volume reQuired Is ostim:llcd
to be 4000 gonons. Wotcr supply appcors odOQuato with 4000 g:Jllons of storago with refills SCheduled ot S d:lY IntOMlls. Dry hydrants observed on w:Jler t::lnk. Road .!lCCOSS to tho
slto Is maintained year-round through tho selVicos of priv:Jle road m:Jlnten.::mco lind const!1Jction contractors . Base mopping by BookdiffSurvey Services, Inc. Sito features induding
housing trailers. waler .:'Ind wasteW:lter t.:)nks. portable tollets:lnd dumpster were field locoted. PIc:l50 noto that this IS:l constnJction slle and th:JI the locotlons of drill OQulpmont
Md OIMr Itoms :lro subject to change. F:lctory-Suill Nonresldonti:J1 Siruetures (Ofr.cc/Housing) hovo :J minimum scpor:ltion distance of 40 ft. RWF 11-35 Site Plan Garfield County, Colorado
Small Temporary Employee Housing and SeptiC Permit Application Applicant:WPXEnergy Rocky MOuntain LLC O~t(l: $opt(lmbof 5. 2013 Cl"ICCked: OJF Fox Engineering Solutions, Inc. 670 ClInyon
Crook DfMl. Gr:u~ Junction. CO 81507 Ph: (970) 250-5505 f f~1t: (626l 1~7 Ema~ co1orooofox l!l'b,,y..n.:lIl.not Ve~rI: 001
Section 35 7: 6 s., R 94 W " ,~ , , , " " '. ) " " I' I , 'NOTE: o 80 j , GRAPHIC SCALE IN FEET liNCH a 80 FEET _-:;~ ..o :::-------E,'(i sl. Pipeline (OyOthers) , , , , '--1.) 10% Swell
Factor Applied to Cui Volume. 2.) Topsoil Depth Based on 12-Soil Depth. 3.) Total Disturbed Area = 3.05 ac. I ~~==~==~==~======-~~~=--'~~~~~~~WPXENERG~ SCAL£, WPX Energy Rocky Mountain,
LLC 13G east '11Ifrd SInd Rifle. Colomdo 81650 Ph. (970) 625·2720 ,.'ax (970) 625·2773 DATE: PLAT: PROJECT: DFT: RWF 11-35 Drill Pad -Plat 2 CONSTRUCTION LAYOUT
•"~ , s~ Sec/ioll 3S r. 6 S., R94 IV ACCESS DESCRIPTION: 1000 a 2000 """----GRAPHIC SCALE IN FEET liNCH = 2000FEET ! FROM THE INTERSECTION OF STATE HIGHWAY 6 AND COUNTY ROAD 323 (RULISON
ROAD) NORTH OF RULISON, PROCEED SOUTHERLY ALONG COUNTY ROAD 323 (RULISON ROAD) '1.1 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 .2.4 MILES TO THE INTERSECTION WITH COUNTY ROAD 325, PROCEED
RIGHT IN A SOUTHERLY DIRECTION TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD, PROCEED LEFT IN AN EASTERLY DIRECTION .0.1 MILES TO THE RWF 11-35 DRILL PAD LOCATION, AS SHOWN HEREON. f I
~ 1~-= ___________ ~ _ ~ _____ --r~~ticffi~nPJ~red~ ~ SCALE: WPXENERGY WPX E R k M t' LLC 136 & sl 7blrd Sl1'r'el nergy ac Y Dun am, ~ Rifle, Colorodo 81650 DATE: j~ PlL (970) 625-2720
PLAT: f'ax (970) 625 -2773 ~ L!;;;==;;;;;;:= PROJECT: DFT: RWF 11-35 Dn'll Pad -Plat 5 ACCESS ROAD & TOPO MAP
August G, 2013 Mr. Fred Jarman, Director Garfield County Building and Planning Department 108 8'" Street, 4'" Floor Glenwood Springs, CO 81 GO 1 RE: RWF 11-35, RWF 23-25, RWF 43-25 Drilling
Pad Locations, Garfield County, Colorado Deal' Mr. Jarman: This letter authorizes WPX Energy Rocky Mountain, LLC to represent me in the submittal and pl'Ocessing of thc required Gmfield
County Small Temporary Employee Housing (STEH) and Individual Sewage Disposal System (IS OS) permits on the above drilling pad locations. //~' ;r; ;:; 1;::,~ Name: 11./f A 1-1-< it-T
Title: __________ _
LIMITED POWER OF ATTORNEY WPX ENERGY ROCKY MOUNTAIN, LLC ("Company") a Delaware limited liabilily company, baving its principal place ofbusincss in the City of Tulsa, County of Tulsa,
State of Oklahoma, does hercby make, constitute aad appoint Bryan S. Hotard wilh the full authority hereinafter provided, the tme and lawful Attollley-in-Faet 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 propcrty or real estate rights of the Company as more specifically
