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: Exxon Mobil Corporation
Mailing Address: PO Box 53
City:Houston State: TX Zip Code:
Phone: ( 970 ) 885-2654
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 12
Well Pad Number: GM 21-12
T 7S R 96W
Assessor's Parcel Number: 240912200006
Zone District: Rural Maximum Number of Permitted Occupants: less than 8
Number of Days the Facility will be at Location: 70
State or Federal Permitting Agency Overseeing Reclamation, Restoration and Revegetation (Name):
(Name): State (Relevant Permit Number): API # 0504522464
Date of Installation: 10/14/14 Date of Removal: 12/23/14
24 -Hour Emergency Contact (1): VVI'A tnergy
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
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 vault-
and-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:
550 BBL/21,000 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.
BUILDING INFORMATION (per unit)
Unit 1
Make:
Serial Number/Unit ID #:
Division of Housing Insignia (provide copy)
Square feet of unit:
Unit 2
Make:
Serial Number/Unit ID #:
Division of Housing Insignia (provide copy)
Square feet of unit:
Unit 3
Make:
Serial Number/Unit ID Th
Division of Housing Insignia (provide copy)
Square feet of unit:
OWTS PERMIT
Permit #:
ISOS Permit Number
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 be t .— m 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
Inspection Report for:
Client:
Location:
Conducted By:
Date Conducted:
Paragraph
Reference
A.
B.
C.
Fox Engineering Solutions, Inc.
670 Canyon Creek Drive, Grand Junction, CO 81507
Ph: (970) 250-5505
Email: coloradofox@bresnan.net
GM 21-12 Small Temporary Employee Housing
WPX Energy Rocky Mountain, LLC
NE 1/4 NW 1/4 of Section 12, T7S, R96W, 6th P.M. Garfield County
David Fox, P.E.
October 13, 2014
Garfield County
Article 7-707 Land Use& Development Code (7/15/13)
Characteristic or Standard Description
Within 48 hours following occupation of the Small Facility,
documentation shall be provided to the Community Development
Department, Sheriff's Office, and relevant fire
protection district(s) that demonstrates and certifies compliance with
the following standards. Notice shall also be provided to these
entities within 48 -hours following
removal of a Small Facility.
General Information reguirements
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.
D Water systems shall comply with standards set forth in section 7-
705.B.
Page 1 of 3
Inspection Comments
Not subject 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 certifications noted on Company
trailer, Unit ID. 354085431, Certification No. 19077, manufactured
by ATCO Structures USA Inc. in 2008; and Driller's trailer, Unit ID.
355117308 with Certification No. 24625, manufactured by ATCO
Structures USA Inc. in 2011. All other aspects not subject to
visual inspection and certification by third party Professional
Engineer.
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 4000 gallons and a water meter were located at
the permitted site.
GM 21-12 Inspection Fox Engineering Solutions, Inc.
WPX Energy Rocky Mountain LLC October 13, 2014
E.
F.
G.
H.1
Wastewater systems shall comply with standards set forth in section
7-705.C.
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.
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.
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.
H.2 Single -station carbon monoxide alarms must be placed in each
Manufactured Home or Recreational Vehicle unit.
J.
Domestic animals are prohibited.
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.
Page 2 of 3
Wastewater disposal at the permitted site will be a vault -and -haul
system. One 4000 -gallon sewage holding tank onsite. 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.
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.
Smoke detectors and fire extinguishers (ABC -rated) located in all
factory built non-residential structures. Factory -Built
Nonresidential Structures have a minimum separation distance of
20 ft. 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 fire
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
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 amended, that are subject to
visual inspection.
GM 21-12 Inspection Fox Engineering Solutions, inc.
WPX Energy Rocky Mountain LLC
Professional Engineer's Attestation
October 13, 2014
hereby attest that I am a Licensed Professional Engineer in the State of Colorado. I attest that! or my
agent have conducted a visual inspection of the Small Facility identified in this 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: October 13, 2014
Print Name and Title: David 3. Fox, Princi al Engineer
Signature:
Page 3 of 3
PE Stamp
WPX Energy Rocky Mountain LLC
GM 21-12 Well Pad
PROPOSED LOCATION:
GM 21-12
( PARACHUTE
LEGEND:
EXISTING ROAD
Uintah Engineering & Land Surveying
x5 2110 Eaxt Vernal, lltah 84078
(438) 780-101.7 '" FAX (43.8+) 789-1813
N
II
1b'PX ENERGY ROCKY MOUNTAIN, LLC
GM 21-12
SECTION 12, T7S, R96W, 6th P.M.
