HomeMy WebLinkAboutApplication.pdf_c Garfield County
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: Chevron
Mailing Address: PO Box 285
Phone: ( 970 )
City: Houston State: TX Zip Code: 77001
E-mail:
Operator's Compliance Officer
Name: WPX Energy Phone: ( 970 ) 285-9377
Mailing Address: PO Box 370
City: Parachute State: CO Zip Code: 81635
E-mail: kris.meil@wpxenergy.com
PROJECT NAME AND LOCATION
Location of Housing Site (Section/Township/Range): S 28
Well Pad Number: TR 24-28-597
T ss R 97W
Assessor's Parcel Number: 213728300004
Zone District: Rural Maximum Number of Permitted Occupants: Ie- - than 8
Number of Days the Facility will be at Location: 63
State or Federal Permitting Agency Overseeing Reclamation, Restoration and Revegetation (Name):
(Name): State (Relevant Permit Number): API #0504517811
Date of Installation: 6/5/14 Date of Removal: 8/6/14
24 -Hour Emergency Contact (1): VVI'A nergy
Phone Number: y it-) Lt55-,5 11
24 -Hour Emergency Contact (2): Phone Number:
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 COGCC-
approved oil/gas well pad) in which reclamation and revegetation are secured
with the permitting agency (Permitted Site); and
Yes
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
Yes
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.
Yes
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
BUILDING INFORMATION (per unit)
Unit 1
Make:
ATCO Structures USA
Serial Number/Unit ID #:
354063605
Division of Housing Insignia (provide copy)
Square feet of unit:
Unit 2
Make:
ATCO Structures USA
Serial Number/Unit ID #:
354085522
Division of Housing Insignia (provide copy)
Square feet of unit:
Unit 3
Make:
ATCO Structures USA
Serial Number/Unit ID #:
354085430
Division of Housing Insignia (provide copy)
Square feet of unit:
OWTS PERMIT
Permit #:
SEPT -5-14-3243
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 above and have provided the required attached information
which is correct and accurate to the best of my knowledge.
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:
See attached report
PE Stamp
Date of Inspection:
See attached report
Name and Title:
Dave Fox, Principal Engineer
Signature
OFFICIAL USE ONLY
File Number: -
Fee Paid: $_ n/a
BUILDING INFORMATION (per unit)
Unit 1
Make:
ATCO Structures USA
Serial Number/Unit ID #:
354063605
Division of Housing Insignia (provide copy)
Square feet of unit:
Unit 2
Make:
ATCO Structures USA
Serial Number/Unit ID #:
354085522
Division of Housing Insignia (provide copy)
Square feet of unit:
Unit 3
Make:
ATCO Structures USA
Serial Number/Unit ID #:
354085430
Division of Housing Insignia (provide copy)
Square feet of unit:
OWTS PERMIT
Permit #:
SEPT -5.14-3243
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 statemm nts a 1 ove and have provided the required attached information
which is correct and accurate 6th • *es of my knowledge.
Signature of Compliance Officer
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:
See attached report
PE Stamp
Date of Inspection:
See attached report
Name and Title:
Dave Fox, Principal Engineer
Signature
OFFICIAL USE ONLY
File Number: -
Fee Paid: $_ n/a
Fox Engineering Solutions, Inc.
670 Canyon Creek Drive, Grand Junction, CO 81507
Ph: (970) 250-5505
Email: coloradofox@bresnan.net
Inspection Report for: TR 24-28-597 Small Temporary Employee Housing
Client: WPX Energy Rocky Mountain, LLC
Location: SE 1/4 SW 1/4 of Section 28, T5S, R97W, 6th P.M. Garfield County
Conducted By: David Fox, P.E.
Date Conducted: June 5, 2014
Paragraph
Reference
Garfield County
Article 7-808(D)(3) Land Use Resolution 2008
Characteristic or Standard Description
3.a. Small Facilities, in the nature of Factory Built Nonresidential
Structures [as defined under C.R.S. 24-32-3302(a)] but NOT
recreational vehicles [as defined under C.R.S. 42-1-102 (61), including
truck, truck tractor, motor home or camper trailer], may be utilized
for housing of workers on projects related to commercial, industrial,
mineral extraction or highway operations, pursuant to the standards
for Small Facilities contained in subsection (2), below. Such facilities
are not subject to Garfield County building and fire codes (building
code, fire code). However, Small Facilities are subject to all pertinent
state (i.e. electrical permits), federal permits and relevant fire
protection district(s) code requirements.
