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 -Submll1 paper & 1 CD copy of the completed application to Planning Department wl;n 48 hours following occupation
(To be completed by the Small Facility Operator -e.g. well pad operator) SectionfTownship/Range Location of Housing Site: Sec 4 -T7S -R94W Well Pad Number: RMV 108-4 Tax Parcel Number
for Parcel Containing Housing Site: 2405-042-00-071 GPS andlor Lat-Long Coordinates of Housing Facility Site (Often included in APD): Lat: 39.473370 Long: -107.88865 Maximum Number of
Occupants at Zone District: Rural Pennitted Site (e.g. well pad): less than 8 ----./-Cumulative Amount of-Time-(i'" Qays} The F-acility Willl:Je at Location: 109 days State or Federal
Pcnuitting Agency Overseeing Reclamation, Restoration and Revegetation and Relevant Permit Number: 0504507194 Date of Installation: 9/12/13 Date of Removal: 12/26/13 Name of Landowner:
WPX Energy Street Address: PO Box 370 City: Parachute Telephone: 970-285-9377 State: CO Email: Zip Code: 81635 Name of Operator's Compliance 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 nerav.com Zip Code: 81635 Company 24-Hour Emergency Contact:
WPX Energy Rocky Mountain, LLC Phone Number: 970-285-9377 ThisAdminisirafive Checklist must be received by the Gatfield County Planning Department within 48 hours following occupancy
of the Small Facility. A copy of this completed Administrative Checklist and all associated submittals shall be. de. livered to the Garlield County Sheriffs Office and relevant Fire
Protection District (if wllhm 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 ofthe Small Facility. II been received
by responsibility to confirm and obtain verification that the Administrative Checklist has 1 STEH-9-13-7712
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: 500BBLI 21,000 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. 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 (0)(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 otrlrzatinn-peTio'd~all-stmcture s~oundatio
n s-a ndassociated 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: 354085522 Manufacture Year: 2008 Size of Unit (Square Feet): 14X56 Unit 2 Make:
ATCO Structures (USA) Inc Serial Number or Unit 10 Number: 354063605 Manufacture Year: 2007 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-8-13-2961 //L _ /L Signature of Operator's Compliance _5 : ~AJ Officer: ( By signing this form, I verify that all
information provided!iJ/this checklist is correct and accurate to the best of my knowledge) Print Name: S. Hotard Title: Attorney-In-Fact 4
Eligibility, Submittal and Petformance Standards Certification Section 7-808(0)(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 (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 (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 _________
sprjokleLS,ysJem, fire detection s~stem, 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. 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 _________ LatitudeLLongitude-.C_o_Q[dinale.s);---.reievant
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 reg ul ations 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 (0) (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 ri n t N a me: _..!:B~r...ly~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: Oavid Fox of Fox Engineering Solutions Signature See Form 8
GARFIELD COUNTY BUILDING AND PLANNING DEPARTMENT FEE SCHEDULE Garfield County, pursuant to Board of County Commissioners ("Board") Resolution No. 98-Q9, 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 /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 General Administrative Permit $-250,--------------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 Mylar Recording Fee 51 $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 _____________ _ RMV 108·4 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 cosnor 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 RIZED REPRESENTATIVE) Date Bryan S. Hotard Print Name WPX Enel'gy Rocky Mountain, LLC Mailing Address: PO Box 370, Parachute, CO 81635 Page 4
:; 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: RMV 108-4
Small Temporary Employee Housing Client: WPX Energy Rocky Mountain, LLC Location: Conducted By: NW 1/4 NE 1/4 of Section 4, T7S, R94W, 6th P.M. Garfield County David Fox, P.E. Date Conducted:
September 12, 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 C.R.S. 24-32-3302(a)] but NOT recreational vehicles (as
defined under CR.S. 42-1-102 (61), Including Company trailer, Unit 10.354085522 with _______ -1ruck,-truc:k.tractor,-motor..home.ot..cam per_traller.J, may bauUllzedl ____ -'-Cer-tification.No_190,43
,-manufactured.by_AT£O ____ -/3.a.(1) 3.a.(2) 3.a.(3) 1 2 for housing of workers on projects related to commercial, Industrial, Structures in 2008; and the WPX Staff trailer, Unit 10
mineral ext raction or highway operations, pursuant to the standa rds for Small Facili ties contained in subsection (2), below. Such facilities 358074402, Certification No. 20566 by
ATca are not subject to Garfield County building and fire codes (building Structures USA in 2007 and Driller's trailer, Unit 10. code, fire code). However, Small Facilities are subject
to all pertinent 354063605 with Certification No. 21939, state (I.e. electrical permits), federal permits and relevant fire protection dlstrict{s) code requirements. manufactured by
AlCO Structures in 2006. All 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 ((OGCC) approved oil/gas 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 ut1l1zation period, all structures. foundations and associated Infrastructure are completely
removed; and, 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 onsile safety of the related commercial, Industrial, extraction or highway operation. Small Facility must comply with all applicable federal, stale and local laws and regulations.
