HomeMy WebLinkAboutApplication.pdf" "r ., <~ Garfield County
Rli ~ 1' .l \! l 1community Development Departmen t
) ., ' th · · 108 8 Street, Suite 401
ONSITE WASTEWATER
TREATMENT SYSTEM
{OWTS)
JUL 2 R zm Gle nwood Springs, CO 81601
(970) 945-8212 PERMIT APPLICATION
GARf!t.:Lu lAJU1\J rY www.garfi eld-county.com
JMMUNITY DEVELOPMENT
TYPE OF CONSTRUCTION ' ' Ill New Installation I D Alteration I D Repair
WASTE TYPE
D Dwelling I D Transient Use I D Comm/Industrial I D Non-Domestic
II Other Describe Q.()_/~~l l.E.H.
INVOLVED PARTIES ····-·····---·-·· ........... -·-··-·-·--·············-··-··--·······-·······-··--··········-···--··---..................... ___ ................ _ ............................................ ~ ....................................... -........................................................................ -................
Property Owner: S H r:: LL exp LD!lA-TI DN A-N D loL}:Q?<?-P hone: ( )
Mailing Address: ~Do N · lY+L IZ.'f._ ASff FD!UJ l lJC~ c/? ·7~ Hou:sro.t::J TX f--T?JT-1
Contractor: /)X'i USP tV'TP 1-P Phone: ( 970 ) Q)!£J3-.3 ~ <//
M aili ng Address: I.IP. Q /.-1 ()fl 1-:c&J .De.... STC /t; l fu_rt..RNiJ.TtJAiCTIOIJ .Co (f /Sb~
Engineer: DIW i D f-CJX fJ. c. Ph o ne: ( )
Maili ng Address : lo -7 (J !'a /1 I /IJ /I.I f!teR.. /(_ fJ~1 Vf' ~flA.11111.li1A/(T//JtJ f7r) F. I s-o 7--
/
PROJECT NAME AND LOCATION
Job Address: ~Q q J -r R <--!'=!-
021///-/b /-~O -O IS-
Assessor's Parcel Number: Sub. Lot Bl ock --
Building or Service Type: T-C. f/. f1.Df2.J (j: ~N/l.>nBedrooms: lf Garbage Gr i nder _
Distance to Nearest Community Sewer System: Lt./ /l1JLE:S
Was an effort made to connect to the Community Sewer System: Al().
Typeof OWTS D Septic Tank i D Aeration Plant J 111 Vault J 0 Vault Privy I D Composting Toilet
i
D Recycling, Potabl'e U'se 0 Recycling J D Pit Privy I 0 Incineration Toilet
D Chemical l'oifet D Other
Ground Condit ions Depth to 1'1 Ground water tabl'e. I Percent Ground srope
Final Disposal by 0 Absorp.tlon t re nch,, Bedl o r Pit I 0 Underground! Dis persal' I D Above Ground Dispersa l
D £vapotr anspi ration 0 Wastewater Pond I D Sand Filter
Ill Other /TtftA ISP/)[/ 71> J £1Af/\j;"///
Water Source & Type D Well J D Spring I 0 Stream or Creek I D Cistern
D Community Water Sy~tem Name
Effluent Will Effluent be discharged directly into waters of the State? D Yes . Ill No
(:ERnflCAllON
Applicant acknowledges t h at t he com p leteness o f the app lication is c ondition a l upon such further
mandatory a nd additio na l t e st. a nd reports as may be re qui re d by t h e local health department to be
made an d furnishe d by t he a pp li cant o r by t he local health d e pa rtment for purposed of the evaluat ion
of the a pplication; and t h e issua nce o f t he permit is su bject to s u ch terms and conditions a s deemed
neces sary to ins ure complia nce with ru le s and regufat io ns made, in fo rm at ion a nd reports s ubmitted
herewith a nd require d t o be s u bm itted by t h e a p plica nt aire o r w ill be rep resented to be true and
corr ect to t he best of my know ledge a nd belie f a1nd a re desig n e d to be rel ied on by t he lo ca l
d epartment of healt h in evalu a ting t he sam e fo r pur poses of iss u ing the permit app fi ed fo r herein. I
fu rther understa nd that a ny fals ific at io n or m isrepresentation m ay re·su lt in the den ia l of the
appl ica tion or revocation of any permit granted based upo n s a id applic at ion and legal a ction for p e rj ury
as p rovided by law.
