HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8'h Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-county.com
SMALL TEMPORARY
EMPLOYEE HOUSING
APPLICATION FORIM
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 Sheriffs Office and Fire Protection District.
INVOLVED PARTIES
Property Owner Name: ern+ -Colorado Film Valley Field office Phone: (970 )8789000
Mailing Address: 2300 River Frontage Road
City: Silt State: CO Zip Code: 81652
E-mail:
Operator's Compliance Officer
Name: WPX Energy Rocky Mountain, LLC Phone: ( 970 ) 285-9377
Mailing Address: PO Box 370
City: Parachute State: CO Zip Code: 81635
E-mail: April.Mestas@wpxenergy.com
PROJECT NAME AND LOCATION
Location of Housing Site (Section/Township/Range): S 4 T rS R 98w
Well Pad Number: GM 32-4 Assessor's Parcel Number: 240921200952
Zone District: Rural Maximum Number of Permitted Occupants: less than 8
Number of Days the Facility will be at Location: 60
State or Federal Permitting Agency Overseeing Reclamation, Restoration and Revegetation (Name):
(Name): BLM (Relevant Permit Number): API # 05-045-22461-00
Date of Installation: 12/28/14 Date of Removal: 02,26/15
24 -Hour Emergency Contact (1):yyi'A tnergy KOCKy ivitn, LLU Phone Number: UfU Lt5b Ud/
24 -Hour Emergency Contact (2): Phone Number:
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.
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
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
Yes
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
2. The Small Facility is located at the Permitted Site for less than a cumulative of 1
Yes
year and at the end of the utilization period, all structures, foundations, and
associated infrastructure are completely removed; and
3. The Small Facility shall have an occupancy of 8 or fewer people who are
Yes
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.
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.
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.
S. 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 BBU21,000 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 ff:
Division of Housing Insignia (provide copy)
Square feet of unit:
Unit 2
Make:
Serial Number/Unit ID g:
Division of Housing Insignia (provide copy)
Square feet of unit:
Unit 3
Make:
Serial Number/Unit ID N:
Division of Housing Insignia (provide copy)
Square feet of unit:
OWTS PERMIT
Permit k:
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 ve and have provided the required attached information
which is correct and accurate to th Ast f 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:
PE Stamp
Date of Inspection:
Name and Title:
Signature
OFFICIAL USE ONLY
File Number: ____---__ Fee Paid: $_n/a
Goudie Dylan
From:
Goudie, Dylan
Sent:
Tuesday, December 30, 2014 12:57 PM
To:
'opschief@gvfpd.org'
Cc:
Reed, Gary
Subject:
***GM 32-4 PAD*** Rig Move On Notification - Fire District and County
Attachments:
Grand Valley Fire Letter GM 32-4 Pad.pdf, BLM Notification Map.pdf
I am notifying you on the attached pad locations we will be commencing drilling operations in the next few days and
these operations will continue for approximately 60 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 32 - 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,
Dylan Goudie
Drilling Engineer - Piceance Basin
WPX Energy- Rocky Mountain, LLC
Email: Dvian.Goudle@wpxenergy.com
Office: (970) 623-8936
Cell: (970) 319-8089
WPXENERGY
WPX ENERGY
GM 32-4 WELL PAD
The well pad site is located in the SW 1/4 NE 1/4 of Section 4, WS, R96W, 6th P.M.
(Lat: 39.469408 Long -108.112800)
Emergency Contact List:
Ma" ORice 970-285-9377av5wered241 lours
Done McAdams RTX Drilling Sup- 970-618-7340
Kevin McDennott-WPX Safety 970-309-1195 Cell
Mark Mu t y -S ill Contractor 970-260-1576 Cell
s site will temporary oBTce and house tip to a maximum of 8 individuals during
and gas drilling activities and is expected to complete in less than 6 months. The
ividuals will occupy 2 individual trailer offices/houses located on the well pad.
e above ground water tank of approximately 500 Barrels capacity on each site.
e potable aboveground water tank of approximately 4000 gallons capacity
site. Potable water demand is estimated to be 300 gallons/day (4individuals x
gpcd).Required minimum fire suppression demand is 2500 gallons.Total
:able and fire suppression volume required is estimated to be 400
lons.Water supply appear adequate with 4000 gallons of storage with refills
leduled at 5 -day intervals.Dry hydrants observed on water tank.
I THE INTERSECTION OF STATE HIGHWAY 6 & COUNTY ROAD 323 (RULISON ROAD) NORTH OF RULISON, PROCEED
HERLY ALONG COUNTY ROAD 323 (RULISON ROAD) +/- 1.1 MILES TO THE INTERSECTION WITH COUNTY ROAD 309
[SON PARACHUTE ]LOAD), PROCEED LEFT IN AN EASTERLY DIRECTION+/- 2.3 MILES TO THE INTERSECTION WITH
4TY ROAD 30L PROCF-ED RIGHT INA SOUTHERLY TO WESTERLY DIRECTION +/- 3.5 MILES TO THE INTERSECTION
I A DIRT/GRAVEI, ROAD, PROCEED LEFT INA SOUTHERLY DIRECTION +/- 1.5 MILES TO THE EXISTING PA 24-12 DRILL
PROCEED ACROSS DRILL PAD TO ACCES ROAD ON WEST SIDE OF DRILL, PAD, PROCEED INA SOUTHERLY TO
TRLY DIRECTION+/- 1.8 MILES TO THE SP 32-14 DRILL PAD LOCATION AS SHOWN.
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PROPOSED LOCATION:
GM 32-4 o{�
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LEGEND: WPX ENERGY ROCKY MOUNTAIN, LLC
---------------- PROPOSED ACCESS ROAD N GM 32-4
EXISTINGROAD
SECTION 4, US, R96W, 6th P.M.
