HomeMy WebLinkAboutApplication.pdfGARFIELD COUNTY Building and Planning Department 108 8 Ih 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 Ihe compleled applicalion 10 Planning Departmenl wlin 48 hours following occupalion
(To be completed by the Small Facili ty Operator -e.g. well pad operator) SectionfTownship/Range Location of Housing Site: Sec 25 -T6S -R94W Well Pad Number: RWF 22-25 Tax Parcel Number
for Parcel Containing Housing Site: 2175-264·00·177 GI'S and/or Lal·Long Coordinales of Housing Faci lily Sile (Of\en inclnded in MO): La!: 39.496945 Long: -107.841114 Maximum Number
of Occupants at Zone District: Rural I'emlilled Sile (e.g. well pad): less than 8 GumulatilLej l.mounLoLTime.(in.Days)_The.Eacility_WilLbe at Location: 30 days State or Federal Pcnnitting
Agency Overseeing Reclamatioll, Restoration and Revegetation and Relevant Penuit Number: 0504521976 Date of Installation: 9/12/13 I Date of Removal: 10/7113 Name of Landowner: Savage,
Joan L Street Address: PO Box 1926 Telephone: Email: 970-625·1675 City: Rifle State: CO Zip Code: 81650 Name of Operator's Compliance Officer: WPX Energy Rocky MOllntain, LLC Bryan S.
Hotard Street Address: PO Box 370 Telephone: 970·285·9377 ext Email: 2754 Brllan.Hotard@wl2xe nergY.com City: Parachute State: CO Zip Code: 81635 Company 24·Hour Emergency Contact: WPX
Energy Rocky Mountain, LLC Phone Number: 970-285-9377 This Administrative Checklist must be received by the Gameld 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 delivered to the Garfield County Sheriffs Office and relevant Fire Protection
District (if within 48 hours applicable) Office and following occupancy of the Small Facility. Additionally, the Garfield County Sheriffsreceipt) or verified 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 STEH-9-13-7713
Fire Suppression Requirements (Per Performance Standard Ll "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 contaiiili1efOllow·"ln'"g'--I----infonnation: 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 Must be Satisfied to be Eligible
as a Small Facility 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, The Small Facility is located at the
Permitted Site for less Applicant Complies (YIN) YES Planning Department Complies (YIN) than a cumulative of one (1) year and at the end of the ----j~-utilization-peTiod_;_alt--structtlre
s_;_fotlndations-and---ye~c-~--j--------I-----j associated infrastructure are completely removed ; and, :>:) The Small Facility shall have an occupancy of eight (8) or fewer people within
a Permitted Site (e.g. well pad) who are employees, contractors or sub-contractors of the operator of the small facility and are needed for onsite safety of the related commercial, industrial,
extraction or highway operation. 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. YES 3
Building Information (Per Unit) Unit 1 Make: Teton Buildings Serial Number or Unit ID Number: 64-6396 Manufacture Year: 2011 Size of Unit (Square Feet): 14X56 Unit 2 Make: ATCO Structures
Serial Number or Unit ID Number: 348137462 Manufacture Year: 2013 Size of Unit (Square Feet): 14X56 Unit 3 Make: Serial Number or Unit ID Number: Manufacture Year: Size of Unit (Square
Feet): Unit 4 Make: Serial Number or Unit ID Number: Manufacture Year: Size of Unit (Square Feet): Unit 5 Make: Serial Number or Unit ID Number: Manufacture Year: Size of Unit (Square
Feet): ISDS Permit ISDS Permit Number SEPT -8-13-2963 ~ Signature of Operator's Compliance ~ ~ Officer: ~~~ ( By signing this form, /verify that all infoPtfiation provicfed in this checklist
is correct and accurate to the best of my know/edge) Print Name: Brvan S Hotard Title: Attorney-In-Fact 4
Eligibility, Submittal and Performance 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 (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 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 _________ LatitudelLongitudELcoordinates.)~r.eIe.\lanLzonELdistdct~maxi
mum-n umber-of-------j occupants; cumulative amount of time (in days) that the Small Facility will be at the specified location; identification of the State or Federal permitting agency
overseeing reclamation, rehabilitation and revegetation of the Permitted Site and relevant permit number; date of installation; date of removal; name and contact information of the landowner;
name and contact information of the Operator's Compliance Officer; 24-hour emergency contact information for the Operator; building information (make, manufacture year, serial number,
size (square feet)); signature and contact information of the Operator's Compliance Officer. S. Wastewater Disposal: 1) Vault System: All vault systems shall be designed and installed
to accommodate the maximum number of persons (eight or less individuals), who will inhabit the Small Facility. In addition, all vault systems shall be equipped with an overflow alarm
device. Vault systems shall be designed to accommodate a minimum of 75 gallons of wastewater per person per day. If a vault system is proposed or has been approved, the Operator must:
a. Demonstrate that year-round vehicular access is available and maintained for safe and regular access for sewage hauling vehicles. b. Maintain all sewage disposal records including
but not limited to trip logs/reports and landfill receipts as public records, available to the County and/or any other interested third party upon request. c. (b) Individual Sewage Disposal
System (ISDS): If an ISDS is proposed, then it shall be designed, installed and operated to accommodate the maximum number of persons who will inhabit the Small 7
Facility (eight or less individuals) and shall otherwise be permitted and operated in accordance with the Garfield County ISDS regulations as contained in BOCC Resolution Number 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 r i n t N a me : _-"B,-,rJ.y-"aC!.n~S-.,-..H!.!.!o~t~aC!.r~d __ Title:
Attorney -In-Fact Phone Number: 970-285-9377 ext 2754 Email: 8ryan.Hotard@wpxenergy.comScott.8rady@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. 98-09, 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. 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 --------;Generamamlnlsmnlve 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 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 -------appltcatian,--such--costs--will-b-e-b-orne lJ)rtl'ie
applicant ana paia prior roffiefma.-----+ 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 22-25 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. ------c4. Th-e~B<rs-e~re-e-sh-aU-b-e-i
rJadd itio. n o-ancf exclusive of-a:nycosnor puolicati;ro;n "o""r'" -----j 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 IZED REPRESENTATIVE) Date Bryan S, Hotard Print Name WPX Enel'gy Rocky Mountain, LLC Mailing Address: PO
Box 370, Parachute, CO 81635 Page 4
..... 3 Fox Engineering Solutions, Inc. 670 Canyon Creek Drive, Grand Junction, CO 81507 Ph: (970) 250-5505/Fax: (626) 784-0667 Email: coforado(ox@bresnan.nef Inspection Report for:
Client: RWF 22-25 Small Temporary Employee Housing WPX Energy Rocky Mountain, LLC Location: Conducted By: SE 1/4 NW 1/4 of Section 25, T6S, R95W, 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 na ture of Factory Built Nonresidential Colorado Division of Housing certifica tions noted on Structures (as defined under eR.S. 24 -32-3302(a)) but NOT
recreational vehicles (as defined under eR.5. 42.1.102 (61), Including Company trailer, Unit 10. 64~ 6396 with Certification ________ twck • .trucklractor?.ffiotor-home.or.campef-traller),
may-be-utlliledC----No.-2 4-1-7-9 r manufactured-by-Teton-Buildings-in-------/for housing of worke rs on projects related to commercial, Industrial, 2011;and Driller's trailer, Unit
10. 348137462 with mineral extraction or highway operations, pursuant to the standards for SmaU Facilities contained in subsection (2), below. Such facilities Certification No.24919,
manufactured by Aleo are not subject to Ga rfield County building and fire codes (building Structures in 2013. All othe r aspects not subject to code, fi re code). However, Small FaciliUes
are subject to all pertinent visual inspection and certification by third p a rty state (I.e. electrical permits), federal permits and relevant fire protection distrlct(s) code requirements.
Professional Engineer. 3 .a.(1) The Small Facility and any associated Infrastructure must be completely contained within a state or federally permitted parcel (such as a Colorado Oil
and Gas Conservation Commission (COGCC) approved 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 located at the Permitted Site for less than a cumulative of one (1) year and at the end of the utilization period, all structu res, foundations and associated Infrastructu
re are completely removed; and, 3 .a.(3) The Small Fac1l1ty shall have an occupancy of eight (8) or fewer people who are employees, co ntractors or sub-con tractors of the ope rator
of the small fac ility and are needed for onsite safely of the rela ted commerCial, industrial, extraction or highway operation. 1 2 Small Facility must comply with all applicable federa
l, 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 thi rd 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 22-25 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 sha ll 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 call form contamination must be disclosed to the Garfie ld County Board of Health or designee within 72 hours from the time the contaminated water was tested. Each
Small Facility sha11 be maintained In a clean, safe and sanitary condition, free of weeds and refu se. Any hazardous or no)(ious materials that must be stored at the Small FaciI,lty
for operational or security reasons must be managed in accordance wilh all applicable federal, state and loca l laws and regulations. At least one thirty (30) gallon (4 cubic feet) wildlife-proof
refuse container shall be provided for each Factory Built Non-Residentia l Structure unit. Said contalne r(s) must be durable, washable, nonabsorbent metal or plastic wi th tight-fitting
lids. 6 Refuse shall be disposed of weekly, at a minimum. Operators must ________ --l<k·eep appropriate rec-ords,-to-be-provided-to-the-County-orany interested t hird party upon request,
to demonstrate that refuse Is collec ted in a timely fashion and disposed of at a licensed facility_ 7 8 9 10 11 Outdoor food storage is prohibited. Factory Built Non-Residential St
ructures equipped by the manufacturer with a fire sprinkler system, fi re detection system, and/or alarm system sha ll be Inspected, tested, and maintained In accordance with the requirements
of the relevant fire protection distrlct(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 nre extlnguisher(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 NonResidential Structure and placed In accordance with applicable fire protection district and/or Colorado Dlv1sion of Housing codes. Domestic animals are prohibited at
all Small Facilities. Page 2 of 5 Fox Engineering Solutions, Inc. September 12, 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 dean, safe and sanitary condition, free of weeds and refuse. One
wildlife-proof trash recepade with a capacity of approximately 20 cubic yards onsite. Individual refuse containers in each office/housing structure. Not subject to visual inspection
and certificatioJl.b_y, __ --t third party Professional Engineer. No outdoor food storage observed on-site. No active fire sprinkler systems observed in any of the factory built non-residential
structures. Smoke detectors observed in all factory built 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,
Class ABC, observed in all structures. No domestic animals observed on-site.