3.a.(1)
3.a.(2)
3.a.(3)
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,
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,
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.
Small Facility must comply with all applicable federal, state and local
laws and regulations.
Page 1 of 5
Inspection Comments
Colorado Division of Housing certifications noted on
Company trailer, Unit ID 358074402, Certification
No. 20566 by ATCO Structures USA in 2007; Driller's
trailer, Unit ID. 354063605 with Certification No.
21939, manufactured by ATCO Structures in 2006;
the Directional trailer, Unit ID.354085522 with
Certification No. 19043, manufactured by ATCO
Structures in 2008; and the Mud trailer, Unit ID
354085430 with Certification No. 19075,
manufactured by ATCO Structures in 2008. All
other aspects not subject to visual inspection and
certification by third party Professional Engineer.
Not subject to visual inspection and certification by
third party Professional Engineer.
Not subject to visual inspection and certification by
third party Professional Engineer.
Not subject to visual inspection and certification by
third party Professional Engineer.
Not subject to visual inspection and certification by
third party Professional Engineer.
TR 24-28-597 Inspection Fox Engineering Solutions, Inc.
WPX Energy Rocky Mountain, LLC June 5, 2014
2 The Small Facility shall NOT contain recreational vehicles as defined
in Section 7-808 (D).
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.
4 Each Small Facility shall be maintained in a clean, safe and sanitary
condition, free of weeds and refuse. Any hazardous or noxious
materials that must be stored at the Small Facility for operational or
security reasons must be managed in accordance with all applicable
federal, state and local laws and regulations.
5 At least one thirty (30) gallon (4 cubic feet) wildlife -proof refuse
container shall be provided for each Factory Built Non -Residential
Structure unit. Said container(s) must be durable, washable, non-
absorbent metal or plastic with tight -fitting lids.
6 Refuse shall be disposed of weekly, at a minimum. Operators must
keep appropriate records, to be provided to the County or any
interested third party upon request, to demonstrate that refuse is
collected in a timely fashion and disposed of at a licensed facility.
7
Outdoor food storage is prohibited.
8 Factory Built Non -Residential Structures equipped by the
manufacturer with a fire sprinkler system, fire detection system,
and/or alarm system shall be inspected, tested, and maintained in
accordance with the requirements of the relevant fire protection
district(s) and the Colorado Division of Housing.
9 Single -station carbon monoxide alarms shall be placed in each
Factory Built Non- Residential Structure.
10 One (1) or more approved fire extinguisher(s) of a type suitable for
flammable liquids, combustible materials and electrical fires (Class
ABC), or dry chemical, shall be located in each Factory Built Non -
Residential Structure and placed in accordance with applicable fire
protection district and/or Colorado Division of Housing codes.
Page 2 of 5
No recreational vehicles observed on site.
Two potable water tanks of approximately 8000
gallons and two 4000 -gallon sewage holding tank
onsite. All tanks and piping located above ground.
No on-site disinfection systems installed.
Site appeared to be maintained in clean, safe and
sanitary condition, free of weeds and refuse.
One wildlife -proof trash recepacle with a capacity of
approximately 20 cubic yards onsite. Individual
refuse containers in each office/housing structure.
Not subject to visual inspection and certification by
third party Professional Engineer.
No outdoor food storage observed on-site.
No active fire sprinkler systems observed in any of
the factory built non-residential structures. Smoke
detectors observed in all factory built non-
residential structures. Colorado Division of Housing
(CDH) compliance tags on all factory built non-
residential structures stating compliance with
nonresidental construction standards of the State of
Colorado.
Carbon monoxide detectors located in all factory
built non-residential structures.
Fire extinguishers, Class ABC, observed in all
structures.
TR 24-28-597 Inspection Fox Engineering Solutions, Inc.
WPX Energy Rocky Mountain, LLC June 5, 2014
11
Domestic animals are prohibited at all Small Facilities.
12 A water storage tank is required to provide water to the sprinkler
system (if applicable) and initial suppression activities. The size of the
water tank shall be determined based on sprinkler calculations and
initial suppression demands. The relevant fire protection district shall
be responsible for determining the size of the water storage tank. If
the Small Facility is not within a fire protection district, the Operator
shall provide at least 2500 gallons of water dedicated to initial fire
suppression which is accessible with a dry hydrant within each
Permitted Site for a Small Facility.
