HomeMy WebLinkAboutApplication.pdfRWF 23-25 Application - Small Temporary Housing.pdf
Community Development Department 108 8th Street, Suite 401 Glenwood Springs, CO 81601 (970) 945-8212 www.garfield-county.com SMALL TEMPORARY EMPLOYEE HOUSING APPLICATION FORM This Application
form must be completed and received by the Garfield County Community Development Department within 48 hours following occupancy of the Small Facility. In addition, documents shall be
provided to the Sherriff’s Office and relevant fire protection district(s) that demonstrate and certify compliance with the following standards. Notice shall also be provided to these
entities within 48-hours following removal of a Small Facility. It is the Operator’s responsibility to confirm and obtain verification that this Application has been received by the
Sheriff’s Office and Fire Protection District. INVOLVED PARTIES Property Owner Name: ____________________________________ Phone: (______)_______________ Mailing Address: _____________________________
_________________________________________ City: _______________________________________ State: _______ Zip Code: ____________________ E-mail:__________________________________________________________
_____________________ Operator’s Compliance Officer Name: ________________________________________________ Phone: (______)_________________ Mailing Address: __________________________________________
____________________________ City: _______________________________________ State: _______ Zip Code: ____________________ E-mail:_______________________________________________________________________
________ PROJECT NAME AND LOCATION Location of Housing Site (Section/Township/Range): S____________ T____________ R___________ Well Pad Number: _________________________ Assessor’s Parcel
Number: __________________ Zone District: _____________ Maximum Number of Permitted Occupants: ______________________ Number of Days the Facility will be at Location: ____________________
State or Federal Permitting Agency Overseeing Reclamation, Restoration and Revegetation (Name): (Name): __________________ (Relevant Permit Number): ___________________________________
Date of Installation: ___________________ Date of Removal: _______________________ 24-Hour Emergency Contact (1): ______________________________ Phone Number: _______________ 24-Hour
Emergency Contact (2): ______________________________ Phone Number: _______________ Joan Savage 970 625-1676 PO Box 1926 Rifle CO 81612 WPX Energy 970 285-9377 PO Box 370 Parachute CO
81635 kris.meil@wpxenergy.com 25 6S 94W RWF 23-25 217526400177 Rural less than 8 130 State API #05-04521982 12/16/13 4/28/14 WPX Energy 970 285-9377 STEH-12-13-7784
ELIGBILITY During times of housing shortage or in remote locations, the use of Factory Built Nonresidential Structures (as defined under C.R.S. § 24-32-3301, as amended, and Resolution
#35 of the Colorado State Housing Board) utilized for a period of time not longer than 1 year or as otherwise specified, for workers who are engaged in commercial, industrial, mineral
extraction, or highway operations and who are needed to support the proper execution and safety of the related operations. Temporary Employee Housing, shall not include Recreational
Vehicles, except in a Small Facility. A Small Temporary Housing Facility shall have all of the following basic characteristics: Complies Y/N 1. The Small Facility and any associated
infrastructure must be completely contained within a State or Federally-permitted parcel (such as a COGCCapproved oil/gas well pad) in which reclamation and revegetation are secured
with the permitting agency (Permitted Site); and 2. The Small Facility is located at the Permitted Site for less than a cumulative of 1 year and at the end of the utilization period,
all structures, foundations, and associated infrastructure are completely removed; and 3. The Small Facility shall have an occupancy of 8 or fewer people who are employees, contractors,
or subcontractors of the operator of the small facility and are needed for on-site safety of the related commercial, industrial, extraction, or highway operation. SUBMITTAL REQUIREMENTS.
The application submitted to the County shall contain the following information: 1. 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. 2. 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. 3. 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. STANDARDS 1.
