HomeMy WebLinkAboutApplicationGarfield County
~~ 1l( c J.i' if\Cf'E a!ity Development Department
1 i.,@~ i ~J l f ~ 08 8 th Street, Suite 401
G enwood Springs, CO 81601
INDIVIDUAL SEWAGE
DISPOSAL SYSTEM
(ISDS)
PERMIT APPLICATION Jmj 2 I} 201 4 (970) 945-8212
GA' ii www.garfield-county.com
I\ -1 f~LD COUNTY
WAUN IT ' n r.\11:"1 f\n ur-•·-
TYPE ot='t BNSTRUCTION
Iii New Installation I D Alteration I D Repair
WASTE TYPE
Iii Dwelling JD Tra nsient Use ID Comm/Industrial I Non -Domestic
D Other Describe
INVOLVED PARTIES
Property Owner: Sta te of Colorado Division of Wildlife Phone :( __ )
Mailing Address : 6060 Broadway, Denver, co 802 16-1029
Contractor: WPX Energy Rocky Mountain, LLC Phone : ( 970 ) 285-9377 ext 2209
Mailing Address : PO Box 370, Parachute, co 81635
Engineer: David Fox Phone : ( 910 ) 250-5505
Mailing Addres s: PO Box 370, Parach ute, co 81635
PROJECT NAME AND LOCATION
Job Address : KP 32-9 -See attached description of pad .
Assessor's Parcel Number: 218 127100201 Sub. Lot Block --
Buildi ng or Service Type : Temporary office & house #Bedrooms: 2 Garbage Grinder No
Distance to Nearest Community Sewer System : NA
Wa s an effort made to conn ec t to the Community Sewer System : N A
Type of ISDS 0 Septic Tank I 0 Aeration Plant I ii V aul t I 0 Va ult Privy I 0 Comp osting Toilet
0 Recycl in g, Potable Use 0 Recycling j 0 Pit Privy I 0 Incin eration Toilet
0 Chem ica l Toilet ii Oth er Hauled lo Down Valley Waste lo< their disposal
Ground Conditions Dep th to 1" Ground w ater t able NA I Percent Ground Slope NA
Final Disposal by 0 Ab so rpt i on trench, Bed o r Pit I D Und erground Di sp ersa l I D Ab ove Ground Di sp ersa l
0 Evapotran spiration D W as t ewat er Pond I D Sand Filter
ii Other Hauled to Oo'Ml Valley Waste for their disposal
Water Source & Type D W ell I 0 Spring j 0 Strea m or Cre ek I 0 Cistern
ii Community W ater System Name DownValloySeptic andWaste
Effluent Will Effluent be discha rged directly i nto waters of the State? 0 Yes ii No
CERTIFICATION
Applicant acknow ledges that the completeness of the app li cat ion is conditional upon such further
mandatory and addi ti ona l test and reports as may be r equ ired by the loca l hea lth department t o be
made and furni shed by the app li can t or by the loc al heal th department for purpose d of th e evaluation
of the application; and the issuance of the permit is subjec t to such terms and conditions as deem ed
necessary t o insure co mpliance w ith ru le s and r eg ulatio ns made, inform ation and repo rts submitted
herewith and required to be submitted by th e applicant are or will be represe nted to be true and
correct t o the best o f my knowledge and belief and are des igned to be reli ed on by the lo ca l
department of hea lth in evaluating the same for purposes of iss ui ng the permit app lied for he rein. I
furth er unders t an d th at any falsification or misr epresen t ation may result in the denial of the
application or revocation of a ny permit g ranted based up on sa id application a nd lega l action for pe rjury
as provided by l aw.
I hereby acknowledge that I have read and understand the Notice and Certification above as well as
hi h is correct and accurate to the best of my knowledge.
Property Owner Print and Sign
OFFICIAL USE ONLY
Special Condition s:
Permit Fee: 1J . Perk Fee: N {{le-Total Fee s: 1 _ '2
"1.:J. DO Fees Pa i d: 11· 1--.3' DO
Building Permit
BLDG DIV: b-2J -z.~11
DATE
High level Alarm
If opt II' Alanl
llPraat
Tank Is Full
One aboveground sewage holding tank with 4000-gallon capacity on-site.
The Vault System is displayed in both of the pictures. Sewage flows esti-
mated to be 300 gallons/day (4 indiv iduals x 75 gpcd). Sewage holding
tank needs to be emptied approximately every 13 days ( 4000 gallons/
300 gallons per day). Wastewater vault is equipped with overflow alarm
device. Williams utilizes the services of a licensed contractor to removed
and haul the wasterwater to a state certified treatment/disposal facility.
One potable aboveground water tank of approximately 4000 gallons ca-
pacity on-site. Posted on the front of the Tank there is a Sign that states
"Potable Water Only". Potable water demand is estimated to be 300 gal-
lon s/day (4 individuals x 75 gpcd). Required minimum fire suppression
demand is 2500 gallons. Total potable and fire suppression demand is
estimated to be 4000 gal-
lons .
Road access to the site is
maintained year round
through the services of pri-
vate road maintenance and
construction contractor.
• SEPTIC
~ c::J.
•
~
KP32-9
Vault System Description
The site will temporarily office and house up to a max imum of four ind ividu-
als dur ing natu ral gas dri ll ing activities and is exp ected to be completed in
one year or less . The ind ivi duals will occupy tw o indi vi dual tra il er offices/
houses located on the well pad . Office/houses have Colorado D ivis ion of
Housing compliance tags.