13 The operator shall document all emergency situations requiring
action by any government agency or fire protection district, in
writing, and such documentation shall be presented to the Planning
Department within 24 hours of the occurrence.
14 All required Access Permits shall be obtained from the Garfield
County Road and Bridge Department or the Colorado Department of
Transportation.
15 The Garfield County Sheriff's Office and relevant fire protection
district(s) shall be notified and provided with all documentation as
outlined in these regulations, within 48 hours following occupation of
each Small Facility. In addition, the Garfield County Sheriff's Office
and relevant fire protection 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.
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.
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.
Page 3 of 5
No domestic animals observed on-site.
Two potable aboveground water tank of
approximately 8000 gallons total capacity on-site.
Potable water demand is estimated to be 600
gallons/day gallons (8 individuals x 75 gpcd).
Required fire suppression demand is 2500 gallons.
Total potable and fire suppression volume required
is estimated to be 8000 gallons. Water supply
appears adequate with 5500 gallons of storage with
refills scheduled at 9 -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.
TR 24-28-597 Inspection Fox Engineering Solutions, Inc.
WPX Energy Rocky Mountain, LLC June 5, 2014
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.
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:
19(a)(1) Demonstrate that year-round vehicular access is available and
maintained for safe and regular access for sewage hauling vehicles.
19(a)(2) Maintain all sewage disposal records including but not limited to trip
logs/reports and landfill receipts as public records, available to the
County and/or any other interested third party upon request.
19(b)
Individual Sewage Disposal System (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.
Page 4 of 5
Not subject to visual inspection and certification by
third party Professional Engineer.
Two aboveground sewage holding tanks with 8000 -
gallon total capacity on-site. Sewage flows
estimated to be 600 gallons/day (8 individuals x 75
gpcd). Sewage holding tanks need to be emptied
approximately every 13 days (8000 gallons / 600
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.
TR 24-28-597 Inspection Fox Engineering Solutions, Inc.
WPX Energy Rocky Mountain, LLC June 5, 2014
I hereby attest that / am a Licensed Professional Engineer in the State of Colorado. I attest that I or my agent has
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:
Date of Inspection:
Print Name and Titl
Signature:
No. 25420 (Colorado PE Stamp
June 5, 2014
David J. Fox, P •incipal Engineer
Page 5 of 5
WPX Energy Rocky Mountain LLC
TR 24-28-597 Well Pad
Section 28
T. 5 S., R. 97 W.
Existsng
Access Road
TR -24-28-597 DRILL
FAD LOCATION
P..9. ej,
ACCESS DESCRIPTION:
FROM THE INTERSECTION OF THE 1-70 FRONTAGE ROAD AND COUNTY ROAD 215 AT PARACHUTE, PROCEED IN A NORTHERLY
DIRECTION ALONG COUNTY ROAD 215 ±72 MILES TO THE INTERSECTION WITH GARDEN GULCH ROAD, PROCEED LEFT IN A
WESTERLY DIRECTION ALONG GARDEN GULCH ROAD ±23.1 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD, PROCEED
LEFT IN A SOUTHERLY DIRECTION ±2.1 MILES TO THE EXISTING TR 24-28-597 DRILL PAD LOCATION, AS SHOWN HEREON.
i36 East Third Street
RL0 Cotomdo 81650
Ph. 2970/ 625-2720
Fax (970) 6252773
Sury • Services, Inc.
SCALE: 1" = 25027
DATE. 1/2l/14
Construction Plan Prepared for:
WPXENEAGY
mss-- WPX Energy Rocky Mountain, LLC
PLAT: 5 n.f 7
PROJECT Tee/ Rtdpe
122.5:
TR 24-28-597 Drill Pad - Plat 5
ACCESS ROAD & TOPO A/TAP
Directions to Site:
Srrrrtin 28
R, 97 W.
109
GRAPHIC SCALE IN FEET
1 INCH =100FEET
I ///^/��28 ft.
/
24 ft.
40 ft.