® Uintah Engineering &Land Surveying ACCESS ROAD mom 27113
ss soum zoo East ve�nel, uwh 114078 &T O P O D1 A P a+oxnl nAr vevc
(435) 789-1017 - PAX (435) 789-1813
SCALE: I°=2000'1 DRAWN By* I.L.Ci V:04-07.14J.hLF.
Goudie, Dylan
From: Goudie, Dylan
Sent: Tuesday, December 30, 2014 1:01 PM
To: 'jsears@garcosheriff.com'
Subject: ***GM 32-4 Pad*** Rig Move On Notification
Attachments: BLM Notification Map.pdf, GARCO Sheriff Letter GM 32-4 Pad.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 60 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 4 - US 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,
Dylan Goudie
Drilling Engineer - Piceance Basin
WPX Energy- Rocky Mountain, LLC
Email: Dvlan.GoudieCawoxenerev.com
Office: (970) 623-8936
Cell: (970) 319-8089
WPXENERGY.-
WPX ENERGY
GM 32-4 WELL PAD
The well pad site is located in the SW 1/4 NE 1/4 of Section 4, T7S, R96W, 6th P.M.
(Lat: 39.469408 Long -108.112800)
Eniergencv Contact List:
Main Office 970-285-9377 answered 24 Hours
Doug McAds ns NPR Drilling Sup - 970-618-7340
Kevin MeD •mott-WPX Safety 970-309-1195 Cell
Mark M by=Spill Contractor 970-260-1576 Cell
s site will temporary office and hoose up to a maximum of 8 individuals during
ural gas drilling activities and is expected to complete in less than 6 months. The
ividuals will occupy 2 individual trailer offices/houses located on the well pad.
e above ground water tank of approximately 500 Barrels capacity on each site.
e potable aboveground water tank of approximately 4000 gallons capacity
site. Potable water demand is estimated to be 300 gallons/clay (4individuals x
gpcd).Required mininmm fire suppression demand is 2500 gallons.Total
.able and fire suppression volume required is estimated to be 400
Ions.Water supply appear adequate with 4000 gallons of storage with refills
teduled at 5 -day intervals.Dty hydrants observed on water tank.
FROM THE INTERSECTION OF STATE HIGHWAY 6,',, COUNTY ROAD 323 (RULISON ROAD) NORTH OF RULISON, PROCEED
SOUTHERLY ALONG COUNTY ROAD 323 (RULISON ROAD)+/- 1.1 MILES TO THE INTERSECTION W1 TH COUNTY ROAD 309
(RULISON PARACHUTE ROAD), PROCEED LEFT IN AN EASTERLY DIRECTION+/- 2.3 MILES TO THE INTERSECTION WITH
COUNTY ROAD 301, PROCEED RIGHT INA SOUTHERLY TO WESTERLY DIRECTION +/- 3.5 MILES TO THE INTERSECTION
WITII A DIRT/GRAVEL ROAD, PROCEED LEFT INA SOUTHERLY DIRECTION+/- 1.5 MILES TO THE EXISTING PA 2412 DRILL
PAD, PROCEED ACROSS DRILL PAD TO ACCES ROAD ON WEST SIDE OF DRILL PAD, PROCEED IN A SOUTHERLY TO
WESTERLY DIRECTION +1- 1.8 MILES'1'0 THE SP 32-14 DRILL PAD LOCATION AS SHOWN.
LEGEND:
PROPOSED
GM 32-4
PROPOSED ACCESS ROAD
EXISTING ROAD
® Uintah Engineering & Land Surveying
(4 South -10 East .A rX (43 Utah 84078
-1813
(435) 789-1017 "' FAX (435) 789-1813
Lori
WPX ENERGY ROCKY MOUNTAIN, LLC
N GM 32-4
SECTION 4, US, R96W, 6th P.M.
ACCESS ROADNT 27 13
& T O P O 1!t A P borml oir vrNc
SCALE: I"=2000' 1 DRAWNBY:I.LA REV:0107.-4OWN
lilll �Yr�l'til"�I,��fi4Ch4U'l�lYil�4�8'I�h�ld��'� I III
02IR]7 R.0
'1:1'� 6OaPa Jean Giber{w
i of Roo Feo: L18.W Dao faa,O.Co 6ARf IE1a OCLtifY t0
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'fulsa,
State of Oklahoma, does hereby snake, constitute and appoint Bryan S. Hotard with the fall
authority hereinafter provided, the true and lawful Attomey-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 Selvage 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;
IL 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 shalt be as good, valid and effectual to all
intents and purposes as if the sante 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
IIIMAIR)MMVdNGF1KIdP°RlONA AN 111111
Repeptlon9: 815004
0212r/20f2 12:18110 Pa "r— gibarleo
2 of 2 0. Fee: Sf a.00 Doc Fea:00.00 GgaF1E1D GOU'(iT 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 Colnmittee to grant powers of attorney this 1" day of January, 2012.
WPX )Et2(i3' RO ) JNTAIN, LLC
By.
D. mes
Its: ice Pr ident
ACKNOWLEDGMENT
STATE OF OKLAHOMA )
as.
COUNTYOFTULSA )
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;?61 1
day ofdauaatj , 2012.
r-1lCIty
/�
NotaryPublio
My Commission Expires: Z— — 25 — 2 (01q
After Recordation Please Return To:
WPX Energy Rocky Mountian, LLC
Atte Land Dept.
PO Box 370
Parachute, CO 81635
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After Recordation Please Return To:
WPX Energy Rocky Mountian, LLC
Atte Land Dept.
PO Box 370
Parachute, CO 81635