The Small Fac1l1ty shall NOT contain recreational vehicles as defined In Sect/on 7-808 (0). Page 1 of 5 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.
RMV 108·8 Inspection WPX Energy Rocky Mountain, llC 3 4 5 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. 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. 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 container(s) must be durable, washable, nonabsorbent metal or plastic with tight-fitting
lids. Fox Engineering Solutions, Inc. September 12, 2013 Two potable water tanks of approximately 8000 gallons and two 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 weekly, at a minimum. Operators must
Not subject to visual inspection and certification by ---------lkeep-appropriate·records;10·be·provided1o1he~ounty.or-anY~-----"th'-i'-r'd'-p-a":r"t-y-P=-ro-f·e-s-s7io-n-a'I '=E-n-g7in-e-e-r.--------
'----Interested third party upon request, to demonstrate that refuse is 7 8 9 10 11 collected in a timely fashion and disposed of at a licensed facility. 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 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 Uqulds, combustible materials and electrical 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 Facilities. 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 built nonresidential 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 detectors located in all factory built non·residential structures. Fire extinguishers,
Class ABC, observed in all structures. No domestic animals observed on·site.
RMV 108-8 Inspection WPX Energy Rocky Mountain, LLC 12 13 14 15 16 17 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 in itial 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. 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 requ ired
Access Permits shall be obtained from the Garfield County Road and Bridge Department or the Colorado Department of Transportation. 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 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 Fox Engineering Solutions, Inc. September 12, 2013 Two potable aboveground water tank of approximately SOOO 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 SOOO gallons. Water supply appears adequate with 5500 gallons of storage with refills scheduled at lS-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.S0S D. 3. of the Garfield County Land Use Code of 200S, as amended,
that are subject to visual inspection.
RMV 108-8 Inspection WPX Energy Rocky Mountain, 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 GPS coordinates or latitude/longitude coordinates); relevant lOne district;
maximum number of occupants; cumulative amount of time (in days) that the Small facility will be at the specified loc3tion; 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 CompHance 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 Facility. 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 1505 regulations as contained in BOCC 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 tess Individuals) and shall otherwise be permitted
and operated in accordance with the Garfield County ISOS regulations as contained in BOCC Resolution Number 1994H-136. Page 4 of 5 Fox Engineering Solutions, Inc. September 12, 2013
Not subject to visual inspection and certification by third party Professional Engineer. Two aboveground sewage holding tank with 8000-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 26.7 days (8000 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.