Small Facilities shall comply with all applicable Federal, State (i.e. Building Codes and electrical permits), and local laws and regulations (i.e. fire code), but are not subject to
County Building Permit. 2. Water Systems. a. Water systems shall comply with standards set forth in section 7-705.B. Water systems must comply with all applicable State and local laws
and regulations. b. All potable water systems must include a meter and the Operator must keep a record of the daily usage. c. For sites to which potable water is hauled, Operators shall:
i. Keep appropriate records, to be provided to the County upon request, to demonstrate that water supplied to a site is from an approved source and that wastewater is Yes Yes Yes
disposed at an approved facility. ii. For water facilities not permitted by the CDPHE, the Operator must conduct monthly tests (or quarterly if an on-site disinfection system is installed)
and maintain records of potable water samples specific for coli form. Any tests indicating coli form contamination must be disclosed to the County Public Health Department. iii. Water
systems facilities permitted by the CDPHE must obtain all necessary State permits or demonstrate that applications for any necessary permits have been submitted prior to a determination
by the County that an application is complete. iv. Maintain compliance with State regulations at all times during operation. d. In no case shall unsafe water be used for drinking nor
shall raw sewage or used water be discharged onto the ground surface. 3. Wastewater Systems. a. Wastewater systems shall comply with standards set forth in section 7-705.C. Wastewater
systems must comply with all applicable State and local laws and regulations. b. Wastewater may be disposed of using either an OWTS or a vault-and-haul system. A vaultand-haul system
must demonstrate the following: i. Year-round access is available and maintained for safe and regular access for sewage hauling vehicles; ii. The Operator can demonstrate and guarantee
an arrangement for hauling sewage; iii. The Operator will maintain all records, including but not limited to, trip logs/reports and landfill receipts; iv. The sewage disposal records
will be maintained as public records to be available to the County upon request; v. The facility will not exceed a cumulative of 1 year at the approved location; and 4. The facility
has been designed to accommodate 75 gallons of wastewater per person per day or an amount derived from engineered calculations taken from metered usage rates at a similar facility that
has been reviewed and approved by the County. 5. 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.
6. Wildlife-proof refuse containers must be provided for trash. Outdoor food storage is prohibited unless facilities are provided that prevent the attraction of animals to the Major
Facility site. 7. Fire Protection and Suppression. a. Provisions for giving alarm in case of fire and fire suppression must be installed per fire codes and as required by the fire protection
district. b. Single-station carbon monoxide alarms must be placed in each Manufactured Home or Recreational Vehicle unit. c. 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: ________________________ gallons 8. Domestic animals are prohibited. 9. The Operator shall obtain a certification inspection conducted by a qualified
professional engineer. The certification shall verify that at the time of inspection the identified Small Facility meets or exceeds the requirements of this section. 550 BBL/21,000
BUILDING INFORMATION (per unit) Unit 1 Make: Serial Number/Unit 10 II: ATeo Structures USA, Im: 354074502 Division of Housing Insignia (provide copy) Square feet of unit: Unit 2 Make:
Serial Number/Unit 10 II: Al CO StrvctlJ(6S USA, Inc 354063966 Division of Housing Insignia (provide copy) Square feet of unit: Unit3 Make: Serial Number/Unit 10 II: Division of Housing
Insignia (provide copy) Square feet of unit: I OWTS PERMIT I hereby attest that I am the designated Compliance Officer for the aforementioned Small Temporary Employee Housing Facility.
I attest that I have read and understand the standards to which the Facility shall be installed and operated and that the Facility shall be constructed and maintained in accordance with
all applicable Garfield County. State of Colorado and Federal Regulations and standards. I have read the statements ab e and have provided the required attached information to my knowledge.