ACCESS ROAD
MAP
M102
06
13
11AR
SCALE: 1" -NIA DRAWNBY:J.L.H. IREVISED:Ilful11dH1
PLAT
SCALE: 1" = 60'
DATE: 02-13-13
DRAWN 8Y: M.D.
REV.: 11-18-13
REV.: 04-25-14
Stock
Yard
Existing
Paved Area
1iA
–5122—
Proposed
Stack Yard
Access Road
FRAC. PAD
(150 X 150)
Cut/Fill
Transition Line
17 I
24 ft.
N
STEAM BOILER
aESEL TANK/
/ PUMP HOuSE
msition
t/FW GENERATORGENERATOR =
w M
Line HOUSE 83
HOUSE
WATER
5361
WPX Energy Rocky Mountain, LLC
PLAT #4_TYPICAL RIG LAYOUT FOR GM 21-12
SECTION 12, T7S, R96W, 6th P.M.
0'
Dxising
LJx/s ge
4
odoo
BULK STORAGE
TANKS
+(11
r000R PIPE BOOM
•,(, 140'
a
�ORILLIRGI
FLOCK X
Gravel
Road
—
64
Existing I
Buried
Pi'peline
f
90' 80'
N Az. 219.252222'
Existing ��} d
Tank x_ l q
1 ` ,`Cate y
I I{{ 11 i1 KNL'CK_E �4
BOOM CRANE
7 LL
/
1 i
1
x
—
Gas Processing I °
Equipment
—x—
n3\ „ Gote
60x45 1
Cas Processing
Equipment
Tanks \ \
\
\ \
0)
Existing
alrneas Fence
ocw
° 75'
g (ts)
A---��i
m6
Separators
12Ox3D
Existing Access
,Road
Gate
Existing
Sul/ding
Existing
Sewer
Cleanout
Existing
Manhole
EXISTING I u
WELL HEAD ,J
GM. 321-12
co
Cuttings
Management
Area
it
Offset From
Power Line
5122 UINTAH ENGINEERING ek LAND SURVEYING
85 Se. 200 East Vernal. Utah 84078 + (435) 789-1317
Directions to Site:
Emergency Contact List:
WPX Office (24 hrs)
Doug McAdam—WPX Drilling
Kevin McDermott—WPX Safety
Mark Mumby—Spill Contractor
970-285-9377
970-618-7340 Cell
970-309-1195 Cell
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. Shed
*Subject to relocation for construction activities
WPXEN ERGYsoma
.,
Notes:
The well pad site is located in the NE 1/4 NW 1/4 of Section 12, T7S,
R96W, 6th P.M. (NAD83 N39.4563° W108.0614° )
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 two 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 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 and water meter 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 Uintah Engineering and Land Surveying. 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.
GM 21-12 Site Plan
Garfield County, Colorado
Small Temporary Employee Housing and
Septic Permit Application
Applicant: WPX Energy Rocky Mountain LLC
Date: October 13, 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: GM 21-12 Rig Move On Notification - Fire District & County
Date: Tuesday, October 14, 2014 1:37:00 PM
Attachments: GM 21-12 Grand Valley Fire Letter.odf
Untitled Extract Pages.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 70 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 12 - T7S R96W.
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
10/14/14
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
GM 21-12 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 70 days.
In accordance with Garfield County Planning and Zoning Regulations, the attached
documentation provides emergency response information and driving directions for the WPX
GM 21-12 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
GM 21-12 Well Pad
PROPOSED LOCATION:
GM 21-12
( PARACHUTE
LEGEND:
EXISTING ROAD
Uintah Engineering & Land Surveying
x5 2110 Eaxt Vernal, lltah 84078
(438) 780-101.7 '" FAX (43.8+) 789-1813
N
II
1b'PX ENERGY ROCKY MOUNTAIN, LLC
GM 21-12
SECTION 12, T7S, R96W, 6th P.M.