'. RMV 108·8 Inspection Fox Engineering Solutions, Inc. WPX Energy Rocky Mountain, LLC September 12, 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 asldentijied 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 (Colorado Date of Inspection: September 12, 2013 Print Name and Title: David J. Fox, ~rin~ngineer
Signature: 0-41 T,«" I ) It ., ',,: .. Page 5 of 5
WPX Energy Rocky Mountain LLC RMV 108-4 Well Pad Directions to Site-.'h'f_~ T.T,". Ir. ww . ..!. ---=~ r -·-/.. rI ------------l 'l' Ii cl: :::"""' .....t ,~ ' _ · .. 1Uf I \ Appro,'m,"
0"" R. \ Eq"pm,,' A", c_4iot~~ I""I~"'J ~\ , \ I ,,i I In; IJ] /Q I 1. W~!C"N:llor Abovoground Tonk (4000 Q:'II.) 2. P~ W:>w. AbovcgroutId T,YI~ (4000 gtII) to roloc.otJon lor COMUuetlon
oetivlU03. llill= WPXENERGY. w::. Tho well pad slto Is located In tho NW 1/4 NE 1/4 of Soctkln 4, T7S. R94W, 6th P.M. (NAD83 N39.4733· W107.~ Tho sito wililompor:lrily office :md house
.::m :lVO'-lgO of four individuClis durin\; nOiur:;l.1 g:ls drilling 3ctrvities and is expected to be completed in ono yo.:.r or less. The ind! ... idU:lls will occupy throe Individual
tr.:Jllor offices/houses located on the wOIl pod. Offlcclhouscs huvo Colorado Division of Housing compllonco togs. Two :ibovoground sowogc holdi~ t:mks with 8000-g:lllon c:lp.:lcity
on-sito. Sew.,ge flows estimated to be 300 gollonsJctJy (4 irulividuals x 75 gpeel). Sew3Qe holding bnk. need~ to be emptied approximately ovory 26.7 d~s (8000 gallons 1300 gallons per
day). Wast~ter vOlJII cQl.llppccl with ov(uflow alarm device. WPXEnergy I.ltilizes the scrvk:es of.a licensed controctor to removo and h3l.lt tho wastcwatcr to a S13lo certified treatment/disposal
facility. Two pobble aboveground water 13nk of approxima:cty 8000 gallons C<lp,xity on-site. Petable water domand Is estlmated to be 300 g::allonsld3y (4 Individuals x 75 gpal). Required
minimum firo suppre-'..slon domand Is 2500 ganons. Tobl potable 3nd fire supprossiOn volume required Is estimated to bo 8000 g3nons. Watcr supply appears adequate with S500 gallons of
stor!lge with rcfiUs 5Cheduted!lt 18 d!ly intcrvals. Dry I'Iydr.lnts obscrved on watcr bnk. Ro;ld !lCCCSS to tho site Is m!lln1.:l.!ned yo::ar-round through lho services of private road
m!llntenMcc !lnd constnJctiOn contractors. B::aso m::apping by BookcliffSurvcy Services, Inc. Site fe!ltures Including housing tr:!lllers, water and w::astew:lter bnks, porbbte toilols
::lnd dumpstor were field 10000ted, Ple!l~o note th!lt this Is a construction ~llo .:md Ihal tho loc::atlons of drill equipment and othor Items are sl.lbJoct to chtJngo. Factory-Built
Nonresidential Structuros (Offico/Houslng) have.3 minimum scpOr;)tion distance of 30 Ft. RMV 108-4 Site Plan Garfield County, Colorado Small Temporary Employee Housing and Septic Permit
Application Applicant:WPXEne!'9Y Rocky Mountain LLC DDto: Soptombor 12, 2013 Choekod: OJF Fox Engineering Solutions, Inc. (170 C:myon Crock Orfvc, Gr:md Jul\CtJoo, CO 81507 F'h: (970)
25().SSOS ! F~x; (~) 784-(l667 Emoi colorodofoxCbfo~an . nol VOf1:Ioo: 001
From: To: Cc: Subject: Date: Attachments: f'.'eil, Kris ~KeYin Whelan" Seed Gary RtoW 108-4 Rig r,'ove On Notification -Fire District & County Thursday, September 12, 2013 3:32:00 Pf>,
BtoW 108-4 f ire pdf StoW 108-4 PE Certification 6 pdf 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 109 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 4 -T7S 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
Energy Planning FDA III 1058 County Road 215 Parachute, CO 81635 (970) 28S -9377 x2209 (970) 623-6583 cell kris meil@WpXEoergy 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 -----J>,h;-970-62.S-1-2~~----------------------------RE: Emergency Response Notification RMV 108-4 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 109 days. In accordance with Garfield County Planning and Zoning Regulations, the attached documentation provides emergency response information and driving directions
for the WPX RMV 108-4 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 RMV 108-4 Well Pad ..,.........,......._......." ,.,," ..ca:ISDI'"~ "-l)fCIPfTneC:Cft)OIOf':TA1"I:_"~A/C)c;.QUonYltOoOD=(MUU!;OtI1IOO.D1_0f'~....oe:r;~
lIClUntM.ooooc:oo.ntn' otC)oo,gl::lll'lA.CONlIOAO! . 1.' wu::roTl< HlaI:lC~wml~IIO'.O:lO\I ~ I'AMCIOUI( OICWl!.''''OCUOu.fl "Allu.sl[1II.Y~C1'ION~....aTQnCM~IONwm.COUf'ITY..oo.D= (1II'U:
nu.J:$OOIlIO.oD~ I'nOC!:tD _, ... .vI ~n:III." OI<I!eTIQN "'.' ....... S TO l'Mf NT1'~W!fMOOU""' IIOAO 1,.""!lII'I'II.C~CMUJC_.~OonJlfrlN"'JOU_""'"t.lM:.C"('~_~10Nl"~TIOM "'"," OIIITICMva.""""'.