12118/13 Signature of Compliance Officer Date I hereby attest that I am a Licensed Professional Engineer in the State of Colorado and that I have conducted a visual inspection of the
installed Small Temporary Housing Facility identified in this application. Based upon my inspection. I certify that the Small Temporary Housing Facility complies with the standards as
forth above and as codified in the Garfield County Land Use and Development Code. PE Certification Number: PE Stamp See attached report Date of Inspection: See attached report Name and
Title: Dave Fox, Principal Engineer Signature OFFICIAL USE ONLY File Number: ____ " ___ _ Fee Paid: L n/a ___ _____ _ S T H E 7 7 8 4
Fox Engineering Solutions, Inc. 670 Canyon Creek Drive, Grand Junction, CO 81507 Ph: (970) 250-5505 Email: coloradofox@bresnan.net Inspection Report for: RWF 23-25 Well Pad -Small Temporary
Employee Housing Prepare for: WPX Energy Rocky Mountain, LLC Location: NE 1/4 SW 1/4 of Section 25, T6S, R94W, 6th P.M. Garfield County Conducted By: David Fox, P.E. Date Conducted:
December 16, 2013 Garfield County Paragraph Article 7-808(D)(3) Land Use Resolution 2008 Reference Characteristic or Standard Description Inspection Comments 3.a. Small Facilities, in
the nature of Factory Built Nonresidential Structures [as defined under C.R.S. 24-32-3302(a)] but NOT recreational vehicles [as defined under C.R.S. 42-1-102 (61), including truck, truck
tractor, motor home or camper trailer], may be utilized for housing of workers on projects related to commercial, industrial, mineral extraction or highway operations, pursuant to the
standards for Small Facilities contained in subsection (2), below. Such facilities are not subject to Garfield County building and fire codes (building code, fire code). However, Small
Facilities are subject to all pertinent state (i.e. electrical permits), federal permits and relevant fire protection district(s) code requirements. Colorado Division of Housing certifications
noted on Company trailer, Unit ID. 354074502 with FBNR Certification No. 21525 manufactured by ATCO Structures USA, Inc. on 04-05-2007; and Driller's trailer, Unit ID. 354063966 with
FBNR Certification No. 21941 manufactured by ATCO Structures USA, Inc. on 4-02-2007. All other aspects not subject to visual inspection and certification by third party 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, Not subject to visual inspection and
certification by third party Professional Engineer. 3.a.(2) The Small Facility is located at the Permitted Site for less than a cumulative of one (1) year and at the end of the utilization
period, all structures, foundations and associated infrastructure are completely removed; and, Not subject to visual inspection and certification by third party Professional Engineer.
3.a.(3) The Small Facility shall have an occupancy of eight (8) or fewer people who are employees, contractors or sub-contractors of the operator of the small facility and are needed
for onsite safety of the related commercial, industrial, extraction or highway operation. Not subject to visual inspection and certification by third party Professional Engineer. 1 Small
Facility must comply with all applicable federal, state and local laws and regulations. Not subject to visual inspection and certification by third party Professional Engineer. 2 The
Small Facility shall NOT contain recreational vehicles as defined in Section 7-808 (D). No recreational vehicles observed on site. Page 1 of 5
RWF 23-25 Inspection WPX Energy Rocky Mountain, LLC Fox Engineering Solutions, Inc. December 16, 2013 3 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. 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. 4 Each Small Facility shall be maintained in a clean, safe and sanitary condition, free of weeds and refuse. Any hazardous or noxious materials
that must be stored at the Small Facility for operational or security reasons must be managed in accordance with all applicable federal, state and local laws and regulations. Site appeared
to be maintained in clean, safe and sanitary condition, free of weeds and refuse. 5 At least one thirty (30) gallon (4 cubic feet) wildlife-proof refuse container shall be provided for
each Factory Built Non-Residential Structure unit. Said container(s) must be durable, washable, nonabsorbent metal or plastic with tight-fitting lids. 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
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. Not subject to visual inspection and certification by third party Professional Engineer. 7 Outdoor food storage is prohibited. No outdoor food storage observed on-site. 8 Factory
Built Non-Residential Structures equipped by the manufacturer with a fire sprinkler system, fire detection system, and/or alarm system shall be inspected, tested, and maintained in accordance
with the requirements of the relevant fire protection district(s) and the Colorado Division of Housing. 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. 9 Single-station carbon monoxide alarms shall be placed in each Factory Built Non-Residential Structure.
Carbon monoxide detector located in all factory built non-residential structure (FBNR). 10 One (1) or more approved fire extinguisher(s) of a type suitable for flammable liquids, combustible
materials and electrical fires (Class ABC), or dry chemical, shall be located in each Factory Built Non-Residential Structure and placed in accordance with applicable fire protection
district and/or Colorado Division of Housing codes. Fire extinguishers observed in all structures. 11 Domestic animals are prohibited at all Small Facilities. No domestic animals observed
on-site. Page 2 of 5
RWF 23-25 Inspection WPX Energy Rocky Mountain, LLC Fox Engineering Solutions, Inc. December 16, 2013 12 A water storage tank is required to provide water to the sprinkler system (if
applicable) and initial suppression activities. The size of the water tank shall be determined based on sprinkler calculations and initial suppression demands. The relevant fire protection
district shall be responsible for determining the size of the water storage tank. If the Small Facility is not within a fire protection district, the Operator shall provide at least
2500 gallons of water dedicated to initial fire suppression which is accessible with a dry hydrant within each Permitted Site for a Small Facility. 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. 13 The operator shall document all emergency situations requiring action by any government agency or fire protection district, in writing, and such
documentation shall be presented to the Planning Department within 24 hours of the occurrence. Not subject to visual inspection and certification by third party Professional Engineer.