I hereby acknowledge that I have read and understand the Notice and Certification above as well as
have provided t he required information which is correct and accurate to the best of my knowledge.
Property Owner Print. andl Sign Date
OFFICIAL. USE ONLY
Special Conditions:
Permit Fee: a9_
~,~ '
Perk Fee: Tota l Fees :: -$ 00
Fees Pa id :
'$1 Q . .QQ_
Issue Date: Balance Due:
~ af2-
0 PROPOSED LOCATfON
OXY USA WTP LP.
Shell 797-09A Pad
Kl Uintah Engineering & Land Surveying
8.f' Souch 200 Ea•• Vcrttul. lJt Ah ft .. 0'78
(431') 78!>·1017 • l'AX ( .. 31') 7 89•11113
Directions to Site:
She/1797·
Drill Rig & E•
Emergency Contact List
Drilling
Drill Site Manager 1: Bobby Holcombe
Drill Site Mana ger 2: Berch Sylvester
Drilling S up eri ntende nt: Chad Frazier
Safety and Spill Res ponse
Safety M anag er: A lonzo Hernandez
OXY HE S Advisor (loca l): Ju stin Booth
Field Opera tions Manager : Chri s Cl ark
956 -279-9
832-5 15-5
806-891-9.
970-985-61
970-8 12-7
97 0-263-31
970-462-8
1111 ~\1".i.f1~1rV~Mll l'i1'.lli'1tlifKlill·~i,i~i~·~lrlll ~·~ 11111
Reception#: 783258 .
03/15/2010 02:32:69 PH Jean Alberico 1 of 1 Reo Fee.:$11.00 Doc Fee:0.00 GARFIELD COUNTY CO
STATEMENT OF AUTHORITY
Chris G. Clark, Regulatory Coordinator/Lead for OXY USA WTP LP, a Delaware
limited partnership, and for OXY USA Inc., a Delaware corporation (jointly "Oxy"),
760 Horizon Drive, Grand Junction, Colorado 81506, is authorized to act on
behalf of, and represent Oxy in all matters related to applications for special use
permits, conditional use permits, administrative permits, limited impact review,
major impact reviews, and land use change permits (and may execute such
applications) submitted to Garfield County, Colorado until such time as Oxy files
of record a statement that Mr. Clark no longer has such authority. Oxy
acknowledges that when any such permits are issued by Garfield County,
Colorado, the County may choose to file them of record and such permits may
contain certain covenants that run with the particular lands identified in such
permits.
STATE OF TEXAS
COUNTY OF HARRIS
OXY USA WTP LP
By: OXY USA Inc., its general partner
By: lJ~~__p~L-
Name: William B. Roby °U
Title: Vice President, Mid-Continent
OXY USA Inc.
By: L_::>~~
Name: William B. Roby
Title: Vice President, Mid-Continent
This instrument was acknowledged before me on this 5 day of March,
2010, by William B. Roby, Vice President of OXY USA Inc. a Delaware
corporation on behalf of OXY USA Inc., a Delaware corporation and on behalf of
OXY USA WTP LP, a Delaware limited partnership.
My Commission Expire
Notary Public, State of Texas
OHAISllNE M SANCHEZ
My commlaelon Expire•
J~ly 2, 2013
)
~ OXY USA WTP LP
DXY
"""'
June 4, 2014
Ms. Tamra Allen
Community Development Department
Garfield County
108 81h Street, Suite 401
Glenwood Springs, CO 81601
RE : Agent Authorization for OXY USA WTP and OXY USA Inc. permitting projects
Garfield County, Colorado
Dear M s. Allen,
760 Hori zon Dr., Suite 101
Grand Jun ction , CO 81 506
Phon e 970.263 .3600
OXY USA WTP LP and OXY USA Inc. (Oxy) authorizes Blair Rollins with Olsson Associates and Katy Middleton with
Blue Sky Permitting and Planning, LLC to act on behalf of and represent Oxy in matters re lated to land use
permitting projects located in Garfield County, Colorado.
Please contact me if you have any questions, comments, concerns, or if you require additional information. I can
be rea ched at 970.263 .3607 or at chris clark@oxy.com.
Cc : file
Ol sson
~ axv OXY USA WTP LP.