RWF 22-25 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 calcula tions and initial suppression demands. The relevant fire protect ion district sha ll 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 fjre suppression which Is accessible with a dry hydrant within each Permitted Site for a Small Facility. The operator shall document all emergency situations requi ring 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. The Garfield County Sheriff's Office and relevant fire
protection distrlct(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 notiflcation, whether hard copy or electronic. The Operator shall maintain records Identifying workers, wheth er employees,
contractors or sub-contractors, and document the da tes 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 certificat ion 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 Artk le 7.808 D. 2. of the Garfield County l and 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 One potable aboveground water tank of approximately 4000 gallons capacity on-site. Potable
water demand is estimated to be 300 gallons/day gallons (4 individuals x 75 gpcd). Required fire suppression demand is 2500 gallons. Total potable and fire suppression volume required
is estimated to be 4000 gallons. Water supply appears adequate with 4000 gallons of storage with refills scheduled at 5-day intervals. Dry hydrant observed on water tank_ Not subject
to visual inspection and certification by third party Professional Engineer. Not subject to visual inspection and certification by third party Professional Engineer. Not subject to visual
inspection and certification by third party Professional Engineer. Not subject to visual inspection and certification by third party Professional Engineer. This inspection was conducted
by a third-party Professional Engineer licensed in Colorado and certifies compliance only with applicable standards set forth in Article 7.808 D. 3. of the Garfield County land Use Code
of 2008, as amended, that are subject to visual inspection.
RWF 22-25 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 GPS (oordlnates or latitude/longitude coordinates); relevan t zone district;
maximum number of occupants; cumulative amount of time (in days) that the Sma11 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 Opera tor'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 o f 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 landflU
receipts as public records, available to the County and/or any other interested third party upon request. Individual Sewage Disposal System (ISDS): If an 15D5 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-13G. proposed, then it
sha ll be designed, Installed and operated to accommodate the maximum number of persons who w1ll inhabit the Small Facility (eight or less individuals) and sha ll otherwise be permitted
and operated In accordance with the Garfield County 1505 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. 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 22-25 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 as Identified above; set forth In Article 7-808 {O} {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 12, 2013 Print Name and T~aVid J. Fox, Principal
Engineer Signature: \L/~ ~_r_¥_: ________ ----'I/hc.,~ '.---co Page 5 of 5
WPX Energy Rocky Mountain LLC RWF22-25 Well Pad Directions to Site· _::$ r ~." . Jf'Hw. ""+ '--'.,~ Approxlmoto Drill Rig & Equipment Area m ill 0 s.-..-c..--~_ Emeraencv Co ntact List:
(24 Hr::) g7()..28S..93n 970-61a.7340 Coli 970-270-9187 CoIl 970-260-1576 ColI [j] i ~~i ,tH I ~ ... -_f_, 'd"n'I~~"tlon " L""",I"" K,,"" Aboveground Tonk (4000 gol.) (4000;.") .t:iclli:..s.:
W PXENERGY. ,~ Tho well pod ~1te Is Jocated In the NW 114 of SectIon 25, res. R94W,6th P.M. (NAD83N39.4970& Wl07.8410") Tho sito wilitompor:lIily offico ::and house on avcr:lgo of four
individu:lIS during nolurol 9!lS drilling octlvitios .:and is expected to be completed In ono yeor or less. The Individuals will occupy throo Individual tr:liler otflcoslhou~es loc:lted
on the well pod. Offlcclhouses h::lvo Colorndo OIv~1on of Housing com>,lIoncc tags, Ono ::aboveground scYr.Igo holding Unk with 4()()()..gollon c::ap:lcity on-sitc. Sevr.lge nows ostirrotod
to be 300 galiortSJdoy (4 individuals x 7S gpcd). SOw.::lge holding wnk. needs to be omptled opproxlm:l.toly every 13.3 dnys (4000 gollons /300 gollon$ per doy). WostCw::ltcr vault equipped
wllh overflow olorm dovico. W PXEnorgy utilizos tho sorvices of ,:, licensod contr.:lctor to remoyo <In<! h:)ul tho waslow:)ler to <I Stale certified troalmenVdlsposal f<lcility. Ooe
pol<lble tlbolf&grouocl w:)tor I<lnk of .:lpproxlm:llely 4000 g.:llions C<lpxity on-slte. POt::lble w:)tor demtmd Is estimtllod to bo 300 g.:lllonsldtly (4 Indlvlduols x 75 gpcd). Required
minimum fire suppresslon domtlnd Is 2500 gallons. Tobl pebblo and firo supprosslon volume required Is ostimtllcd to be 4000 gol1ons. Woler supply oppoors odeQu,:,le with 4000 gol1ons
of slorago with rofills scheduled nt 5 doy inlorvols. Dry hyd ~nts obsorved on wnter tonk. Rood access to tho she Is m.:llnl.:llned yeor-round threugh the ::ervloos of prtv:lte rood
mninlennnco ond construction controctors. &l<'...c mtlpplng by BookcliffSurvoy Services. Inc. Site feotures Induding housing troilors. w::ltor Md w:)stCW::ller I<lnks. port:Iblo toilol$
::Ind dumpster were field 10000ted. Please note thtlt this Is 0 construction site ::Ind thot the lDC:l tlons of drill equipment nnd other Itoms,:,m subject to change. F.:lctory·6ullt
Nonresldonti,:,1 StnJcturos (OfflcolHouslng) Myo.:l minimum sep::lrotion dlst.:lrlCO of 29 ft. RWF22-25 Site Plan Garfield County, Colorado Small Temporary Employee Housing and SeptiC
Permit Application Applicant:WPXEnergy Rocky Mountain l lC !kI1o:.$cptoml»t 12. 2013 ChQelcod: OJF Fox Engineering Solutions. Inc. 670 C;I!1Yon Cree4< [)o'Ivc. Gr;:u"od J\lnetlon, CO
81S07 Ph: (970) 2so...SS05 f F~x: (G26) 784-<1667 E=~ color!ldofoxCbro~on.not VOI"'Jon: 001
From: To: Cc: Subject: Date: Attachments: f'.'el1, Kris "Kevin Whelan" Reed Gary RWF 22-25 RIg Nove On Notification -Fire DistrIct & County Thursday, September 12, 2013 3:44:00 Pt-1
RWF 22-25 Letters Pdf RWF 22-25 Pf eertmCSltlon 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 30 days. At which time I will notify you of the removal of the employee housing. This notification is per the GAReO regulations for our pad located in
Sec 25 -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 Mell
WPX Energy Planning FOA 111 1058 County Road 215 Parachute, CO 81635 (970) 285-9377 x2209 (970) 623·6583 cell krjs mejl@WpXfnergycom 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 22-25 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 30 days. In accordance
with Garfield County Planning and Zoning Regulations, the attached documentation provides emergency response information and driving directions for the WPX RWF 22-25 pad. Should you
have any fmiher questions or concerns regarding this notification, feel free to contact me at (970)263-6583. Sincerely, ~A~--<-f Kris Meil Plmming Coordinator -Piceance District Kris.meil@wpxenergy.c
om
WPX Energy Rocky Mountain LLC RWF22-25 Well Pad ~~ _.. -._.......".. .. '.'' -, f_T>C:llfTtMS[cnoorOllI' .. n:_Y ' _COOM1"I'IIOAO~~"OI'I'I!.I..I3ON.""XXto$OUI'H(M.Y~ COMT"I' """"':1:1
.tl!1ftL1 ' 01'><1: ~C1lONWIT>< ~ OOOAO:oooI, ~O~ICTI I<MOtM1VILYDIIIa:TIDN ~.:IMIlC!I TO TIC tm:IIlICC'TIOfO _ COI.MI"r JIO,t.O~, ~Ctl) I'IIO~ II< NI (-.$TO!\. Y DlM:t1ION ... , ""-1:11