14 All required Access Permits shall be obtained from the Garfield County Road and Bridge Department or the Colorado Department of Transportation. Not subject to visual inspection and
certification by third party Professional Engineer. 15 The Garfield County Sheriff’s Office and relevant fire protection district(s) shall be notified and provided with all documentation
as outlined in these regulations, within 48 hours following occupation of each Small Facility. In addition, the Garfield County Sheriff’s Office and relevant fire protection 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. Not subject to visual inspection and certification by third party Professional Engineer. 16 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. Not subject to visual inspection and certification by third party Professional Engineer. 17 The Operator shall obtain a certification inspection conducted by a third-party
Professional Engineer Licensed in the State of Colorado. The certification shall verify that at the time of inspection the identified Small Facility meets or exceeds the standards set
forth in Article 7.808 D. 2. of the Garfield County Land Use Code of 2008, as amended. This certification shall be on forms provided by the Garfield County Planning Department. The certification
shall be provided to the Garfield County Planning Department within 48 hours following occupation of the Small Facility. 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. Page 3 of 5
RWF 23-25 Inspection WPX Energy Rocky Mountain, LLC Fox Engineering Solutions, Inc. December 16, 2013 18 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
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. Not subject to visual inspection and certification by third party Professional
Engineer. 19(a) 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: 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.
19(a)(1) Demonstrate that year-round vehicular access is available and maintained for safe and regular access for sewage hauling vehicles. Not subject to visual inspection and certification
by third party Professional Engineer. 19(a)(2) Maintain all sewage disposal records including but not limited to trip logs/reports and landfill receipts as public records, available
to the County and/or any other interested third party upon request. Not subject to visual inspection and certification by third party Professional Engineer. 19(b) Individual Sewage Disposal
System (ISDS): If an ISDS is Facility (eight or less individuals) and shall otherwise be permitted and operated in accordance with the Garfield County ISDS regulations as contained in
BOCC Resolution Number 1994H-136. proposed, then it shall be designed, installed and operated to accommodate the maximum number of persons who will inhabit the Small Facility (eight
or less individuals) and shall otherwise be permitted and operated in accordance with the Garfield County ISDS regulations as contained in BOCC Resolution Number 1994H-136. Not subject
to visual inspection and certification by third party Professional Engineer. Page 4 of 5
RWF 23-25 Inspection Fox Engineering Solutions, Inc. WPX Energy Rocky Mountain, LLC December 16, 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 (D) (3) of the Unified Land Use
Resolution of 2008, for Garfield County, Colorado. PE Certification Number: No. 25420 (Colorado PE Stamp Date of Inspection: December 16, 2013 Print Name and Title: David J_ ~o~ndPal
Engineer Signature: V ~ f <?C Page 5 of 5
Notes: The well pad site is located in the NE 1/4 SW 1/4 of Section 25, T6S , R94W, 6th P.M. (NAD83 N39.4940o W107.8378o) The site will temporarily office and house an average of four
individuals during natural gas drilling activities and is expected to be completed in one year or less. The individuals will occupy three individual trailer offices/houses located on
the well pad. Office/houses have Colorado Division of Housing compliance tags. 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 tank needs to be emptied approximately every 13.3 days (4000 gallons /300 gallons per day). Wastewater vault equipped with overflow
alarm device. WPX Energy utilizes the services of a licensed contractor to remove and haul the wastewater to a State certified treatment/disposal facility. One potable aboveground water
tank of approximately 4000 gallons capacity on-site. Potable water demand is estimated to be 300 gallons/day (4 individuals x 75 gpcd). Required minimum 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 hydrants observed on water tank. Road access to the site is maintained year-round through the services of private road maintenance and construction contractors. Base mapping
by Bookcliff Survey Services, Inc. Site features including housing trailers, water and wastewater tanks, portable toilets and dumpster were field located. Please note that this is a