..........,.·-~---
Kimberly Evans
July 7, 2014
Shell Exploration and Production
200 N. Dairy Ashford
WCK4374
Houston, TX 77079
Attention: Mr. Brad Penn
Re: Shell 797-09-HNi Well
Section 09·T7S-R97W
Garfield County, Colorado
Dear Mr. Penn:
5 Greenway Plaza, Suite 110, Houston, Texas 7704S-0521
P.O. Sox zroro, Houston, Texas mzr-mo
Ol!!ce: (713) 366·5593
Fax: (713) 985-1667
E-mail: klmberly_evans@oxy.com
Sent by Federal Express
Through previous written and verbal communications, OXY USA WTP LP ("Oxy") has informed
you that a new well location has been identified, and will be drilled from the Shell 797·09A
Pad,
Oxy requests certain approvals, consents, and waivers from, and that certain elections be
made by, Shell Frontier Oil & Gas Inc. and Shell Oil Company (together, "Shell").
Aporovals and Consents
1. Pursuant to the terms of Article Twenty In that certain Oil and Gas Lease dated June 1,
2004, between Oxy and Shell, as amended, Oxy does hereby request approval of the locations
for the following well:
Shell 797-09-HNl; 330' FNL, 2,350' FWL
Located In Section 09·T7S-R97W, Garfield County, Colorado (the "Well").
2. Oxy requests that Shell consent, pursuant to Section 7-808 of the Garfield county Unified
Land Use Resolutlon, to Oxy installing temporary employee housing for eight or less indiViduals
for a period of less than -one ·year in connection with the drilling and completion activities
related to tl)e Well. Oxy will .. notlfy Shell of the date of anticipated occupancy and when
temporary housing units are vacated.
3. oxy requests that Shell consent to allow Oxy to act on its behalf as Surface Owner, solely
for the purpose of obtaining necessary temporary employee housing permits from Garfield
County, to the above referenced well, and only the referenced well.
Waivers
1. In connection with this Well, Oxy requests that Shell waive the requirement in Article
Twenty (20) of the Lease that requires Oxy to submit all proposed locations of well sites
to Shell at least twenty (20) days before conducting earth work, or conducting any
other activity relating to locating a well on the land and before filing an Application for
Permit to Drill, Deepen or Re-enter and Operate with the Colorado 011 and Gas
Conservation Commission ("COGCC").
Furthermore, with the granting of this waver, it is agreed and understood between the
parties hereto that State Rules 305 and 305 are waived solely for the purposes of
operations to be conducted related to the above referenced well, and only the
referenced well.
2. In connection with the Well, Ox:y requests that Shell waive all rights to advance notice,
consultation, seek a hearing , extend any comment period, and any other similar right
pursuant to current and future practices, procedures, rules, and regulations of the
COGCC .
Please forward one executed original of this letter to my attention at your earliest convenience.
Thank you for your consideration In this matter. If you have any questions, please feel free to
contact me at the telephone number listed above.
Sincerely,
OXY USA WTP LP
Kimberly Evans
Land Negotiator
Mid -Continent Business Unit
By execution hereof, Shell Frontier Oil &. Gas Inc. and Shell Oil Company grant all
approvals, consents and waivers requested by Oxy in this letter agreement.
Name:~~~~--...-..""'=.--.....,.. Jiff Tumbull
Title: Attoriley·In·Fac t
Date: __..,1 /t--"-l b......,.}~11 __
Shell Oil Company
Name: __ ~S_m_1DJ_ro_n_S.~16MIGD~-------
Title: __ A_Tr_o..,...RNEY_--r-JN_F_'A_cr __
Date: ___ 7. _J ...__( ?"'--*t_l _L( __
STATE OF TEXAS §
COUl'ITY OF HARRIS §
The~.re~rent was ack~d be.fore.me on this the J1#..day of July,
2014, by \.11; • In Fli.c.r of Shell Frontier Oil
l!r. Gas Inc., on behalf of said corporation.