Sect ion 9
T. 6 S., R 91 W
~ IT E M ~ ~ PAD ~ ~
"" P IT t .. ::;
18259 11 35 7 6000 902
0 0
~ ::;
I
f
~
REVISED: 7/ 1 6/ 13
SCA L E: J" a JO Q'
DA TE: 6114113
PLAT: 2 o(7
PROJECT: ~K~o~ko~e~e~ll~i ____ ,
DFT: ~ct=v~s ______
1
cc
*NOTES:
1.) Topsoil Volum e Based o n 12" Soil Depth .
2 .) 10% Swe ll Factor Ap p lied to Earthwork
Cut Volum e.
3.) Total Di sturbed Area = ±6.45 ac.
Construction Plan Prepared for:
WPXENERGY. . WP X Energy Ro cky Mountain, LLC
KP 32-9 Drill P ad -Plat 2
CONSTRUCT/ON LAYOUT
Section 9
T. 6 S., R 91 W
""' . ~-GRAPHIC SCA LE IN FEET
l lU~•~fEET
AC CESS DE SCRIPTION: {Garfield Creek Access)
FROM TH E IN TERSECTION OF COLORADO INTERSTATE 70 OVERPASS (E xit 97) AND RIVER FRONTAGE ROAD SOUTH OF Sil T,
COLORADO, PROCEED EAST ±0.4 MILES ALON G R IVER FRO NTAGE ROAD TO THE INTERSECTION WITH COUNTY ROAD 3 11 (D IVI DE
CREE K ROAD), PRO CEED R IGHT IN A SOUTHERLY TO EASTERLY DI RECT ION ±2.0 MILE S TO A 'Y' INTERSECTION WITH COUN TY ROAD
335, PRO CEED L EFT IN AN EASTERLY DI RECTI ON ALO N G CO UNTY ROAD 335(Colorado River Road ) ±3.8 MILES TO THE INTERSECTION
COUNTY ROAD 3 12(Ga rfield C reek Road), PRO CEED RIGHT IN A SOUTHERLY DIRECTION ON COUNTY ROAD 312 ±0.3 MILES TO AN
INTER SECTI ON WITH A DIRT GRAVEL ROAD , PROCEED RIGHT IN A WESTERLY DIRECTION ±0.3 MILES TO THE KP 32-9 D R ILL PAD
LOCATION , AS SHOWN HEREON.
Construction Plan Prepared for:
SCALE: J" • 2000' WPX EN ERGY . _..___ WPX Energy Rocky Mountain, LL C
DATE: _..3"-'12oul"-"IJ....,2'----1--------------------i
PLAT: ~5~o~f7 ____ ,
;: PROJE c 1: -"'K=ok=·o=pe=11i~· ___
1
KP 32-9 Dn"ll Pad -Plat 5 l lL;;;;;;;;;;;;;;;;;;;;;:::!!~~~~ll~~~~~~llrl~~D~r~1 :~~~c~w~s~~~~~~~~~l;;;;;;;;;;;;;;;;;;;;;;;;~A~C~C~'E~S.~S~R~O~~~D~.kl~'AP~;;;;;;;;;;;;;;;;;;;;;;;;~
LIMITED POWER OF ATTORNEY
WPX ENERGY ROCKY MOUNTAIN, LLC ("Company'') a Delaware limited
liability company, having its principal place of business in the Cily of Tulsa, County of Tulsa,
Slate of Oklahoma, does hereby make, constitute and appoint Bryan S. Hotard with the full
authority hereinafter provided, the true 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
License.•, Utilitie.•, Snow Removal and Private Consbuction of County Roads;
2. Agreements and other documentation that grant easements, righl• 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 easements;
6. Agreements subordinating mortgage rights to easement or lease ;
7. Agreements relating to the modification and relocation of Company faciliti.,.;
8. Rental or lease agreements for surface use or oilier surface use agreements and all notices
related to the pipeline agreements;
9. Agreements for the purchase or sale of real property nnd for the lease of real property for
residential or commercial pllJllOSes 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 ntility services utilized by Company's facilities;
11. Agreements modifying, amending, renewing, extending, ratifying forfeiting, canceling
and terminating any and all ofthe 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 Biyan 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
Attorney-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.
1111 Wl'.i. l'M114A'.l'ilW, Ni\!' r+ltlilr-'i+\(lrti:lilll lofi'l.~·~ 11111 R•ceptlon#: 515004
e2/2T/20t2 12118110 Pl'I Jhtl Albarlco
2 er 2 fht0 Fee:s1e:.e0 Doc Fee:e.eo GRRFIB.D COUNTY co
IN WITNESS WHEREOF, WPX Energy Rocky Mountain, LLC has caused tl1is
Limited Power of Attorney to be signed by one of its Vice Presidents, duly authorized by its
Management Conunittee to grant powers of attorney this 1" day of January, 2012.
ACKNOWLEDGMENT
STATEOFOKLAHOMA )
) ss.
COUNTY OF TULSA )
BEFORE ME, the undersigned authority, a Notary Public in and for said County and State,
on this day personally appeared, Jerry D. Barnes personally known to me 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.
IN WITNESS WHEREOF, J have hereunto set my hand and affixed my notary seal, theZoJh
day of.JM•BJY, 2012.
F~j
Notazy Pu lie
My Commission Expires: 2.-'2-B-J-O/r_/,
After Recordation Please Return To:
WPX Energy R°'ky Mountian, LLC
Attn: Land Dept.
POllox 370
Parachute, CO 81635
2