construction site and that the locations of drill equipment and other items are subject to change. Factory-Built Nonresidential Structures (Office/Housing) have a minimum separation
distance of 20 ft. RWF 23-25 Site Plan Garfield County, Colorado Small Temporary Employee Housing and Septic Permit Application Applicant:WPX Energy Rocky Mountain,LLC Date December
16, 2013 Checked: DJF Version: 001 Fox Engineering Solutions, Inc. 670 Canyon Creek Drive, Grand Junction, CO 81507 Ph: (970) 250-5505 Email: coloradofox@bresnan.net Directions to Site:
WPX Energy Rocky Mountain LLC RWF 23-25 Well Pad Identification & Location Key* 1. Wastewater Aboveground Tank (4000 gal.) 2. Potable Water Aboveground Tank (4000 gal) 3. Portable Toilets
4.Wildlife-proof dumpster 5. Company Man Office/Housing 6. Driller's Office/Housing 7. Shed * Subject to relocation for construction activities. Emergency Contact List: WPX Office (24
Hrs) 970-285-9377 Doug McAdam-WPX Drilling 970-618-7340 Cell Scott Brady-WPX Drilling Sup-970-270-9187 Cell Kevin McDermott-WPX Safety-970-309-1195 Cell Mark Mumby -Spill Contractor-970-260-1576
Cell 6 5 34 Approximate Drill Rig & Equipment Area 1 2 20 ft.
From: Meil, Kris To: "Kevin Whelan" Cc: Reed, Gary Subject: RWF 23-25 Rig Move On Notification -Fire District & County Date: Monday, December 16, 2013 1:47:00 PM Attachments: RWF 23-25
Rifle Fire Letter.doc RWF 23-25 PE Map.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 130 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 lay out and emergency contact information. Should you have any questions please let me know. Thanks, Kris Meil WPX Energy
Planning FOA III 1058 County Road 215 Parachute, CO 81635 (970) 285-9377 x2209 (970) 623-6583 cell kris.meil@WPXEnergy.com
WPX Energy 1058 County Road 215 P.O. Box 370 Parachute, Colorado 81635 (970) 285-9377 12/13/13 Colorado River Fire Rescue Emergency Operations Attn: Kevin Whelan 1850 Railroad Ave Rifle,
CO 81650 Ph: 970-625-1243 RE: Emergency Response Notification RWF 23-25 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 130 days. In accordance
with Garfield County Planning and Zoning Regulations, the attached documentation provides emergency response information and driving directions for the WPX RWF 23-25 pad. Should you
have any further questions or concerns regarding this notification, feel free to contact me at (970)263-6583. Sincerely, Kris Meil Planning Coordinator – Piceance District Kris.meil@wpxenergy.com
Notes: The well pad site is located in the NE 1/4 SW 1/4 of Section 25, T6S , R94W, 6th P.M. (NAD83 N39.4940o W107.8378o) The site will temporarily office and house an average of four
individuals during natural gas drilling activities and is expected to be completed in one year or less. The individuals will occupy three individual trailer offices/houses located on
the well pad. Office/houses have Colorado Division of Housing compliance tags. 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 tank needs to be emptied approximately every 13.3 days (4000 gallons /300 gallons per day). Wastewater vault equipped with overflow
alarm device. WPX Energy utilizes the services of a licensed contractor to remove and haul the wastewater to a State certified treatment/disposal facility. One potable aboveground water
tank of approximately 4000 gallons capacity on-site. Potable water demand is estimated to be 300 gallons/day (4 individuals x 75 gpcd). Required minimum 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 hydrants observed on water tank. Road access to the site is maintained year-round through the services of private road maintenance and construction contractors. Base mapping
by Bookcliff Survey Services, Inc. Site features including housing trailers, water and wastewater tanks, portable toilets and dumpster were field located. Please note that this is a
construction site and that the locations of drill equipment and other items are subject to change. Factory-Built Nonresidential Structures (Office/Housing) have a minimum separation
distance of 20 ft. RWF 23-25 Site Plan Garfield County, Colorado Small Temporary Employee Housing and Septic Permit Application Applicant:WPX Energy Rocky Mountain,LLC Date December
16, 2013 Checked: DJF Version: 001 Fox Engineering Solutions, Inc. 670 Canyon Creek Drive, Grand Junction, CO 81507 Ph: (970) 250-5505 Email: coloradofox@bresnan.net Directions to Site:
WPX Energy Rocky Mountain LLC RWF 23-25 Well Pad Identification & Location Key* 1. Wastewater Aboveground Tank (4000 gal.) 2. Potable Water Aboveground Tank (4000 gal) 3. Portable Toilets
4.Wildlife-proof dumpster 5. Company Man Office/Housing 6. Driller's Office/Housing 7. Shed * Subject to relocation for construction activities. Emergency Contact List: WPX Office (24
Hrs) 970-285-9377 Doug McAdam-WPX Drilling 970-618-7340 Cell Scott Brady-WPX Drilling Sup-970-270-9187 Cell Kevin McDermott-WPX Safety-970-309-1195 Cell Mark Mumby -Spill Contractor-970-260-1576
Cell 6 5 34 Approximate Drill Rig & Equipment Area 1 2 20 ft.