STATE OF TEXAS §
COUNTY OF HARRIS §
h'l~~.i~(~ LINDA E. LARA f~' ':\Notary Public, State of Texas \1· .... ~W My Commission Expires
+~fl,fif~" February 04, 2017
Notary Public for the State of
~ axv
~
I·
I
I
COMMERCIAL TERMS
Version 4 -25APR2014
1-~-coM~E2,.R1'0~00':00L1Jas.~1~6~s No~ -.• T •.. ·.·.-. +~_··~ ....••.... ~. EFFeCTiVE-ol.re----... ----r-----;;13e-~ =:__ ~·-----.... ."j· _ . . . _ ~~a. 201.f--=:_~==-I ___ 1_0_1_4 ______ -1
These Commercial Terms, 21000078516 ("C hmercial Terms"), effective as of July 8, 2014 ('Effective Dale"), by and between
Contraclor and Company (both of which may ereinafter be referred to individually as a 'Party" or collectively as lhe 'Parties') is
comprised of the body hereof and the Exhib' s !isled, if any, in the below Table of Exhibits. All referenced Exhibits are hereby
incorporated into and made a part of these Co nercial Terms by reference hereto, and by signature below Contractor acknowledges
receiot of all listed Exhibits. · l
ISSUED TO: \ I ISSUED BY: , I
Superior Energy Services, LLC dba HB 11ntals LC
Physical Address:
5813 Hwy 90 East I
Broussard, LA 70518 '· I
Mailing Address:
Same as above
:
I
Herein Called "CONTRACTOR'
Contact:
Phone No.:
Mobile:
Email:
Jason Gentry
970-242-4555
970-250·6962
jasong@hbrental.com
i' ..
i !
'
OXY USA INC OXY WTP LP
Physical Address:
5 Greenway Plaza, Suite 110
Houston, Texas 77046
Mailing Address:
Same as above
Contact:
Phone No.:
Direct No:
Email
Herein Called "COMPANY" and/or "OXY"
Alisa Crosby
713-215-7000
713-985-6391
Alisa_crosby@oxy.com
Contractor and Company mutually agree that the~' Comrnerciai Terms shiiilbesubject to and governed bythe terms.and conditions of
MASTER SERVICE AGREEMENT NO. MSA-11-072 effective September 27, 2011 ("Agreement').
In the event of inconsistencies between these Co mercial Terms, which have been accepted and duly executed by representatives of
the Parties hereto, with authority sufficient to bind ach, and the Agreement, the provisions of the Agreement shall control, unless such
conflict is specifically noted in these Commercial erms and the Parties specifically agree that the noted conflict is to be governed by
lhe provisions of these Commercial Terms.
IN WITNESS HEREOF, the Parties have duly these Commercial Terms effective as of the date first above written.
CONTRACTOR COMPANY
Superior Energy$•""'""• LLC d~a HB p,.enta~ U
By / ".,. '"""''-' L.J.,v;
-I . '
Name '>.P.,:b (),J{vy' i '
Title O(.e:?•~,'o•/..;. lt.z.....,)1-<•/rt
I Dale 7/1 ~/rt \ I
~;y u. '"" 'Q: z ~
Name _L_~ i/,,_~
Title 1e'tr" \&M f'11q~J1,,-i
Date: :J II '1 / 1 'j
! •
COMMERCIAL TERMS CONTINUATION PAGE
COMMERCIAL TERMS NO.
IOraclo PO Number! EFFECT IVE DATE PAGE
21000078516 -· _ ~uly 8, ~014 ____ ., __ ._ ____ 2_o_f 4----;
~1 ~'---------·-..._.--. ~ =-= -=---_ ~=-=--== ~=
1. SCOPE OF WORK:
CONTRACTOR sha ll provide material ,, services, and/o r equipment related to providing Mobile Housing Units and Service at
th e rig site as stated below:
• CONTRACTOR will provide ti 1e rig up/ rig down of the un its and transportation of th e units to the Rig sit e.
• All units will comply wit h the a~ licable fi re code standards.
• CONTRACTOR will provide p 11 able water and dispose of waste from the Units.
o CONTRACTOR mus nstall a meter to provide daily water readings at the Rig site.
o Daily records will be (E pt by COMPANY men on loca ti on .
o CON TRACTOR will J r >vide at least 75 per gallons of potable water per manf per day.
o CONTRACTOR will ti€ so urci ng COMPANY the potable water fr om the City of Grand Junction.
o Usage logs will be ke:> and turned into COMPANY monthly .
o Waste will be picked p and disposed of at least two (2) ti mes per week (more if requ ire d by Oxy), year
round .
o All wa ste pick up will Di logged and turned into COMPANY the first of every month.
o All waste receipts fror 1 disposal location will be kept on file fo r COMPANIES review.
o All COMPANY waste viii be disposed of at the Garfield Cou nty Dum p, located betwee n Parach ute and
Rifl e.
o Sewer Vaults will be ct eas t 4,000 gallons per unit.