Exist. Limn r
of Disturbance
-' / 4,/
/
// I
0 3 ❑ / 1/
3F /
10x10"
Flare Pit
I
Exist. Limit I
of Disturbance
REVISED: 2/21/14
N
139 Ease Thin! .Street
Rifle, Colorado 31650
Pig (970) 625-2720
Fax (970) 02.5 2 7
BOOKCL
Sury Services, Inc
.SCALE. 1 " — 100'
DATE: 1/21/14
Construction Plan Prepared for:
WPXENERGY WPX Energy Rocky Mountain, LLC
PLAT: 4 0f 9
PROJECT° Trail Ridge
DFT: CS
TR 24-28-597 Drill Pad - Plat 4
DRILL RIG LAYOUT
Emergency Contact List:
WPX Office (24 Hrs) 970-285-9377
Lyn Cass-WPX Drilling 970-263-2716 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
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. Directional Engineer's Office/Housing
8. Mud Engineer's Office/Housing
Subject to relocation for construction activities.
WPXENERGY,.
Notes:
The well pad site is located in the SE 1/4 SW 1/4 of Section 28, T5S, R97W ,
6th P.M. (NAD83 N39.5801° W108.2854°)
The site will temporarily office and house an average of eight individuals during
natural gas drilling activities and is expected to be completed in one year or
less. The individuals will occupy four individual trailer offices/houses located
on the well pad. Office/houses have Colorado Division of Housing compliance
tags.
Two aboveground sewage holding tanks with 8000 -gallon capacity on-site.
Sewage flows estimated to be 600 gallons/day (8 individuals x 75 gpcd).
Sewage holding tank needs to be emptied approximately every 13 days (8000
gallons / 600 gallons per day). Wastewater vault equipped with overflow alarm
device. WPXEnergy utilizes the services of a licensed contractor to remove
and haul the wastewater to a State certified treatment/disposal facility.
Two potable aboveground water tanks of approximately 8000 gallons total
capacity on-site. Potable water demand is estimated to be 600 gallons/day
(8 individuals x 75 gpcd). Required minimum fire suppression demand is 2500
gallons. Total potable water available is estimated to be 5500 gallons. Water
supply appears adequate with 5500 gallons of storage with refills scheduled at
9 day intervals (5500 gallons/600 gallons per day). 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 BookcliffSurvey 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.
TR 24-28-597 Site Plan
Garfield County, Colorado
Small Temporary Employee Housing and
Septic Permit Application
Applicant: WPXEnergy Rocky Mountain LLC
Date: June 5, 2014 Checked: DJF
Fox Engineering Solutions, Inc.
670 Canyon Creek Drive, Grand Junction, CO 81507
Ph: (970) 250-5505
Email coloradofox@bresnan.net
Version: 001
From: Meil, Kris
To: "Rob Ferguson"
Cc: Reed, Gary
Subject: TR 24-28-597 Rig Move On Notification - Fire District & County
Date: Monday, June 09, 2014 9:48:00 AM
Attachments: Grand Valley Fire Letter.odf
TR 24-28-597 PE Certification 6.pdf
I am notifying you on the attached pad locations we will be commencing drilling operations
in the next few days and these operations will continue for approximately 63 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 28 - TSS R97W.
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 111
1058 County Road 215
Parachute, CO 81635
(970) 285-9377 x2209
(970) 623-6583 cell
kris.meilC WPXEnergy.com
WPXENERGY
WPXENERGY.
WPX Energy
1058 County Road 215
P.O. Box 370
Parachute, Colorado 81635
(970) 285-9377
6/9/14
Grand Valley Fire Protection District
Emergency Operations
Attn: Rob Ferguson
0124 Stone Quarry Rd
Parachute, CO 81635
Ph: 970-285-9119
RE: Emergency Response Notification
TR 24-28-597 pad
Dear Rob:
This letter is to inform the Grand Valley Fire Protection District that WPX Energy will soon
commence drilling operations on the above mentioned drilling location. WPX will provide rig
site housing accommodations for the duration of the drilling operation approximately 63 days.
In accordance with Garfield County Planning and Zoning Regulations, the attached
documentation provides emergency response information and driving directions for the WPX
TR 24-28-597 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
WPX Energy Rocky Mountain LLC
TR 24-28-597 Well Pad
Section 28
T. 5 S., R. 97 W.
Existsng
Access Road
TR -24-28-597 DRILL
FAD LOCATION
P..9. ej,
ACCESS DESCRIPTION:
FROM THE INTERSECTION OF THE 1-70 FRONTAGE ROAD AND COUNTY ROAD 215 AT PARACHUTE, PROCEED IN A NORTHERLY
DIRECTION ALONG COUNTY ROAD 215 ±72 MILES TO THE INTERSECTION WITH GARDEN GULCH ROAD, PROCEED LEFT IN A
WESTERLY DIRECTION ALONG GARDEN GULCH ROAD ±23.1 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD, PROCEED
LEFT IN A SOUTHERLY DIRECTION ±2.1 MILES TO THE EXISTING TR 24-28-597 DRILL PAD LOCATION, AS SHOWN HEREON.
i36 East Third Street
RL0 Cotomdo 81650
Ph. 2970/ 625-2720
Fax (970) 6252773
Sury • Services, Inc.