~_".MmIIl"o.u:C'ID'IoA,.....uTOTIC~_,_~~..olOC':"O"l. "':;~I<CJIIC()K. Directions to Site---, T. 7 .~ . N."'~ "" --1'--,-,-/' I 1I5 i ir ---------------'II 'O~' l t 0::::""""' .....
, ~ ,-. .. ~ I I, \,,~ \-i \ I-cl-I~ 'i!~ ~.s..".~~ '~J<t""""" Emergency Contact I jst' WPX omeo (24 HrlI) 97D·21l5-9377 Doug Mi:Adom-WPX Drilling 970-618-7340 Coli Secn S,ody-WPX Drilling
Sup-97()'27{),91S7 Coil Kovln McDormoU-WPX Safoty. 970-309-1 195 COli M:lrk Mumby-Spill Contr:lctol-970-260-1576 con /,, ,, I k __ " ---I • • , \ i ,, ,,I i I!{i ~, /Jj I I d"n!lflerrt~n
& Loc~tJon KW 1. Wp~tOW:lIOf AbovogT'OlJnd Ton~ (4000 gol.) 2 . Pptnblo Wlltcr Abovogr¢ul\d TlInk (4000 gal) to rolocntlon for ccmwudlon oC!lVl~o=. WPXENERGY. IS ----'> Not= Tho well
pad slto Is lo~tod In tho NW 1/4 NE 1/4 of Secllon 4. T7S, R94W, 6th P.M. (NAD83 N39.4733° W107.88S8") Tho site will tcmpor.)rily offico :'Ind house an ;'Ivemge of four individuals during
nnluml gas drilling ::lctivitics :'Ind is expected to be completed in one yO:l.r or loss. The IndlvldU:lls will occupy three Individual tralter offices/houses located on tho woll pod.
Officolhouses h:.lVO Colol';]do Division of Housing complionco 1395 . Two :lbovoground SCW;'lgo holding t:mks with 8000-g01l0n cop.:lcity on-sito. Sewage flows ostimatod to be 300 g:ll1onslday
(4 individu.:lIs x 75 gped). Sew3ge holding tank noeds to bo omptloo :lpproxlm.)!ely every 26.7 days (8000 9;]110115 I 300 9;]110115 por day). Wostowotor voull equipped with ovorflow
<ll.)rm dovlco. WPXEncrgy utllizos tho sONlccs of a licensed controctor to remove and Mul tho wastewater to a Stato certified treOltmentldlspo~ 1 facility. Two pebble aboveground water
tank of approximately 8000 9allons ~pac;ty on-slto. Potable water demand Is estimated to be 300 gOlllonsJdo.y (4 Indlvlduo.ls x 75 gpcd). Required minimum 11m suppression dem.and Is
2500 gOllions. Total potable and firo suppression volume required Is ostlmnted to be 8000 galions. Water supply o.ppeal"S adequato with 5500 galions of storOlgo with refills SCheduled
at 18 do.y intervals. Dry hydl":mts observed on water lonk . Road access to the site Is malntllined yoo.r-round through the services of privato rood maintonance and construction contractors.