2. TERM:
These Commercia l Terms shall be effe, ·ve begin ning July 8, 2014 and con tinue in effect through December 30, 2015 (the
"Term"). Any orders placed by the C fc mpany for Work, prior to th e term ination date but not delivered or performed by
Co ntrac tor unti l after the terminatio n da e shall be governed by th ese Commercial Terms. These Commercia l Terms may be
extend ed by th e mutu al written agreem en of the Parties hereto .
3. COMPENSATION:
Contractor will be co mpen sa ted for Worl equested by COMPANY in writing in accordance with th e rates below:
• Rental day rate is in cl usive of a east one "court esy ca ll' a week .
• Service ca lls, when Oxy is NOT ; I fa ult , is with no cost to Oxy.
• All billable service work will be t it ed at th e hourly rates.
• The Rental day rates include th Winterizi ng Service of th e Units .
• All prices are for complete site clfl ~rin gs of housing and infrastructure.
• HB Rentals will haul the units if ·e quested by Oxy .
• Service calls. when Oxy is at fat I , is billed at $50/per hr for Se rvice Tec h, $50/per hr for Service Truck.
• House Cleaning will be perforrni ~c by HB Rentals (3'd party) when requested by Company Man at that location .
--~~.:.· ........ ,., i.:J,•,r~7.~ !i;:.;";~.:.1 :r :J 111:l l .. ,11 11 1 u ~ ...... • '" :+'\1::..• c.. "·::<,;· ·" .. ,:' ... ::~!F7•°'.'.' <·t ~ .. ....... " . .. _,_
Quantity Each prlre Total Requested ·-
Size of Unit l>esaiption of Equipment
14><60 skid 112x24 office New Execut I~ e unit/two piece/ bump office I 1 $185.00 $185.00
1 $105.00 $105.00
2 $105.00 $210.00
14><60 skid I Two bd( room with office 1------------+---+-l-----'-'-.;;.....c...;;c;....... _______ ,_-+---=---1-_..!..;;.=.:.;:-'---+---..:..----1
14><60 skid Crew C i :arter
8X20 mud Lab Mud lab
~~--·--1 $40.00 $40.00
Version 4 -2SAPR2014
12x24 Bumi?.. office skid_~
Subzero fresh water tank --------·~·-~ Subzero sewage ho!din e tan L_
_liftsta ~l~_n ___ --·.
office ------·----allon tank
~---·-·-------.
Gen~---~-·-----i~-•'-'------·----·---
Transformer Panel -------VSAT Communications ---------
Other Miscellaneous Services
1 ~.oo $6s.oo
_2 _.L_i6_5~. $130~_
2 ·1· $65.00 . $130.00 8 $15.00 $120.00
.
1 ·· $200.00 · -__ ·$200.oo
_l_ ---1!.~ $100.00
• _1 -_g_oo~ ---$100.00
_ 1 I $65 :00 $65.00
~ -·-$15.0£.. $15.00
Total Rental
Rate $1,465.00
Unit Price ...---------------++------·---------·--+---+---------~----1 Water I!~~ ____ _
•••water cost
Sew<1geHa~--·--__
0 •~oisposa~--__
-~~l-----~ ---.
Water Cost ·-----·---------· ______ ,, __ _
Sewer dis osal fees ------·
__ $120.00 Per hour ------.. Per ga_!!~ .• ----~
Per hour $120.00
-----~--Per allon __ $0-30
Per hour
•••Trash Dlsposa.!.!!!,_ ·---... T~~posal Fi;e __ . ·-----Cost+ ------Wi~ch Truck ·--· -------·-----------· Per hour
~ Techn!clan (~ach) -----Pe~----__ $50.00
P .. er. ho~ _ I _ $50.00
cost+ ___ r_ ~~ Service Truck and Tools (e ach}~--.