SCALE: 1" = 25027
DATE. 1/2l/14
Construction Plan Prepared for:
WPXENEAGY
mss-- WPX Energy Rocky Mountain, LLC
PLAT: 5 n.f 7
PROJECT Tee/ Rtdpe
122.5:
TR 24-28-597 Drill Pad - Plat 5
ACCESS ROAD & TOPO A/TAP
Directions to Site:
Srrrrtin 28
R, 97 W.
109
GRAPHIC SCALE IN FEET
1 INCH =100FEET
I ///^/��28 ft.
/
24 ft.
40 ft.
Exist. Limn r
of Disturbance
-' / 4,/
/
// I
0 3 ❑ / 1/
3F /
10x10"
Flare Pit
I
Exist. Limit I
of Disturbance
REVISED: 2/21/14
N
139 Ease Thin! .Street
Rifle, Colorado 31650
Pig (970) 625-2720
Fax (970) 02.5 2 7
BOOKCL
Sury Services, Inc
.SCALE. 1 " — 100'
DATE: 1/21/14
Construction Plan Prepared for:
WPXENERGY WPX Energy Rocky Mountain, LLC
PLAT: 4 0f 9
PROJECT° Trail Ridge
DFT: CS
TR 24-28-597 Drill Pad - Plat 4
DRILL RIG LAYOUT
Emergency Contact List:
WPX Office (24 Hrs) 970-285-9377
Lyn Cass-WPX Drilling 970-263-2716 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
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. Directional Engineer's Office/Housing
8. Mud Engineer's Office/Housing
Subject to relocation for construction activities.
WPXENERGY,.
Notes:
The well pad site is located in the SE 1/4 SW 1/4 of Section 28, T5S, R97W ,
6th P.M. (NAD83 N39.5801° W108.2854°)
The site will temporarily office and house an average of eight individuals during
natural gas drilling activities and is expected to be completed in one year or
less. The individuals will occupy four individual trailer offices/houses located
on the well pad. Office/houses have Colorado Division of Housing compliance
tags.
Two aboveground sewage holding tanks with 8000 -gallon capacity on-site.
Sewage flows estimated to be 600 gallons/day (8 individuals x 75 gpcd).
Sewage holding tank needs to be emptied approximately every 13 days (8000
gallons / 600 gallons per day). Wastewater vault equipped with overflow alarm
device. WPXEnergy utilizes the services of a licensed contractor to remove
and haul the wastewater to a State certified treatment/disposal facility.
Two potable aboveground water tanks of approximately 8000 gallons total
capacity on-site. Potable water demand is estimated to be 600 gallons/day
(8 individuals x 75 gpcd). Required minimum fire suppression demand is 2500
gallons. Total potable water available is estimated to be 5500 gallons. Water
supply appears adequate with 5500 gallons of storage with refills scheduled at
9 day intervals (5500 gallons/600 gallons per day). 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 BookcliffSurvey 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.
TR 24-28-597 Site Plan
Garfield County, Colorado
Small Temporary Employee Housing and
Septic Permit Application
Applicant: WPXEnergy Rocky Mountain LLC
Date: June 5, 2014 Checked: DJF
Fox Engineering Solutions, Inc.
670 Canyon Creek Drive, Grand Junction, CO 81507
Ph: (970) 250-5505
Email coloradofox@bresnan.net
Version: 001
From: Meil, Kris
To: "Jim Sears"
Cc: Reed, Gary
Subject: TR 24-28-597 Rig Move On Notification
Date: Monday, June 09, 2014 9:50:00 AM
Attachments: GARCO Sheriff Letter.odf
TR 24-28-597 PE Certification 6.pdf
I am notifying you on the attached pad locations we will be commencing drilling operations
in the next few days and these operations will continue for approximately 63 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 28 - TSS R97W.
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 111
1058 County Road 215
Parachute, CO 81635
(970) 285-9377 x2209
(970) 623-6583 cell
kris.meilC WPXEnergy.com
WPXENERGY
WPXENERGY.