ACCESS ROAD
MAP
M102
06
13
11AR
SCALE: 1" -NIA DRAWNBY:J.L.H. IREVISED:Ilful11dH1
PLAT
SCALE: 1" = 60'
DATE: 02-13-13
DRAWN 8Y: M.D.
REV.: 11-18-13
REV.: 04-25-14
Stock
Yard
Existing
Paved Area
1iA
–5122—
Proposed
Stack Yard
Access Road
FRAC. PAD
(150 X 150)
Cut/Fill
Transition Line
17 I
24 ft.
N
STEAM BOILER
aESEL TANK/
/ PUMP HOuSE
msition
t/FW GENERATORGENERATOR =
w M
Line HOUSE 83
HOUSE
WATER
5361
WPX Energy Rocky Mountain, LLC
PLAT #4_TYPICAL RIG LAYOUT FOR GM 21-12
SECTION 12, T7S, R96W, 6th P.M.
0'
Dxising
LJx/s ge
4
odoo
BULK STORAGE
TANKS
+(11
r000R PIPE BOOM
•,(, 140'
a
�ORILLIRGI
FLOCK X
Gravel
Road
—
64
Existing I
Buried
Pi'peline
f
90' 80'
N Az. 219.252222'
Existing ��} d
Tank x_ l q
1 ` ,`Cate y
I I{{ 11 i1 KNL'CK_E �4
BOOM CRANE
7 LL
/
1 i
1
x
—
Gas Processing I °
Equipment
—x—
n3\ „ Gote
60x45 1
Cas Processing
Equipment
Tanks \ \
\
\ \
0)
Existing
alrneas Fence
ocw
° 75'
g (ts)
A---��i
m6
Separators
12Ox3D
Existing Access
,Road
Gate
Existing
Sul/ding
Existing
Sewer
Cleanout
Existing
Manhole
EXISTING I u
WELL HEAD ,J
GM. 321-12
co
Cuttings
Management
Area
it
Offset From
Power Line
5122 UINTAH ENGINEERING ek LAND SURVEYING
85 Se. 200 East Vernal. Utah 84078 + (435) 789-1317
Directions to Site:
Emergency Contact List:
WPX Office (24 hrs)
Doug McAdam—WPX Drilling
Kevin McDermott—WPX Safety
Mark Mumby—Spill Contractor
970-285-9377
970-618-7340 Cell
970-309-1195 Cell
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. Shed
*Subject to relocation for construction activities
WPXEN ERGYsoma
.,
Notes:
The well pad site is located in the NE 1/4 NW 1/4 of Section 12, T7S,
R96W, 6th P.M. (NAD83 N39.4563° W108.0614° )
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 two 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 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 and water meter 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 Uintah Engineering and Land Surveying. 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.
GM 21-12 Site Plan
Garfield County, Colorado
Small Temporary Employee Housing and
Septic Permit Application
Applicant: WPX Energy Rocky Mountain LLC
Date: October 13, 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: GM 21-12 Rig Move On Notification
Date: Tuesday, October 14, 2014 1:38:00 PM
Attachments: GM 21-12 GARCO Sheriff Letter.gdf
Untitled Extract Pages.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 70 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 12 - T7S R96W
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
October 14, 2014
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
GM 21-12 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 70 days.
In accordance with Garfield County Planning and Zoning Regulations, the attached
documentation provides emergency response information and driving directions for the WPX
GM 21-12 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
GM 21-12 Well Pad
PROPOSED LOCATION:
GM 21-12
( PARACHUTE
LEGEND:
EXISTING ROAD
Uintah Engineering & Land Surveying
x5 2110 Eaxt Vernal, lltah 84078
(438) 780-101.7 '" FAX (43.8+) 789-1813
N
II
1b'PX ENERGY ROCKY MOUNTAIN, LLC
GM 21-12
SECTION 12, T7S, R96W, 6th P.M.
ACCESS ROAD
MAP
M102
06
13
11AR
SCALE: 1" -NIA DRAWNBY:J.L.H. IREVISED:Ilful11dH1
PLAT
SCALE: 1" = 60'
DATE: 02-13-13
DRAWN 8Y: M.D.