Pilot Cars and per"!i!!._ _____ . __
Cleaning Charges upon return of 81;1ild ing 1 • f~~n_g _ __1450.00
--------·----Per Tank ------Water tank ~n& charge upo~~l!
i--3'_d_P_artv_ .. ....._•n_s.._e_ct_o_r _______ _...1--Cost __ v + 15~ {range} ______ _ .~er in~pection $200-$2,000
Other Mfsc:eflaneous Rental Unit Price i----
Additional TV Satellite Receivers Additio nal TV ~ellite Recef~!;!S --.. P~·;·day · I =· -$15.00
14x60 skid 12K24 ~ ~. --· • ~~tive unlt/~o piece/ bump off!~e Per day • -1. ·-· __ $185~
x60skld ____ .. ___ --~-Twobl!droomwlthoffice ____ ~-Per day __ . ____ }105.00
~~~---·---· _ CtewQuarte_r __________ _Perday __ ·-----$~
8X20 mud lab __ --------1ii•-M_u_d_l_ab ________ ---·--Pe~~!_-1-_,. $40.~
. Subzero_fr_e_s!'_w_a_te_rt<1_n_k____ __ 3000 gallon tank ·-----__ Per day $65.00
~~~ sewa J!~~n e tan_!<_____ 4000 ~~a~ __ ·-· ·--· !.~r day -==-. • -:-__:__j6S.OO
Llfts~_tlo_n ______ . -·· Liftstat~-------··-·-P ~~day ---· .. ___ $~
Gener~~~----~ __ G~ry~-__ __ __ Perd..!!__ _ '· --· __g<?O.OO
• Trans_fo_r~!r_P_a_nel ___ -· .~ ~ ~~~~~n~ributionpanet __ Perday t -$100.00 VSAT_Co_~municat_io_n_s _____ , tn~t~ndphonesy~·----__ P~-~-= C ~---$100:00_
Trash Sin
Water Meter ---------· ---Ground Rod
Hou~.!_2~anlng (o_n location) -~ --·
I COMPANY's Supply Chain Contract S
issues for these Commercial Tenns .
Version 4•_ 25APR2014
~phone~~---,--'"''Y I __ $65.00
'rrash Bin ~-Per day $15.00
e~W .. aterTank. -=--==--+~meter _$200 .. ~$75~.00
-f-+:~od $20.00 Ro Party COf!1pany . ·= =---=-=--l_LP er hou' =-. = ~5.oo_
I
ialist, spec ified below, is the contact person for all commercial and contractual
COMMERCIAL TERMS CONTINUATION PAGE
COMMERCIAL TERMS NO.
f..----· (Oracle PO Number!
21000078516
EFFE_C_T-IV-E--0--A-T_E ______ .. I~ PAGE
··--+--+r! ---·--J7u""1y""s"", _"'2_0~1""4.::_-.:: ______ ::t==--'4_o_l 4 ____ ---l
'
Alisa Crosby ),I
Sr. Contracts Specialist, Supply Chain
Alisa crosby@oxy.com l
713-985-6391 !
713-215·7000
CONTRACTOR may request changes additions to the Scope of Work and/or pricing schedule provided that such changes
or additions are requested in writing < submitted to COMPANY Supply Chain Contract Specialist. Ali proposed changes
must be submitted via email a minimur of 45 days prior to the requested effective date. If COMPANY Supply Chain Contract
Specialist accepts the proposed cha es, an Amendment to these Commercial Tenns shall be executed to reflect the
changes. ll the proposed changes are ~' t accepted, COMPANY Supply Chain Contract Specialist shall notify CONTRACTOR
in writing within 45 days of the request bmission
4. SPECIAL PROVISIONS:
INVOICING:
All invoicing must be done electronicall , hrough Oxy's approved electronic invoicing service.
All invoices must reference the specific anket Purchase Agreement (BPA) number assigned for each Oxy Business location
and the ProjectlTask number, and shall i elude sufficient detail (dates, hours, rates, material charges) to support the charges.
All supporting documents (e.g., time sh ts/field tickets, freight bills, etc.) must accompany invoices in order that COMPANY
may reasonably ascertain the basis for ch charges. CONTRACTOR shall keep daily time sheets on those persons directly
engaged in the work on this project. All · 1e sheets/field tickets must be stamped and signed by COMPANY's personnel and
submitted in support of CONTRACTOR' invoice.
In the event CONTRACTOR is reques d to provide services or material not specified above, CONTRACTOR shall
provide a written estimate to COMPA 's Technical and Supply Chain contacts (as identified on page 1 herein) for
approval, prior to the work being per rmed. Said signed estimate shall be attached to any subsequent invoices.