WPX Energy
1058 County Road 215
P.O. Box 370
Parachute, Colorado 81635
(970) 285-9377
6/9/14
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
TR 24-28-597 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 63 days.
In accordance with Garfield County Planning and Zoning Regulations, the attached
documentation provides emergency response information and driving directions for the WPX
TR 24-28-597 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
WPX Energy Rocky Mountain LLC
TR 24-28-597 Well Pad
Section 28
T. 5 S., R. 97 W.
Existsng
Access Road
TR -24-28-597 DRILL
FAD LOCATION
P..9. ej,
ACCESS DESCRIPTION:
FROM THE INTERSECTION OF THE 1-70 FRONTAGE ROAD AND COUNTY ROAD 215 AT PARACHUTE, PROCEED IN A NORTHERLY
DIRECTION ALONG COUNTY ROAD 215 ±72 MILES TO THE INTERSECTION WITH GARDEN GULCH ROAD, PROCEED LEFT IN A
WESTERLY DIRECTION ALONG GARDEN GULCH ROAD ±23.1 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD, PROCEED
LEFT IN A SOUTHERLY DIRECTION ±2.1 MILES TO THE EXISTING TR 24-28-597 DRILL PAD LOCATION, AS SHOWN HEREON.
i36 East Third Street
RL0 Cotomdo 81650
Ph. 2970/ 625-2720
Fax (970) 6252773
Sury • Services, Inc.
SCALE: 1" = 25027
DATE. 1/2l/14
Construction Plan Prepared for:
WPXENEAGY
mss-- WPX Energy Rocky Mountain, LLC
PLAT: 5 n.f 7
PROJECT Tee/ Rtdpe
122.5:
TR 24-28-597 Drill Pad - Plat 5
ACCESS ROAD & TOPO A/TAP
Directions to Site:
Srrrrtin 28
R, 97 W.
109
GRAPHIC SCALE IN FEET
1 INCH =100FEET
I ///^/��28 ft.
/
24 ft.
40 ft.
Exist. Limn r
of Disturbance
-' / 4,/
/
// I
0 3 ❑ / 1/
3F /
10x10"
Flare Pit
I
Exist. Limit I
of Disturbance
REVISED: 2/21/14
N
139 Ease Thin! .Street
Rifle, Colorado 31650
Pig (970) 625-2720
Fax (970) 02.5 2 7
BOOKCL
Sury Services, Inc
.SCALE. 1 " — 100'
DATE: 1/21/14
Construction Plan Prepared for:
WPXENERGY WPX Energy Rocky Mountain, LLC
PLAT: 4 0f 9
PROJECT° Trail Ridge
DFT: CS
TR 24-28-597 Drill Pad - Plat 4
DRILL RIG LAYOUT
Emergency Contact List:
WPX Office (24 Hrs) 970-285-9377
Lyn Cass-WPX Drilling 970-263-2716 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
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. Directional Engineer's Office/Housing
8. Mud Engineer's Office/Housing
Subject to relocation for construction activities.
WPXENERGY,.
Notes:
The well pad site is located in the SE 1/4 SW 1/4 of Section 28, T5S, R97W ,
6th P.M. (NAD83 N39.5801° W108.2854°)
The site will temporarily office and house an average of eight individuals during
natural gas drilling activities and is expected to be completed in one year or
less. The individuals will occupy four individual trailer offices/houses located
on the well pad. Office/houses have Colorado Division of Housing compliance
tags.
Two aboveground sewage holding tanks with 8000 -gallon capacity on-site.
Sewage flows estimated to be 600 gallons/day (8 individuals x 75 gpcd).
Sewage holding tank needs to be emptied approximately every 13 days (8000
gallons / 600 gallons per day). Wastewater vault equipped with overflow alarm
device. WPXEnergy utilizes the services of a licensed contractor to remove
and haul the wastewater to a State certified treatment/disposal facility.
Two potable aboveground water tanks of approximately 8000 gallons total
capacity on-site. Potable water demand is estimated to be 600 gallons/day
(8 individuals x 75 gpcd). Required minimum fire suppression demand is 2500
gallons. Total potable water available is estimated to be 5500 gallons. Water
supply appears adequate with 5500 gallons of storage with refills scheduled at
9 day intervals (5500 gallons/600 gallons per day). 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 BookcliffSurvey 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.