From: Meil, Kris To: "Jim Sears" Cc: Reed, Gary Subject: RWF 23-25 Rig Move On Notification Date: Monday, December 16, 2013 1:48:00 PM Attachments: RWF 23-25 GARCO Sheriff Letter.doc
RWF 23-25 PE Map.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
130 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 lay out and emergency contact information. Should you have any questions please let me know. Thanks, Kris Meil WPX Energy Planning FOA III 1058
County Road 215 Parachute, CO 81635 (970) 285-9377 x2209 (970) 623-6583 cell kris.meil@WPXEnergy.com
WPX Energy 1058 County Road 215 P.O. Box 370 Parachute, Colorado 81635 (970) 285-9377 12/13/13 Garfield County Sheriff’s Office Emergency Operations Attn: Jim Sears 108 8th Street Glenwood
Springs, CO 81601 Ph: 970-945-0453 RE: Emergency Response Notification RWF 23-25 pad Dear Jim: This letter is to inform the Garfield County Sheriff’s Department that WPX Energy will
soon commence drilling operations on the above mentioned drilling location. WPX will provide rig site housing accommodations for the duration of the drilling operation approximately
130 days. In accordance with Garfield County Planning and Zoning Regulations, the attached documentation provides emergency response information and driving directions for the WPX RWF
23-25 pad. Should you have any further questions or concerns regarding this notification, feel free to contact me at (970)263-6583. Sincerely, Kris Meil Planning Coordinator – Piceance
District Kris.meil@wpxenergy.com
Notes: The well pad site is located in the NE 1/4 SW 1/4 of Section 25, T6S , R94W, 6th P.M. (NAD83 N39.4940o W107.8378o) The site will temporarily office and house an average of four
individuals during natural gas drilling activities and is expected to be completed in one year or less. The individuals will occupy three individual trailer offices/houses located on
the well pad. Office/houses have Colorado Division of Housing compliance tags. 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 tank needs to be emptied approximately every 13.3 days (4000 gallons /300 gallons per day). Wastewater vault equipped with overflow
alarm device. WPX Energy utilizes the services of a licensed contractor to remove and haul the wastewater to a State certified treatment/disposal facility. One potable aboveground water
tank of approximately 4000 gallons capacity on-site. Potable water demand is estimated to be 300 gallons/day (4 individuals x 75 gpcd). Required minimum 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 hydrants observed on water tank. Road access to the site is maintained year-round through the services of private road maintenance and construction contractors. Base mapping
by Bookcliff Survey Services, Inc. Site features including housing trailers, water and wastewater tanks, portable toilets and dumpster were field located. Please note that this is a
construction site and that the locations of drill equipment and other items are subject to change. Factory-Built Nonresidential Structures (Office/Housing) have a minimum separation
distance of 20 ft. RWF 23-25 Site Plan Garfield County, Colorado Small Temporary Employee Housing and Septic Permit Application Applicant:WPX Energy Rocky Mountain,LLC Date December
16, 2013 Checked: DJF Version: 001 Fox Engineering Solutions, Inc. 670 Canyon Creek Drive, Grand Junction, CO 81507 Ph: (970) 250-5505 Email: coloradofox@bresnan.net Directions to Site:
WPX Energy Rocky Mountain LLC RWF 23-25 Well Pad Identification & Location Key* 1. Wastewater Aboveground Tank (4000 gal.) 2. Potable Water Aboveground Tank (4000 gal) 3. Portable Toilets
4.Wildlife-proof dumpster 5. Company Man Office/Housing 6. Driller's Office/Housing 7. Shed * Subject to relocation for construction activities. Emergency Contact List: WPX Office (24
Hrs) 970-285-9377 Doug McAdam-WPX Drilling 970-618-7340 Cell Scott Brady-WPX Drilling Sup-970-270-9187 Cell Kevin McDermott-WPX Safety-970-309-1195 Cell Mark Mumby -Spill Contractor-970-260-1576
Cell 6 5 34 Approximate Drill Rig & Equipment Area 1 2 20 ft.