TO TWI: ~CTIOOI~COUHTVIIC.ODJ17(11o_c--..~tolOilC>'lTlII .. ~yOWltCTlOOl.'7M1lC Sronc: ~cnoor-... A~_vnll!OAO. ""OC[CDNClMT"NI~y _CT1OHg,~"":~l'O""I'fTI:..uC1lClOl WIT1<APIU_VD.Ift)IO,D.~_""~II..YC~I
IIA""'::~fOtH(_::...~ 00II\.I.~o,o::.o,1lOIf. ~:;.oorwtI1CftCOI". Directions to Site· • '-.-,<-~ Approxlmato Drill Rig & Equipment AreZl ~ ru ~o -~-'--"-'--~~ ~" Emergency Contact List-WPX
Office (24 H,.,) 970·28$09377 Doug Mc;A(Wn. WPX DrtlllrIQ 97G-e18-7340 Coli Seen Broey.WPX crOOng Sup-970-210-9187 ColI KoW! McConnon· WPX S:l/oty. 911).3(l9.1195 Coli M;Ifk Mumby' $pOI
Conttxtor. 970-26Q.1S16 ColI Ul -""" ..... .. ' ....... -i .~~ . t. ... } I ,). ~wp~.:!s Dn71/bd ·PfDt-l DRJU.~1A 1'OlI1' '.., ... nllllr-nll ..... ' . l "",,'lnn KMI'" T:II1~ 10 roloe:l~OfI
fQt eonWl,Ictlon N.oll:s., WPXENERGY. ,,~ _ ., ' The well pnd sllo Is Ioc:Jtcd In tho NW 1/4 of Sectlon 25, TGS. R94W.6th P.M. (NAD83N39.49700 W107.8410") Tho site will tompor:lrily
offico::and houso .:m .:lVcr::ago of four individu<lls during notur:ll gas drilling :Jctivi ties :md is oxpocted to be completed in one yeCir or l e ~. The IndlvldUCIls will occupy three
IndlvlduCiI tr::Illor offices/hou!:es loc:Jted on the won p<ld. Offlc:elhouses MvC Color.:ldo Division of Housing com;lll:mcc togs. Ono <:Ib0v09round sowClgo holding t.:lnk with 4DOO-g<lllon
c.::ap<:Icity on-sIte. Sew<:lge flows estimCited to be 300 gCltlonS/d <lY (4 Individuals x 75 gpcd). SOw:lge holding L:mk needs to be emptied approxlm:.'l tely every 13.3 dClys (4000
gClllons 1300 g:.'lllons per d::.y). Wastow:1tcr VClU!t equipped with overflow :ll::um clcvico. WPXEnergy utilil:cs tho ~C$ of a licensed contr:X:lor 10 remove and t\aul tho wastcW3ter
to:l Sbto ccrtirlCd trc:ltmcnVdlspo$31 facility. One potablo <:Iboveground w:.'ltcr t.:lnk of <:Ipproxim<:lloly 4000 9<:111ons c:Jpacity on-site. Potilble w:.'l ter domand Is estlmilted
to be 300 g::JllonS/day (4 Indlvldu::Jl!: lC 75 gpcd). RoquIred minimum nro suppre~lon dcm!lOd Is 2500 9a"ons. Towl pot.:lblo and nre ~pprossion volume required is cstim::JlC(! to be
4000 gaDons. Walor supply .::tPPO::J~ ::Jdeqva!o wllh 4000 gallons of slo~go with refills scheduled <:It 5 day intorvals. Dry hydrants observed on W:.'ltOf bnk. RO:ld :lcce~ 10 th e
site Is molnlalned year-round through Ihe servlcos of prlvato road ~Intenanco and construction controctors. Base mapping by SookcliffSurvcy Services. Inc. SilO features inclucling housing
tr.li10~, water and wast0W3ter I.::tnks, porbble toilets and dumpstor were field loc:Jled. Please note Ih::lt this Is a construction slto Md tMI the loc.::atlons of drill equipment and
other Items ::Ire subject to ch::lnge. Factory-Bullt NonresIdential Structures (Office/Houslng) havo a minimum separation dlsl3nco of 29 ft. RWF22-25 Site Plan Garfield County, Colorado
Small Temporary Employee Housing and Septic Permit Application Applicant:WPX Energy Rocky Mountain llC Doto): Soptll1Tlbor 12. 2Ot3 Chackod: OJF Fox Engineering Solutions, Inc. 670 C;u1yon
Creek onyo, Gr.YId Junetion, C081507 Ph: (970) 2SO-55051 Fmc:: (626) 784-0667 em:l~ c:oIomdofoxC tml::.n:1Il.not Vortllon:OOl
from: To: Cc: Subject: Date: Attachments: "1eil, Kris "l im Sears" Reed Gary RWF 22-25 RIg Nove On Notification Thursday, September 12, 2013 3:46:00 Pf'>' RWE 22-25 l etters pd f RWE
22-25 pF Certjflcatjon 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
30 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 25 -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 Energy Planning FOA III lOS8 County
Road 21S Parachute, CO 8163S (970) 285 -9377 x2209 (970) 623-6583 cell krjs mej!@WpXEnergy com 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 81h Street Glenwood