TR 24-28-597 Site Plan
Garfield County, Colorado
Small Temporary Employee Housing and
Septic Permit Application
Applicant: WPXEnergy Rocky Mountain LLC
Date: June 5, 2014 Checked: DJF
Fox Engineering Solutions, Inc.
670 Canyon Creek Drive, Grand Junction, CO 81507
Ph: (970) 250-5505
Email coloradofox@bresnan.net
Version: 001
KA.7010 TRAIL RIOGGITR 24.28•S97\IR 24.2B•S97.dw0, 2/21/:014 2;12 O2 PM
Section 28
T. 5 S, R. 97 W
yJ�k ,
Exist. Limit fir --_J'/ Fk
of Disturbance ---',...,(//111.-1:-,`- Fa�,;o
,,,,,,,,.„,.2._-„,.. I, /-- 1
1,,,r ,l i 1 \ /
1 m/ 1��i k ,;_
�� !,11111! 1t1 e�•\\e6 ,. /
RF 4/ %lilt/, ,,,, 1 i 9e
/'"/ /
.F°°� / se / / / % -
; j L /
�� }s\ -P / 0 100
/
/ / GRAPHIC SCALE IN FEET
44
^ , I/% /
},1 7.",
// �/ / /.
/1/11j
1I1'
ll/
/ / \j r
1 / / 89, Prop. r„
R 3j3
/ l �' / 8a- &- fe S13 -2859
,43,-6 _ FX4! S!. 28_
8$•. FXi3! T TIP 9
A J st. 7 -,3244 -.5.9.x -
Pro
2428 -S
Pr°p .r R614 -28-5g
24..`,50)
28859'
.'o, S 44 B85g�
1- pt�er EXist. Pad
/ /
//1
1 l INN_ Edge of
I f / / j Existing Pad
/
I
\ 11/4,k
N
'\ \ off_`:
�'• ♦ .fit- �
\ \ \\ I \ \ \
\' \
U
ESTIMATED EARTHWORK QUANTITIES (cy)
ITEM
CUT
FILL
TOPSOIL
EXCESS
PAD
0
0
0
0
PIT
0
0
TOTALS
0
0
0
0
,1
r,
•
A
ek
•cA
90.
44 •�<a.2g39j 66
,�.
Exist Limit
of Disturbance
S`3
Op,
1 INCH =100FEET
�Qc i I i
fit
11111
r r r
x7,gl
J
G l/ .,120, Fly
l r 4r,
\
\`\\\\\_\�\\`\t `�
REVISED.' 2/21/14
*NOTE:
1.) No Additional Earthwork Anticipated at this site.
2.) Total Disturbed Area = ±7.98 ac.
136 East Third Street
Rifle, Colorado 81650
Ph. (9 701 625-2720
Fax 19 701 625-2773 .i+,ije
BOOKCI.TFF
Sury - Services, Inc.
SCALE: 1 " = 100'
DATE: 1/21/14
Construction Plan Prepared for:
WPXEvimpl RGY WPX Energy Rocky Mountain, LLC
PLAT- 2 of 9
PROJECT: Trail Ridge
Dl f: - cs
TR 24-28-597 Drill Pad - Plat 2
- CONSTRUCTION LAYOUT
9
Ntc2010 TRATI. RIDGE \TR 2448497\TR 2426.597
Section 28
T 5S., R. 97W
ACCESS DESCRIPTION:
FROM THE INTERSECTION OF THE 1-70 FRONTAGE ROAD AND COUNTY ROAD 215 AT PARACHUTE, PROCEED IN A NORTHERLY
DIRECTION ALONG COUNTY ROAD 215 ±7.2 MILES TO THE INTERSECTION WITH GARDEN GULCH ROAD, PROCEED LEFT IN A
WESTERLY DIRECTION ALONG GARDEN GULCH ROAD ±23.1 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD, PROCEED
LEFT IN A SOUTHERLY DIRECTION ±2.1 MILES TO THE EXISTING TR 24-28-597 DRILL PAD LOCATION, AS SHOWN HEREON.
136 East Third Street
Rhe, Colorado 81650
Pk (970) 625-2720
Fax (970)625-2773 .�i'��II�//i�k
BOOKCLIFF
Sury Services, Inc,
SCALE: I" = 2000'
DATE: 1/21/ 14
Construction Plan Prepared for:
WPXENERGY WPX Energy Rocky Mountain, LLC
PLAT- 5 of 7
PROJECT. Trail Ridge
DFT es
TR 24-28-597 Drill Pad - Plat 5
-ACCESS ROAD & TOPO MAP
Ill�YCrbl'MppWY 8O&tliulir'ftl 'Ii+n4dai III!