Baso mapping by BookcliffSurvcy Services, Inc. Site features including housing trailers. water and wastewllter ttlnks, portoble tellets and dumpster were field locoted. Please note thot
this Is a construction site and that the locations of drill equIpment and other Items are subject to change. Factory-Built Nonresidential Structures (OfficefHouslng) have a minimum separ;ltion
dist:lnco of 30 Ft. RMV 108-4 Site Plan Garfield County, Colorado Smail Temporary Employee Housing and SeptiC Permit Application Applicant:WPXEnergy Rocky Mountain LLC Data: Soptomoor
12. 2013 ChackO<:!: DJF Fox Engineering Solutions, Inc. 670 Ctlnyon Crook Drlvi'!. Grand Junction. CO 81507 Ph: (970) 25(1.55051 FolC: (626) 784-0667 Emo~ COloroc:!ofox@br<n:non.Mt Vorclon:
001
From: To: Cc: Subject: Date: Attachments: Neil, Kris nJ!m Spam" Reed Gary Rf'.1V 108-4 Rig t·1ove On Notification Thursday, September 12, 2013 3:37:00 Pf'.1 I am noti fying you on the
attached pad locations we will be commencing drilling operations in the next few days and these operations will continue for approximately 109 days. At which time I will notify you of
the removal of the employee housing. This notification is per the GARCO regu lations for our pad located in Sec 4 -T7S 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 Energy Planning FDA III 1058 County Road 215 Parachute, CO 81635 (970) 285-9377
x2209 (970) 623 -6583 cell his mejl@WpXEnergy com WPXENERGY
WPX WPX Energy 1058 County Road 215 P.O. Box 370 Parachute, Colorado 81635 (970) 285-9377 9/6113 Garfield County Sheriffs Office Emergency Operations Attn: Jim Sears 108 8th Street Glenwood
Springs, CO 81601 ----~J>h:_9-10~9.i1 5~O!l53 __________________________ _ RE: Emergency Response Notification RMV 108-4 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 109 days. In accordance with Garfield County Plmming and Zoning Regulations, the attached documentation provides emergency response information and driving directions
for the WPX RMV 108-4 pad. Should you have any further questions or concerns regarding this notification, feel free to contact me at (970)263-6583. Sincerely, ~A~--<-f Kris Meil Planning
Coordinator -Piceance District Kris. meil@wpxenergy.com
WPX Energy Rocky Mountain LLC RMV 108-4 Well Pad Directions to Site' -, T. T .... /l";:1r. r~~r r-------------------------+,,~"" -~ , \~ i \. ~ \ \ A",.,I,..._ Drill RI, \ E" ,,,,,,,,,,
AM, \ I ~$oor~, " ~ .... .,., Eme raencv Contact List: S70-2ss.93n 970-618-13040 Col 970-270-9187 Con COt'I!r.letOr. 970.260-1576 Con , ,I I I I I i'-~=-\ ,I fni iJJ /11 I 1t1,.nrlf).,nrln"
A. l"""llnn K .. v" 1. W:l~lor AboYegn)und Tonk (4000 0"1.) ~::X:~'::' Al)ovoground Tlri (4000gal) 4. W11c:lIlfo-proof dumpGlO' 5.~y Moo 0Iflc0IH0u'"~ 6.Do1I~(~ Oft'oecIHOI$Ig 7.WP~~
uctlvl!lo~. WPXENERGY_ e ( --~ Tho welt pad sllo islocalGd In tho t{W 1/4 NE 1/4 of Soctlon 4. T7S, R94W, 6th P.M. (NADS3N39.-4733· W107.SSSSO) Tho sito wllilompor:lrily offico and houso
:In :lYOf:lgO of four individu:lls during n.:ltur::ll 9.1$ drilling ::lctivities ::lnd is oxpo'Clod to bo completed in one ye:lf or less. Thelndlvldu::lIS will occupy throo Indlvtdu31
tf3iler offlce5fhouses loc:ltod on tho well p::ld. Officoft1ouscs MVO Colorndo Division of Housing com:;)lI:lnco bgs. Two :lbovogtound SClW:lgo holding t.::Inks with ~:llion C3pacity
on-site. Sew<lge flows estim:l!tMj to be 300 gallons/dO))' (4 individuals x 75 gpccl). Sewage holding bnk needs to be emptied opproxi!Tl3!e/y ~ 26.7 d:lYS (8000 gonons 1300 g;llloos
per d;ly). W:lStowoter voul! equipped with overllow otorm device. WPXEnergy utili~cs tho sorvlces Of ;l Ilconscd contractor to removo;lOd haul the W3s!ewnler 10 ;l Sbto cortlfiCd !roatmonVdispoS31