/' I I ( ""' PNf/7 /. :::: 1' T.68.,R94 I i' 50'''''' ( ~( , , , , Section25~.~~,w J. . ",' //./////77 " , :It -: , '" :kr -f-i -L , _/i /4' I ~~#~_ I i I I ,, ) GRAPHIC SCALE IN fEET
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' , , II :, , I ._~ ': l' ! ~ Ii ," ": 1_: :5\ , , I N~~ Nk 125,1 --.ar ' ' S~-; '" '!;, \ \ , , : ! ('1'iff I " >ri : 'r" , C, ,' , \\\;\\:\I.i'\ ' N I ( I ' I , ,: :\ ' I I I I I \
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I rJR' : I Y ~I I ; I (~ \ 1-,//,-/.> .. ..-___ J I /i .... 1' I i \ ",,_ I, I 11" I I iii .,--' ,/'---I I Iii \ I \ -1,\ I I I! ,cu EARTI-iWORK QUANTITIES (cy) I \ I 1 \ I I ITEM CUT
FILL --! k~~: I ' ! W~ -I /'/I ""'-1.) Topsoil Volume Based on 12" Soil_D~. 2.) Swell Factor of 10% Applied to Ea"t..< .. I \ "/3, C" Vol,m._ PAD 36580 22947 8600 5033 P'T 0 0 .nT. 36580
22947 8600 5033 ! '". ,~, -r for: ; ~~';~~IIS) = I h:I: ~ 1US-Z1"13 PlAT. ! '"'" RWF 23-25 Drill Pad -Plat 2 CONSTRUC110N LAYOen'
Section25 T.6S..R94W. ACCESS DESCRIPTION: , .. o ------GRAPHIC SCALE r<I FEET 1 INCH . 2000 FEET FROM THE INTERSECTION OF STATE HIGHWAY 6 AND COUNTY ROAD 323 NORTH OF RULISON, PROCEED
SOUTHERLY ALONG COUNTY ROAD 323 ±1.1 MILES TO THE INTERSEC110N WITH COUNTY ROAD 309, PROCEED LEFT IN AN EASTERLY DIRECTION :t2.3 MILES TO THE INTERSECTION WITH COUNTY ROAD 320, PROCEED
RIGHT IN AN EASTERLY DIRECTION :1:6.1 MILES TO THE INTERSECTION WITH COUNTY ROAD 317 (Beaver Creek Road), PROCEED RIGHT IN A SOUTHERLY DIRECTION ±1.7 MILES TO THE INTERSECTION WITH A
DIRT/GRAVEL ROAD, PROCEED RIGHT IN AN WESTERLY DIRECTION ±D.6 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD, PROCEED RIGHT IN A NORTHERLY DIRECTION ±D.2 MILES TO THE RWF 23-25 DRILL
PAD LOCATION, AS SHOWN HEREON. WPX Energy Rocky Mountain, LLC RWF 23-25 Dri1l Pad -Plat 5 ACCESS ROAD & TOro MAP
August 6, 2013 MI'. Fred Jarman, Director Garfield County Building and Planning Department 108 8th Street, 4th Floor Glenwood Springs, CO 8160 I RE: RWF 11-35, RWF 23-25, RWF 43-25 Drilling
Pad Locations, Garfield County, Colorado Deal' MI'. Jarman: This letter authorizes WI'X Energy Rocky Mountain, LLC to represent me in the submittal and processing of the required Gnrfield
County Small Temporary Employee Housing (STEH) and Illdividllal Sewage Disposal System (lSDS) permits on the above drilling pad locations. /i';' ;e;:;~~ Name: !Iv J'-h 7hz.< /t T Title:
__________ _
fillli M" .. I'lJhl\li.MU,rK.uIr1"I'rI'l+.If.wr./AJ~ II\U~ 11111 Reeep\!onMt BIGDa. 02/27120t2 t2:t.· II) PH JUl'I ntb!t1 .. _ , 01 , RaG F""ISil . OO 000 FUIO. 0 ~laD CC>tMJV CO LIMITED
POWER OF ATTORNEY WPX ENERGY ROCKY MOUNTAIN, LLC ("Company") a Delaware limited liability compallY, having its principal place of business In tbe City of Tulsa, County of Tulsa, StAte
of Oklahoma, does hereby make, constitute and appoint Bryan S. Hotard with the fnll amhority hereinafler provided, the tme and lawfnl Auomey-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 associfltlOO, in whole
or in part, to enter into, execute, deliver, file and accept all in!i(rumcnls and documenls affecting the real property or real eslate rights of the Company as more specifically set