01/27/201112.110-108 Jay. Aiberloo
1 or 2 Rao reetS16.01 aoo ree,o.00 CARFIELD CJLIAY CO
LTMITED POWER OF ATTORNEY
WPX ENERGY ROCKY MOUNTAIN, LLC ("Company") a Delaware limited
liability company, having its principal place of business in the City of Tulsa, County of Tulsa,
State of Oklahoma, does hereby make, constitute and appoint Bryan S. Hotard with the full
authority hereinafter provided, the tele and lawful Attorney -in -Fact of the Company, authorized
and empowered on behalf of the Company and in the Company's name, and for the sole and
exclusive benefit of the Company and not on behalf of any other person, corporation or
association, in whole or in part, to enter into, execute, deliver, file and accept all instruments and
documents affecting the real property or real estate rights of the Company as more specifically
set forth below: :
1. Applications and documentation associated with Garfield County or Rio Blanco
permitting requirements for including, but not Limited to, Independent Sewage Disposal
Systems, Small Temporary Employee Housing, Major Impact Reviews, Limited Impact
Reviews, Oil and Gas well permitting, Driveway Access, County Road Maintenance,
Temporary Living Quarters, Temporary Use Permits, Surface Use Permits, Surface Use
Licenses, Utilities, Snow Removal and Private Construction of County Roads;
2. Agreements and other documentation That grant easements, rights of way, licenses, or
permits to Company and also instruments where the Company grants such rights to
others;
3. Agreements that assign easements, rights of way, licenses, permits or surface leases in
connection with the Company's operations;
4. Releases and Partial Releases of easements and rights of way;
5. Agreements allowing encroachments onto easements and rights of way owned by
Company and landowner instruments and conveyances on others casements;
6. Agreements subordinating mortgage rights to easement or lease ;
7. Agreements relating to the modification and relocation of Company Facilities;
8. Rental or lease agreements for surface use or other surface use agreements and all notices
related to the pipeline agreements;
9. Agreements for the purchase or sale of real property and for the lease of real property for
residential or commercial purposes or otherwise in connection with the Company's
operations;
10. Agreements to obtain water services, electrical, gas or oil services or the provision of
other utility services utilized by Company's facilities;
11. Agreements modifying, amending, renewing, extending, ratifying forfeiting, canceling
and terminating any and all of the aforementioned types of instruments and documents.
WPX ENERGY ROCKY MOUNTAIN, LLC hereby declares that each and every
act, matter and thing which shall be given, made and done by Bryan S. Hotard in connection with
the exercise of any or all of the aforesaid powers shall be as good, valid and effectual to all
intents 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
Attomey-in-Fact shall lawfully do or cause to be done by virtue hereof. This Limited Power of
Attorney shall remain in full force and effect until terminated by Company.
v
IIIhWilVIII 'MI:f lciltli 'RlMiti IiP41144 MI III
Receptlond: 815004
02/27/2012 12.18:10 PA Jun RIberleo
2 or 2 Rye Fea:S16.00 Doe Fee:0.00 GARFIELD COUNTY CO
IN WITNESS WHEREOF, WPX Energy Rocky Mountain, LLC has caused this
Limited Power of Attorney to be signed by one of its Vice Presidents, duly authorized by its
Management Committee to grant powers of attorney this li1 day of January, 2012.
WPX :«t.-., R0TAIN, LLC
By.
D. roes
Its ice Pr ident
t
ACKNOWLEDGMENT
STATE OF OKLAHOMA )
) ss.
COUNTY OF TULSA
BEFORE ME, the undersigned authority, a Notary Public in and for said County and State,
on this day personally appeared, Jerry D. Games personally known to me to be the Vice President of
WPX Energy Rocky Mountain, LLC a Delaware limited liability company, who acknowledged to me
that he has executed the above LIMITED POWER OF ATTORNEY authorized by Company's
Management Committee. �/�
114 WITNESS WHEREOF, I have hereunto set my hand and affixed my notary seal, the/ Cl+t )
day ofdanuary; 2012.
F€Wuoty
�_ A r,L__,-k
Notary Public
My Commission Expires: 2. ' z.3 Z OIL/
After Recordation Please Return To:
WPX Energy Rocky Mountian, LLC
Attn: Land Dept.
PO Box 370
Parachute, CO 81635
2