facility. Two pobble oboveground wotor bnk of opproximolely 8000 gollons c.::lp;lcity on-slle. Poloblo woler demand Is eSllmated 10 be 300 gollom:/dny (4 Indlvlduols x 75 gpcd). Roqulred
minimum flro suppre~lon dcm:':md Is 2500 gallons. Total potablo and flro supprossion volume roqulrod is ostimated 10 be 8000 gallons. Wolter supply nppc:m: :ldoqU.Jto with 5500 gallons
of storago with rofills scheduled:lt 1e d:ly inIOrv:l!s. Dry hydr:lnts observed on w;);tcr bnk. RO.:ld ;lCCCSS to the slto Is molnblnod YC;lr..ft)und through the SCtVicos of privato
rood maintenance nnd constnJction contractors. Boso mapping by BookcliffSurvey Services, Inc. Sito feil!ures Including housing tr3l1ers, Willer ond WOSIOW<ller tanks, portable toilets
ond dumpster were field located. Ple:lse nolo thot this Is a construction site and thot the 10C3llons of drill equipment and olhor Itoms oro subject to chongo. Factory-Built Nonrosldontl31
Structuros (Off1co/Houslng) h:lvO 0 minimum scpOlt:ltion distance of 30 Ft. RMV 108-4 Site Plan Garfield County, Colorado Small Temporary Employee Housing and SeptiC Permit Application
Applicant: WPXEnergy Rocky Mountain LlC D:o!O: $cQIombaf 12. 2013 Chockod: OJF Fox Engineering Solutions. Inc. 670 CoJnyon Creek Drtvo, Gr.:Ind Junction, CO 81507 1>11: (970) 250-55051
F(OC (fi26) 784-0067 Emll~ eoIorIlClQfox(j)tlroon:m.nol VorcIon: 001
r I \ /--.", \ + I , : ~iSI. RM<t 108-4 /" r I Extst. Pad Elav.: .1579-1.0 /I II I r 1 I I 1 ,.' B J: \ . o f1l\/1'~~". \~'-I ~ f: .'1 I~/1 ~ , 1 C W#{ C 19.8' '-I, \ , 1 ---..... ,
\ , ......... /" .-" , \/./~ /\. /'--___.-; I _--, .... I ~ £~Ces. .-'' f " ........... f ~ SOiJSfOck. ,/' ..----------, I , I _~/(.:f3()/'Irt-PI/BAre.", 1,-----------------------.....--,
-'.-., {rI .... .... .--7' V_V Oc~y) -..fl _ -___ I ESTIMATED EARTHWORK QUANTITIES (cy) .;, <: /' /' IliTB;;-roUi:-rFiu:~lTo;;SOiLlE:KC~s'E~·~ .... ~~~~<::J,)//:--t-.... /Kr.. .. ~ ..
-" -'~---. ~ f ',_ 1 I, 1 '---,,-s.. 1 I . ---~ . 1 I I I 1 /1.) Topsoil Volume Based on 12-Soil Depth. ".,..-..... 3.) Swell Factor of 15% Applied to /' Earthwork Cui Volume . ( .-3.)
Tolal Disturbed Area = ±7.S0 ac. REVISED: 5/30/13 r' " ===~~~~~ __ ~~~_i==~~~~~--~---T------------------~ WPXENERGY. are . -':-:''-'':'':-----1 WPX Energy Rocky Mountain, LLC
Section 4 T. 7 s., R. 94 HI. /10p00 -..--0 2000 ! GRAPHIC SCALE IN FEET ACCESS DESCRIPTION: liNCH = 2000 FEET FROM THE INTERSECTION OF STATE HIGHWAY 6 AND COUNTY ROAD 323 (RULISON ROAD)
NORTH OF RULISON, PROCEED : SOUTH 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 .1 .1 MILES TO THE INTERSECTION WITH COUNTY ROAD • 329 (SPRUCE CREEK
ROAD) , PROCEED RIGHT IN A SOUTHERLY DIRECTION ±0,6 MILES TO AN INTERSECTION WITH A .f. DIRT/GRAVEL ROAD, PROCEED RIGHT IN A WESTERLY DIRECTION .0.1 MILES TO THE EXISTING RMV 108·4 DRILL
PAD LOCATION, AS SHOWN HEREON. f ,,~~ _____ =-__ -= ____ ~ _____ ~ _________ ~Ic.~~~OrlPfi~~~red~r:i1 I r WPXENERGY . ~ 136Ba.' ''''''''''''' SCALE, ,"-:,"-"'''''' ___ 1 WPX Energy Rocky
Mountain, LLC ~ Rifle. Colomdo81650 DATE: > PtL (970) 625-2720 PLAT. ~ Fax (970) 6'25-277.1 : ~ PROJECT, """""""----1 OFT: RMV 108·4 Drill Pad · Plat 5 ACCESS ROAD & TOPO MAP
1111 ~i~oI.ll"lla.tl,r.fU,"HMolr 1'ri'(+oIf.Lo+r.'i~,Ir\U~ I' "' ReceptJo~~ : DIGOQ4 02/2712()12 12 : 10: lD PH Jean Alberleo 1 of '1 Rto FU:116 . GO OX! F .. :O . C3 CARFIELO COtRlTY
CO LIMITED POWER OF ATTORNEY WPX ENERGY ROCKY MOUNTAIN, LLC ("Company") a Delaware limited liability company, having its principal place of business in the City of Tulsa, County of Tulsa,
Slate of Oklahoma, does hcreby makc, constitute and appoint Bryan S, Hotard with the fnll authority hereinaftcr provided, the tme and lawful Attomey-in-Fact of the Company, authorized