forth below: : 1. Applications and documentalion associated with Garfield County or Rio Blanco pemlitting rcquirtments for including, but not limited to, Independcnt Sewage Disposal
Systems, Small Temporary Employee Housing, Major Impact Reyiews, Linlited Impact Reviews, Oil and Gas well permitting, Driveway Acces., County Road Maintenance, Temporary Living Quarters,
Temporary Use Penults, Surface Use Pennits, Surface Usc Licenses, Utilities, Snow Removal and Private Construction of County Road.; 2. Agreements and other documentation that grant casements,
righL' of way, licenses, or pem,it. to Company and also instruments where the Company gnlnts such rights to others; 3. Agreemenls that assign easements, rigbts of way, licenses, permits
or surface leases in connection with the CompallY's operations; 4. Releases and Partial Releases of easements and rigbts of way; 5. Agreements allowing encroachments onto easements and
righls of way owned by Company and landowner instruments and conveyances on others casements; 6. Agreements subordinating mortgage rights to easement or lease; 7. Agreements relating
to the modification Rod relooation of Company facilities; 8. Rental or lease agreements for surface use or oU,er surface use agreements and all notices related to Ibe piJleline agreements;
9. Agreements for th. purebase or sale of real property nnd for tbe leas. of r.al property for residential or commercial purposes or otherwise in connection with the Company's operations;
10. Agreements to obtain waler services, electrical, gas or oil services or the provision of other utility services utili2ed by Company's racllities; II. Agreements modifYing, amending,
renewing, extending, ratifying rorfeiting, canceling alld terminating nny and all of the nforementioned types of instruments and documents. WPX ENERGY ROCKY MOUNTAIN, LLC hereby declares
Ihat each and every act, mailer and tiling wl.lch sball be given, made and done by Bryan S. HOlBrd in connection with the exercise of any or all of the aforesaid powers sball be as good,
valid and effectual to all Intents and purposes 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 Allorney-in-Fact shall lawfully do or cause 10 be done by virtue hereof. This Limited Power of Allomey shall remain in full forc. and effect until terminated by Company.
111111 ~1'I'U!I~>Vi,IllW,Nr\rr+lt'''rr+\ClrKlWJ I,~~'~ I' "' R.~.ptJonV: at50~ eU2T120t2 121'1'10 Po" Jun Rlb,,.leo 2 or 2 RIrO Fee:1t .00 Doc Fu;O.CO ~ARfJEl.O C~1 co IN WITNESS WHEREOF,
WPX Energy Rocky Mountain, LLC has c?u«d Ihis Limited Power of Attorney to he signed by one of ils Vice Presidenls, duly authori1.ed by its Monagomenl Committee to grant power. of attorney
this \" day of January, 2012. ACKNOWLEDGMENT STATE OF OKLAHOMA ) ) .s. COUNTY OF TULSA ) BEFORE ME, the undersigoed aUlhority, a Notary Public In and for said County and State, on this
day personally appeared, Jerry D. Barne, personally known to me 10 be the Vice Presidenl of WPX Energy Rocky Mountain, LLC a Delaware limiled liability company, who acknowledged to me
Ihal 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 notary seal, th.Zoih
day of.JtmQ..,., 2012. Fe!or-uwy My Commission Expires: After Recordation Please Return To: WPX Energy Rocky Mountian, LLC Attn: Land Dept. POBox 370 Parachute, CO 81635 2