REV.: 11-18-13
REV.: 04-25-14
Stock
Yard
Existing
Paved Area
1iA
–5122—
Proposed
Stack Yard
Access Road
FRAC. PAD
(150 X 150)
Cut/Fill
Transition Line
17 I
24 ft.
N
STEAM BOILER
aESEL TANK/
/ PUMP HOuSE
msition
t/FW GENERATORGENERATOR =
w M
Line HOUSE 83
HOUSE
WATER
5361
WPX Energy Rocky Mountain, LLC
PLAT #4_TYPICAL RIG LAYOUT FOR GM 21-12
SECTION 12, T7S, R96W, 6th P.M.
0'
Dxising
LJx/s ge
4
odoo
BULK STORAGE
TANKS
+(11
r000R PIPE BOOM
•,(, 140'
a
�ORILLIRGI
FLOCK X
Gravel
Road
—
64
Existing I
Buried
Pi'peline
f
90' 80'
N Az. 219.252222'
Existing ��} d
Tank x_ l q
1 ` ,`Cate y
I I{{ 11 i1 KNL'CK_E �4
BOOM CRANE
7 LL
/
1 i
1
x
—
Gas Processing I °
Equipment
—x—
n3\ „ Gote
60x45 1
Cas Processing
Equipment
Tanks \ \
\
\ \
0)
Existing
alrneas Fence
ocw
° 75'
g (ts)
A---��i
m6
Separators
12Ox3D
Existing Access
,Road
Gate
Existing
Sul/ding
Existing
Sewer
Cleanout
Existing
Manhole
EXISTING I u
WELL HEAD ,J
GM. 321-12
co
Cuttings
Management
Area
it
Offset From
Power Line
5122 UINTAH ENGINEERING ek LAND SURVEYING
85 Se. 200 East Vernal. Utah 84078 + (435) 789-1317
Directions to Site:
Emergency Contact List:
WPX Office (24 hrs)
Doug McAdam—WPX Drilling
Kevin McDermott—WPX Safety
Mark Mumby—Spill Contractor
970-285-9377
970-618-7340 Cell
970-309-1195 Cell
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. Shed
*Subject to relocation for construction activities
WPXEN ERGYsoma
.,
Notes:
The well pad site is located in the NE 1/4 NW 1/4 of Section 12, T7S,
R96W, 6th P.M. (NAD83 N39.4563° W108.0614° )
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 two 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 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 and water meter 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 Uintah Engineering and Land Surveying. 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.
GM 21-12 Site Plan
Garfield County, Colorado
Small Temporary Employee Housing and
Septic Permit Application
Applicant: WPX Energy Rocky Mountain LLC
Date: October 13, 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
SCALE: 1" = 60'
DATE: 09-21-12
DRAWN BY: M.D.
REV.: 02-13-13
REV.: 03-13-13
REV.: 11-18-13
REV.: 04-25-14
REV.: 05-05-14
Stock \5128 A
Yard
Existing
Paved Area
C-2.2'
El. 27.6'
6A
C-1.3'
'El. 30.1'
FRAC. PAD
(150 X 150) 1
FINISHED GRADE = 5128.8' /
\ Existing
/�� Drainage
i 7 F-0.4'
\ / \
F-0.7' /7
El. 28.1'
C-1.6'
El. 30.4',
B1 WPX Energy Rocky Mountain, LLC
A
PLAT #2_LOCATION LAYOUT FOR GM 21-12
SECTION 12, T7S, R96W, 6th P.M.
5130
:130'
co
C-2.6'
%E/. 28.0'
80'
5128
! F-1.0'
Y El. 24.4'
Gas Processing
Equipm en t
Conduit
Panel
5122
F-3.9
Existing
CMP
0
to
in
N
•� Q6CI
•••G�STE:•••
• I•
•
•SUR A N 0�•,•
El. 28.4' 1%.•�0 -05.
Approx.
X90' Sta. 3+55
\ C-2.6'
El. 28.0'
Gravel
Road
C-3.7'' Top of s).
El. 29.1' I Cut Slope uo
1 81 El. 29.1'
••
•
•
•
•
•
•
•
•
0 •!