set forth below: : I. 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 HOllsing, Major Impact Reviews, Limited Impact Reviews, Oil alld Gas well permitting, Driveway Access, COlUlty Road Maintenance, Temporary Living Quarters,
Temporary Usc Pcrnli1s, Surface Use Petmits, Surface Usc Licenses, Utilities, Snow Removal nnd Private Constmction of County Roads; 2. Agreements and other documentation that grant easements,
rights of way, licenses, or pennit. to Company and also instmment. where the Compnny grants suell rights to others; 3. Agreements that assign easements, rights of way: licenses, permits
or surt:1ce leases in connection with the Company's operations; 4. Relenses and Partial Releases of easements nnd rights of way; 5. Agreements allowing encroachments onto easements and
rights of way owned by Company and landowner instruments and conveyances on others casements; 6. Agreements subordinating mortgage rights to easement or lease; 7. Agreements relating
to the modification and relocation of Company faciliti es; 8. Rental or lease agreements for surface use or other surface use agreements and all notices related to the pipeline agreements;
9. Agreements for the purchase or sale ofreal property nnd for the lease of real property for residential or commercial purposes or otherwise iu connection with the Company's operntions;
10. Agreements to obtain water selvices, electrical, gas or oil services or the provision of other utility services utilized by Company's facilities; 11. Agreements modifying, amending,
renewing, extending, ratifying forfeiting, canceling and temunating nny nnd nil of the aforementioned Iypes of instmments and documents. WPX ENERGY ROCKY MOUNTAIN, LLC hereby declares
that eneh and every act, matter and thing which shnll he given, made and done by Bryan S. Hotard in connection with the exercise of any or all of the nforesnid powers shnll be as good,
valid and effectual to all intents and purposes as if the same had bcen given, made and done by WPX Energy Rocky Mountain, LLC in its limited liability company presence and it hereby
ratifies whatsoever Attorney-ill-Fact shall lawfully do or cause to be done by virtue hereof. This Limited Power of Attomey shall remain in full force and effect until terminated by
Company.
• 1111 ~'I~.I'IAII'IIl',rIIIY,r!rllllol~l~rf+l~lrto:IWlI'~.~'~ 11111 Reoeption": B15004 02127/2012 12= 19: 10 PI1 J .. n nlberloQ 2 of 2 Re<l Foe:$16.IlO I>oQ Foo;O.OO <>ARFIELO COU:fTY
CO IN WITNESS WHEREOF, WPX Encrgy Rocky Mountain, LLC has cau,ed this Limited Power of AUomey to he signed hy onc of its Vice Presidents, duly authorized by its Management Committee
to grant powers ofattomey tbis 1" day of January, 2012. TAIN, LLC ACI(NOWLEDGMENT STA Til OF OKLAHOMA ) ) ss. COUNTY OF TULSA ) BEFORE ME, the lmdersigned authority, a Notary Public
in and for said County and State, on thi, day personally appeared, Jerry D. Barnes personally known to me to be the Vice President of WPX Energy Rocky Mountain, LLC a Delaware limited
liability company, who acknowledged to me that he has executed the above LIMITED POWER OF A TIORNEY authorized by Company's Managemeut Committee. 1--'.LlLl...Lt,.LbU<LU<L¥I--->...L:-J-'f---'<)-'1
OJJc Notary Public My Commission Expires: 1 -Z 3-2-()/1--f After Recordation Please Return To: WPX Energy Rocky Mountiall, LLC Attn: Land Dept. POllox 370 Parachute, CO 81635 2