Electronic Transmittals:
Commercial Tenns may be execute in any number of counterparts; and when executed in counterpart, all such
counterparts shall constitute one do men!. An electronically transmitted copy of a counterpart executed by a Party shall
be binding to the same extent as th1 riginaf counterpart executed by such Party, and to the extent that the preceding
clause is read as being in conflicl wi Article 2. 7 of the Agreement, the Parties hereto specifically agree that any such
conflict is to be governed by said cl se of these Commercial Terms.
j Version 4-25APR2014
Fox Engineering Solutions, Inc.
670 Canyon Creek Drive, Grand Junction, CO 81507
Ph: (970) 250-5505
Email: co/oradofox@bresnan.net
Inspection Report for:
Client:
Shell 797-09A Small Temporary Employee Housing
OXY USA WTP LP .
Location :
Conducted By:
NWl/4 of Section 9, T7S, R97W, 6th P.M. Garfield County
David Fox, P .E.
Date Conducted: July 25, 2014
Garfield County
Paragraph Article 7-707 Land Use& Development Code (7/15/13}
Reference Characteristic or Standard Description
A. Wit hin 48 hours following occupation of the Small Faci lity,
documentation shall be provided to the Community Development
Department, Sheriffs Office, and relevant fire
B.
c.
protection district(s ) that d e monstrates and certifies compliance with
the following s tandards. Notice shall also be provided to these
e ntities w it hin 48-hours following
removal of a Sma ll Facility.
Gener a l Inform a tion reguirements
Small f acilitie s shall comply with a ll applicable Federal, St ate (i.e.
Bui ld ing Codes and electrical pe rm it s}, and loca l la ws a nd regulation s
(i.e. fire code), but are not subject to Co unty Bui lding Permit.
Page 1of3
Inspection Comments
Not subj ect to visual inspection and certification by
third party Professional Engineer.
Not subject to visual inspection and certification by
third party Professional Engineer.
Colorado Division of Housing insignias noted on all
factory-built nonresidential structures located at the
permitted site. These insignias certify that the unit
is constructed in compliance with applicable codes
and regulations adopted by the Colorado State
Housing Board per Resolution 35. Insignias noted on
Company trailer, Unit ID. 360085418 with
Certification No. 19078, manufactured by ATCO
Structures USA on 3 -03-08; Driller's trailer, Unit ID.
358085424 with Certification No . 19055,
manufactured by ATCO Structures USA on 2-2008;
and Company Office trailer, Unit ID. 324141922 with
Certification No. 25960, manufactured by Britco
Structures on 3-01-14. All other aspects not subject
to visual inspection and certification by third party
Professional Engineer.
)
Shell 797-09A Inspection
OXY USA WTP LP
D
E.
F.
G.
H.1
H.2
Water system s shall comply with standards set forth in section 7-
705.B.
Wastewater systems shall comply with stan dards set forth in section
7-705.C.
Each Small Fa cility shall be maintaine d in a cl ean, safe, and san itary
conditio n , fr ee o f weeds and refu se. Any hazardou s o r noxiou s
materia ls that m ust be sto re d at the Small Facility for operational o r
s ecurity reasons must be managed in accordance with a ll applicable
Federa l, State, and local law s and regul a t ions.
Wil dlife-p roof r e fuse conta iners must be provided for t rash . Outdoor
food storage is prohibite d unless f acilitie s a re provided that prevent
the attr action of anim a ls t o t he Major Facil ity site.
Provisions for g ivin g ala rm in case of fi re and fi re suppr ession m ust
be installed per fir e codes and as req uired by th e fi re protecti o n
dis tr ict.
Sin g le-station carb on monoxide a la r ms must be placed in each
Page 2 o f 5
Fox Engineering Solutions, Inc.
July 28, 2014
The water system at this location is not a public
water system, as defined by the Colorado
Department of Public Health & Environment -WQCC
Regulation No. 11. It is not subject to State
permitting requirements. A potable water tank with
a capacity of approximately 3500 gallons and a
water meter were located at the permitted site.
Wastewater disposal at the permitted site will be a
vault-and-haul system. One 4000-gallon sewage
holding tank onsite. Sewage flows est imated 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 w ith overflow alarm
device.
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 . Individua l
refuse containers in each office/housing structure.
Smoke detectors and fire extinguishers (ABC-rated)
located in all factory built non-residential structures.
Factory-Bu il t Nonresidential Structures have a
min imum separation distance of 20 ft. One potable
aboveground water tank of approximately 3500
gallons capacity on-site. Potable water demand is
estimated to be 300 gallons/day (4 ind ividuals x 75
gpcd). Required fi re suppression demand is 2500
gallons. Dry hydrant connection observed on water
tank.