and empowered On behalf of the Company And in the Company's name, and for the sole ano exclusive bencfit of the Company and not on bchalf of any other persou, corporation or association,
in whole or in part, to enter into, execute, deliver, file and Accept all instruments and documenls affecting the real property or real estate lights of the Company as more specifically
set forth below: : I. Applications and documentation associated with Garfield County or Rio Blanco pemlittillg requirements for including, hut not limited to, Independent Sewage Disposal
Systems, Small Temporary Employee Housing, Major Impact Reviews, Limited Impact Reviews, Oil and Gas well permitting, Driveway Access, COlUlty Road Maintenance, Temporary Living Quarters,
Temporary Usc Permits, Surface Use Permits, Surface Use Licenses, Utilities, Snow Removol ond Private Construction of County Roads; 2. Agreements and other documentation that grant casements,
rights of way, licenses, or pennits to Company and also instmments where the Company grants sneh rights to others; 1----------~3-. -Agreements-tbat-assign-easements.fights-of-wa~licensesrpermitS"OLsu
rfaecJ.easesJn ________ _ connection with the Company's operations; 4. Releases and Partial Releases of easements and rigbts of way; 5. Agreements ollowing encroachments onto easements
and rights of way owned by Company and londowner instruments and conveyances on others casements; 6. Agreements subordinating mortgage rights to casement or lease; 7. Agreements relating
to tbe modification and I·eloc.tion of Company facilities; 8. Rental or lease agreements for surface nse or other snrface lise agreements and all notices related to the pipeline agreements;
9. Agreements for tbe purchase or snle of real property and for the Icase of real property for residential or commercial purposes or othelwise in connection with the Company's operations;
10. Agreements to obtain water services, electrical, gas or oil services or the provision of other utility services utilized by Company's facilities; II . Agreements modifying, amending,
renewing, extending, ratifying forfeiting, canceling and temunating any and all of the aforementioned types of instmments and documents. WPX ENERGY ROCKY MOUNTAIN, LLC hereby declares
tbat each and evelY act, matler and thing which shall be given, made and done by Bryan S. Hotnrd in connection with the exercise of any or all of the aforesaid powers sholl be as good,
valid and effectual to all inlents and Pllrposes as if the same had been given, made and done by WPX Energy Rocky Mountain, LLC in its limited liability company presence and it hereby
ratifies whatsoever AtIorney-in-Fact shall lawfully do or cause to be dOlle by virtue hereof. This Limited Power of Attorney shall remnin in full force and effect until tenninated by
Company.
• .111 ~'!~.IoI'lIIw\A',r.I~,N!'l r\ol~'''r!+\~'r/('II!J ,,~.~,~ II "' ReooptJonU: Q16004 02/27/201212,18 , 10 PH "un nlberlco 2 of 2 Reo Fo.zSIS.CO 000 F80;O.OO CMFl£lO COlW'Y CO IN
WITNESS WHEREOF, WPX Energy Rocky Mountain, LLC has eauRed this Limited Power of AUomey to be signed by one of its Vice Presidents, duly authorized by its Mnoagement Committee to grant
powers of attorney tbis I" day of January, 2012. W PXJ}NIBRGi\) Its: 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 to me 10 be Ibe Vice President of WPX Energy Rocky Mountain, LLC a Delaware limited
liability company, wlto acknowledged to me that he has executed the above LIMITED POWER OF ATTORNEY authorized by Company's Management Committee. IN WITNESS WHEREOF, J have hereunto
set my hand and affixed my not3lY seal, theZlJifj day of..JMua177 20 12. Fcl:ntruy Notary Public My Commission Expires: 2.-2-3-J-Olrf After Recordation Please Return To: WPX Energy Rocky
Mountiau, LLC Attn: Laud Dept. POBox 370 Parachute, CO 81635 2