Springs, CO 81601 ________ ~P~h~:9~7~5~Q4~3L_ __________ ~ _____________________________________ --~ RE: Emergency Response Notification RWF 22-25 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 30 days. In accordance with Garfield County Planning and Zoning Regulations, the attached documentation provides emergency response
infOlmation and driving directions for the WPX RWF 22-25 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 PlalUling Coordinator -Piceance District Kris.meil@wpxenergy.com
WPX Energy Rocky Mountain LLC RWF22-25 Well Pad Directions to Site' ._::: To ~ .c.,.,. w Approxlm.:lte Drill Rig & Equipment Area ru ~O $oooc-,-_ ~--\. . Emergency Contact I iSl ' WPX
ornco (24 HnI) 970·285-93n Doug MeAd~m . WPX DrUlIOQ 971).618-7340 Cell Scott BtOOy_WPX Ori1llng Su~ 970-270-9187 Coil Kovin Mc:OonnoIt. WPX SlIroty-970-309-1195 CoIl M.:IrttMumby ·
SpIll COnIDdOr· 970-260-1576 CoIl aJ ql i'1~ 1. lI!:lowotor Abovoground Tonk (4000 g,lI.) I ' ~.r;t:'.~~ ~.~.t,,: AOOvogrl>Und Tllnk (4000 1l~1) to rolocoUon for con~trudlon No.tes.'
WP=XENE RGY. . > The well pad slto Is Ioc..=Ited In tho NW 1/4 of Section 25. T6S. R94W,6th P ,M. (NA083N39.A970· W107.8A10") Tho site will tompor:lrily offico:lnd houso an avemgo of
four Individu:ll!: durlng natuml gas drilling octivities :lnd is oxpocted to be comploted in one Yo:lr or less. The IndMduol!: will occupy three indivlduollrollor offices!hou!:os located
on tho well p:ld. Offlcclhousos h!:Jvo Col()l';ldo Division of Hou!:lng comOlIl:lnCt! bgs, One :lbovoground scw.:lgo holding ~nk with 4QOO-g:lllon cop:lcily on-slto. SOW:lgo flows estim:ltod
to be 300 g.3l1onS/doy (4 individuals x 75 gped). Sew:age holding t:lnk needs to be emptied approxlmotely overy' 3.3 d.3}'S (ACOO golion!: 1300 g;::lIlons por d:lY). W:lStowotcr V:lult
equipped with overliow olorm device. WPXEncrgy utilizes tho sONIces 0 1 0 Uconscd controctor to remove Olnd haul tho w.'lstowater to.3 State ccrtlrlCd lfoatmenVdlspoS<lI facility. One
pomble obovoground w::lter t:mk of approxim.31ely 4000 g.3l1ons C3p:1city on-slto. Pot:lblo woter demond Is ostlmatoo 10 be 300 g.:lllonsiday (4 Indlvlduols x 75 gped). Required minimum
flro !:uppresslon dem:md Is 2500 g:.llons. Total poUbtc ond firo supprcssion IIOh"lrrlO ro<;uircd Is estltrultccl 10 be 4000 9alloos. Woter !:upply :lPpcors OdcquOlto with 4000 gOltfOns
of storage with refills scheduled ot 5 d:ly intCfV.:lis. Dry hydr:Jnts observed 00 w.'l\or unk.. Road :lccess to the site Is m::Jlnmlnod year-round through the services of priv:lto ro.:ld
mOllntennnco Olnd construction contrOlclors. B:lse rn:lpping by BookcliffSurvoy $crvices. Inc. Slto IO:ll\Jrcs Including housing tr.:Iilors. w.'ltor Olnd WOl!:tCW::Jtor tank.s. porbblo
toilets:lnd dumpstor were flold IocoIted. Please note tnat this Is 0 construction site and th:lt tho locotlons of drl ll equip mont and other Items oro subject to ch::lI1go. Factory-Built
NonresidC!ntial Structures (OmCC!/Houslng) have a mInimum ~mtion distanCt! of 29 It RWF22-25 Site Plan Garfield County, Colorado Small Temporary Employee Housing and SeptiC Permit Application
ApplicantWPXEnergy Rocky Mountain LLC Ooto: SoptombOr 12. 2{l13 Chcel<od: OJF Fox Engineering Solutions, Inc. 1570 ClInyon Cfeek Drfve. Gr:md Jundlon. co 151501 Ph: (970) 250-55051 FOI<:
(&25) 184-0661 Emo~ c.olorodofoKllbfO".,n::an.not VOlllior1: 001
Section 25 1: 6 s., R 94 W. ,I I I~/;" II I I ; I I I I I " I /I , , I , I I Dryfighf ' I \ I I I I I ,I , , , , , I \ \ , , I I I I I /I ,//I \ , \ ' /I ,/I I I ,' I : I ' \ \ I , \
\ \ , , I I I I I I I I \ \ c /I I //I . Ed9(J'/I , I I ///I I /I ////////I I I ///I I //------o 80 -______ ~ 1 • -_ GRAPHIC SCAlE IN FEET ---~ I I I I I , I I I /,/.//--._-___ ---l
INCH= 80FEEr. -___ -_ ,,/, \ I I I l''" I I I /I , I /50'01$//./REIj~ PNT. ././I /I I F9,9' I 'I /\ \ '/1 P~. R~~F 51 \ 81 \ prop. RWF 1 :::~~~~~:~~. \> I ,I Prop. RWF 41 i' . I p,rop.