Single-station carbon monoxide detectors located in
all factory built non-residential structures
Shell 797-09A Inspection
OXY USA WTP LP
I.
J.
Domestic animals are prohibited.
The Operator shall obtain a certiflcation inspection conducted by a
quatrfied professional engineer. The certification shall verify that at
the time of inspection the Identified Small Facility meets or exceeds
the requirements of this section.
Professional Engineer's Attestation
Fox Engineering Solutions, Inc.
July 28, 2014
No domestic animals observed on-site.
This inspection was conducted by a qualified
Professional Engineer licensed in Colorado and
certifies compliance with applicable standards set
forth in Article 7. 707 of the Land Use and
Development Code (7 /15/13), as 1amended, that are
subject to visual inspection.
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 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 7-707 of the Land Use& Development Code (Effective 7 /15/13), for
Garfield County, Colorado.
PE Certification Number: No. 25420 (Colorado}
Date of Inspection: July 25, 2014
Print Name and Title: David J. Fox, Principal Engineer
Signature: 0. ft,,l~
Page 3 of5
JXY USA WTP LP.
Shell 797-09A Pad
She/I 797-09A Well Pad
Drill Rig & Equipment Layout
~ ~
',
~
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'
.'
-
Notes:
~
DXY
~
The well pad site is located in the NW 1/4 of Section 9, T7S , R97W, 6th
P.M . (NAD83 N39.46657° W108.22578°)
The site will temporarily office and house an average of four individuals
during natural gas d rilling activities and is expected to be completed in
one year or less. The individuals will occupy two individua l 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 nows 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 I 300 gallons per day). Wastewater vau lt
equipped with overflow alarm device. OXY utilizes the services of a
licensed contractor to remove and haul the w astewater to a State
certified treatmenVdisposal facility.
One potable aboveg round w ater tank of approxim ately 3500 gallons
capacity on-site. Potable water demand is estimated to be 300 gallons/
day (4 ind ividua ls x 75 gpcd ). Required minimum fi re suppression
de mand is 2500 gallons. Potable water supply appears adequate with
1000 gallons of storage w ith refills occurring at 3 .3 day intervals. Dry
hydrants observed on water tank.
,-11 Road access to the site is mainta ined year-round through the services
of private road maintena nce and construction contractors.
Base mapping by Unita Engineering and La nd Surveying. Site features
including housing trailers, water and wastewater tanks, portable toilets
and dumpster w ere field located. Please note that this is a construction
site and that the locations of drill equipment and other items are subject
to change.
'. ' II Fa ctory-Built Nonresidential Structur es (Office/Housing) have a
. -.. ; minimum separation distance of 20 ft . . '','
/ 11 -:.~~-1~~5A~;1~~;'-! l !CW;Al:i~: •• J;~;;.,1,i.A1 1 r x~~~-:~ / "S)C G(l ) < ·, 111 S he ll 797-09A Site Plan
Directi ons to Site:
Em ergen cy C o nta c t Lis t
Drilling
OOl Site~,..,_ 1: Bobby~
g:::~~~~~=
S.fety and Spill Response
Safety Manager. Alonzo H@manclez
OXY HES -(local): Justin Boolh
F"oetd Ope<aticn$ Manager: CM1 ~
956-279-9856 Cd
832-515-5714 Cd
806-891-9473 Cea
97().93~
97o-812·7738Cel
97().263-3648 ottioe
97().462-8375 Cel
1. WO>tewater Aboo;egtOUrld Tonic (4000 fl'/.)
2. -Watltr /l.bowground Tank (3500 '}al.
l. Pottable T oiltJts
4. Wildlife.proof dumpster
5. Company M11n Housing
6.0rillor'•Olf~
7. Compony-. °"""'
'SUOjfH::t to rw/oc.tton fOrcon3truetJOn ~~
Garfield County, Colorado
Small Te mporary Employ ee Housing and
Septi c Pe rmit Application
Applicant OXY USA WTP LP
Oate: July 28. 2014 Checked: OJF VeBion: 001
Fox En gineering Solutions, Inc.
670 Canyon Creek Drive, Grand Junction. CO 81507
Ph : (970) 250-5505 :.'
Email: coloradofox@bresnan.net