84 '�
I
Existing
Buried
Pipeline
i
I
Cut/Fill I
Transition Line
/
C-0.3' ---I-
GateEl. _25.7'- ���
% /10 I-u---n-,iL r
�-�( 140' Proposed GM 411-12 Exist M 21-12 90' 80'
N Az. 219.252222' s A 507 Proposed GM 531-12
1 --*--c- Proposed GM/ 332-12 0-0 Proposed aii 32-12
Z5' (typJ i /' '
TX �' +/ B04x-
005 m A040 osed Gil/ 342-12 +X_ -
Gate B03o A03
ExistingProposed GIM 343-120-0 proposed GM 542-12 I
Tank Awesed Gv 443-12 c GM 43-12 1
X� �x
I
Existing
Building
Sta. 1+80
Existing
Fence
- -x-
\
\./ Gate's
Gate
Gate .
EXISTING
WELL HEAD
GM 321-12
Sta. 1+05
GRADE
E/. 25.4'
Tanks
60x45
Gas Processing
\
Equipmen t
150'
Separators
120x30
O
co
Cuttings
Management
Area
Anchor
(TYP.)
Sta. 0+00
EL 21.5'
El. 22.8'
Existing Access
Road
15122
Elev. Ungraded Ground At GM 411-12 Loc. Stake = 5125.7' UINTAH ENGINEERING & LAND SURVEYING
FINISHED GRADE ELEV. AT GM 411-12 LOC. STAKE = 5125.4 85 So. 200 East * Vernal, Utah 84078 * (435) 789-1017
Proposed
Stack Yard
Access Road
Approx.
Toe of
Fill Slope
II
230' Offset From
Power Line
Existing
Sewer
Cleanout
Existing
Manhole
El.
28.1'
5128.
Topsoil Stockpile
F-1.5'
El. 23.9' /
5124
LEGEND:
EXISTING ROAD
Uintah Engineering & Land Surveying
85 South 200 East Vernal, Utah 84078
(435) 789-1017 * FAX (435) 789-1813
WPX ENERGY ROCKY MOUNTAIN, LLC
N
GM 21-12
SECTION 12, T7S, R96W, 6th P.M.
ACCESS ROAD 102106 13
MAP MONTH DAY YEAR
SCALE: 1" = 20001 DRAWN BY: J.L.H.(REVISED: 00-00-00
5
PLAT
■III FilitrINA11111,1114,1114L1IC 01111.4. II 111
Reception#: 815004
02/27/2012 12:18:10 PM Jean filberioo
1 of 2 Rea Fee:S18.00 Doo Fee:0.00 GARFIELD COUNTY CO
LIMITED 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 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
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 Ieases 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 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
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.
v
X1116''al'IAi«'illitti 1t'PiltIwwI#CIrC1114 11I11
Recap tion#: 81E004
02/27/2012 12:18:10 PM Jaen Alberico
2 or 2 Rec Fee:$16.00 Doc Fee:0.00 GARFIELD COUNTY CO
IN WITNESS WHEREOF, WPX Energy Rocky Mountain, LLC has caused this
Limited Power of Attorney to be signed by one of its Vice Presidents, duly authorized by its
Management Committee to grant powers of attorney this 1s` day of January, 2012.
WPX RO ..._. TAIN, LLC
By.
D. rhes
Its: ice Pr ident
ACKNOWLEDGMENT
STATE OF OKLAHOMA )
) ss.
COUNTY OF TULSA )
BEFORE ME, the undersigned authority, a Notary Public in and for said County and State,
on this day personally appeared, Jerry D. Barnes personally known to me to be the Vice President of
WPX Energy Rocky Mountain, LLC a Delaware limited liability company, who acknowledged to me
that he has executed the above LIMITED POWER OF ATTORNEY authorized by Company's
Management Committee.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my notary seal, the L -U 4 1
day of January, 2012.
Notary Public
My Commission Expires: 2 - 23 0124
'QUEERLY J. DENT
Not.ye.u. In$ d1x 0.4
Sub of°M wm.
Commlubn 0110001064
My ComnW bn coins 223¢011
After Recordation Please Return To:
WPX Energy Rocky Mountian, LLC
Attn: Land Dept.
PO Box 370
Parachute, CO 81635
2