R\YF 31 t·fj!'/I /I ' , I ~ J I Prop. RWF ;i~J;I~~:: I I I prop. RWF ,9 I " I I Prop.IRWf , 9») . ,' //: : : :, :1) ! I I I I , ' ,e//I I I ) r,\V 1,,6, 6' \ \ I 6 t(,~ r,r,\'4 \ '0"
I "\ \ ! I ~e yf3 s\ v I " /", ' \ \~Q~,~eO A ~O,e : : \ \ O\<;\) ",~(\1 I I \\\ \ s\"\fv : :t \ /\ \ \ : I , \ \ II I, --------.----_ (){}40--//E#1 , I , , I I /I I I '1:"-'--. I I
I I I I I I I I /I /I ///////////I ,I ,I //////I /I /" I I I I' I ///, , , ,, , , , , , I //,/I I I I ///Line I I I I I I I I,, //I ! /I I ! ! ! I I I ! /////I I ' I I I I I I I I I
I /I I //I I I I I I /I I /I I /I I I /, I I -\'-<f.L='--L+~-'-----'---C C ,' " J=d9~'of Trpe's ~#5~~~~~'~~~~T.;;4~ _ ~~+-__ ~~ F 12.2' -'.--..8 #38 I ~ ~ , " C 10,6' \ , , I , , , \
\ , , , \ ,I I \ \ \ I \ \ Proposed \ Aqcess Road \ \ \ //I I //
• ~ o ~ ! Section 25 1: 6 s., R 94 W, 10~00 __0 20I 00 GRAPHIC SCALE IN FEET 1 INCH::: 2000 FEET ACCESS DESCRIPTION: FROM THE INTERSECTION OF STATE HIGHWAY 6 AND COUNTY ROAD 323 NORTH
OF RULISON, PROCEED SOUTHERLY ALONG COUNTY ROAD 323 .,., MILES TO THE INTERSECTION WITH COUNTY ROAD 309, PROCEED LEFT IN AN EASTERLY DIRECTION '2.3 MILES TO THE INTERSECTION WITH COUNTY
ROAD 320, PROCEED RIGHT IN AN EASTERLY DIRECTION .6.' MILES TO THE INTERSECTION WITH COUNTY ROAD 317 (Beaver Creek Road), PROCEED RIGHT IN A SOUTHERLY DIRECTION .'.7 MILES TO THE INTERSECTION
WITH A DIRT)GRAVEL ROAD, PROCEED RIGHT IN AN WESTERLY DIRECTION .0.6 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD, PROCEED RIGHT IN A NORTHERLY DIRECTION .0.6 MILES TO THE RWF 22-25
DRILL PAD LOCATION, AS SHOWN HEREON. ~ ' L-__ ~~ _____ ~ _________ .-__________ -r~~Uclicffi~an~~~~~ " I F WPXENERGY . ~"> 13Uo•• ' Ih"" SIred SCALEc -'--,=-..."""'-----1 WPX Energy
Rocky Mountain, LLC ~ Rifle, Colorr.zdo 81650 DATE: I Ph. (970)625.2720 PLA.1': Fox (970) 625·2713 RWF 22-25 Dlill Pad -Plat 5 PROJECT: -"""""'---____ 1 iU-____ ~~~~!!!!!!~~~~~!!~~D~n~,
__ ~~~~~;b _ ~A~C~C.~~~S~S~R~O~~~D~&~TO~~O~~~~~P~ __ -il
August 22, 2013 Mr. Fred Jarman, Director Garfield COllnty Building and Planning Department lOS Sill Street, 4'h Floor Glenwood Springs, CO SI601 RE: RWF 22-25 Drilling Pad Locations,
Garfield County, Colorado Dear Mr. Jarman: This letter authorizes WPX Energy Rocky Mountain, LLC to represent me in the submittal and processing of the required Garfield County Small
Temporary Employee Housing (STEI-I) and Individual Sewage Disposal System (ISDS) permits on the above drilling pad locations. Sincerely,
LIMITED POWER OF ATTORNEY WPX ENERGY ROCKY MOUNTAIN, LLC ("Company") a Delaware limited liability company, having its principal placc of business in the Cily of Tulsa, County of Tulsa,
Slate of Oklahoma, does hereby makc, conslilute and appoint Brynu S. Hotard with the full authority bereinaficr provided, the tme and lawful Attolllcy-in-Fact of the Company, authorized
and empowered on behalf of the Company and in the Company's name, and for the sole and exclusive benefit of the Company and not on behalf of any other person, corporation or assoeialion,
in whole or in part, to enter into, execute, deliver, file and accept all instmmcnts and doeumenls affecting the real property or real estate rights of the Company as more specilically
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 Housing, Major Impact Reviews, Limited Impact RevielVs, Oil and Gas lVell pemlitting, Driveway Access, COlUlty Road Maintenance, Temporary Living Quarters,
Temporary Usc Permits, Surface Use Permits, Surface Usc Licenses, Utilities, Snow Removal and Private Constmction of County Roads; 2. Agreements and other documcntation that grant easements,
rights of way, licenses, or pennits to Company and also instrument~ where the Company grants such rights to olhers; -------------'13. Agreements-thaHlssign-easemellts, fights-of-way-:
licellses,-permits_or_surfacc_leaseu "L ________ _ connection with the Company's operations; 4. Releases and Partial Releases of easements and rights of way; 5. Agreements allowing encroachments
onto easements and rights of way owned by Company and landowner insh'uments and conveyances on others case men Is; 6. Agreements subordinating mortgage rights to casemcnt or lease; 7.
Agreements relating to the modification and relocation of Company facilitic,;; 8. Rental or lease agreements for sur[.,ce use or other smface lise agreements and all notices related
to the pipeline agreements; 9. Agreements for the pnrehase or sale of real property and for the lease of real property for residential or commercial purposes or otherwise in connection
with the Company's operations; 10. Agreements to obtain water services, electrical, gas or oil scrvices or the provision of other utility services utilized by Company's facilities; II.
Agreements modifying, amending, renewing, extending, ratifying forfeiting, canceling and terminating any and all of the aforementioned types of instrument. and documents. WPX ENERGY
ROCKY MOUNTAIN, LLC hereby declares that each and evmy act, matter and thing which shall be given, made and done by Bryan S. Hotard in cOlmection with the exercise of any or all of the
aforesRid powers shall be as good, valid and effectual to all inlents and purposes as if the SRme had been given, made and done by WPX Energy Rocky Mountain, LLC in its limited liability
company presence and it hereby ratilies whatsoever Attorney-in-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 tcrminated by Company.
1111 WoIoI'II111o\11,IIIU, r~m"~'.tr!+\(lrlI:iWI"~.~'~ 1'111 R.ooptJonU: 816004 02/27/2012 12l 18 : 10 PM Jean R1borlco 2 or 2 Reo FUI S16 .CO Doc Flle :O.OO <iAAFIELO Cou:flY CO IN
WITNESS WHEREOF, WPX Energy Rocky Mountain, LLC has cauBed Ihis Limited Power of Atlomey to he signed by one of its Vice Presidenls, duly autborized by ils Management Committee to grant
powers of attorney Ibis ," day of January, 2012. TAIN,LLC Its: ACKNOWLEDGMENT STATE OF OKLAHOMA ) ) ss. COUNTY OF TULSA ) BEFORE ME, the undersigned autbority, a Notary Public in and
for said County and Siale, on Ihis day personally appeared, Jerry D. Barnes personally known to me to be the Vice Presidenl of WPX Energy Rocky Mounlain, LLC a Delaware limited liabilily
compMy, who acknowledgcd 10 me that he has executed Ihe above LIMITED POWER OF ATTORNEY authorized by Company's Managemenl Committee. IN WITNESS WHEREOF, I have hereunto set my hand
and affixed my 1I00aty seal, Ih. _ day of-JrumnfY;' 20 12. F.eh-uo.xl Notary Public My Commission Expires: 2. -2. 3-'J. Q I z.f After Recordation Please Return To: WPX Energy Rocky Mountian,
LLC Attn: Land Dept. POBox 370 Parachute, CO 81635 , 2