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HomeMy WebLinkAboutApplicationGar.field County Community Development Department 108 81h Street, Suite 401 Glenwood Springs, CO 81601 (970) 945-8212 ONSITE WASTEWATER TREATMENT SYSTEM {OWTS) PERMIT APPLICATION www .garfield-county.com TYPE OF CONSTRUCTION x New Installation I Cl Alteration I Cl Repair WASTE TYPE X Dwelling I Cl Transient Use I Cl Comm/Industrial I Cl Non -Domestic Cl Other Describe -INVOLVED PARTIES Property Owner: You berg Beaver Creek Ranch Phone:(716) 622-4212 Mailing Address: 215S101h Street1 SAC Cit~ IA 50583 -2137 Contractor: WPX Energy Rockv Mountain1 LLC Phone: (970} 285 -9377 Mailing Address: PO Box 3701 Parachute 1 CO 81635 Engineer: David Fox Phone: (970} 250-5505 Mailing Address: PO Box 3701 Parachute, CO 81635 PROJECT NAME AND LOCATION Job Address: RU 44-7 Pad -See the attached ~lat for descri~tion Assessor's Parcel Number: 240307300001 Sub. lot Block -- Building or Service Type: Temporary office & house #Bedrooms: 2 Garbage Grinder No Distance to Nearest Community Sewer System: NA Was an effort made to connect to the Community Sewer System: NA TypeofOWTS a Septic Tank I a Aeration Plant I x Vault I 0 Vault Privy 1 0 Composting Toilet D Recycling, Potable Use D Recycling I Cl Pit Privy I D Incineration Toilet 0 Chemical Toilet XOther Hauled to Down Vallell Waste for their disgosal Ground Conditions Depth to 111 Ground water table NA I Percent Ground Slope NA Final Disposal by a Absorption trench, Bed or Pit I D Underground Dispersal I a Above Ground Dispersal 0 Evapotranspiration D Wastewater Pond I D Sand Filter X Other Hau led to Down Vall ell Waste for thglr dlsgosa 1 Water Source & Type D Well I D Spring I D Stream or Creek I D astern X Community Water System Name Down Vallell Segti c and Waste Effluent Wiii Effluent be discharged directly Into waters of the State? D Yes XNo CERTIFICATION Applicant acknowledges that the completeness of the application is conditional upon such further mandatory and additional test and reports as may be required by the local health department to be made and furnished by the applicant or by the local health department for purposed of the evaluation of the application; and the issuance of the permit is subject to such terms and conditions as deemed necessary to insure compliance with rules and regulations made, information and reports submitted herewith and required to be submitted by the applicant are or will be represented to be true and correct to the best of my knowledge and belief and are designed to be relied on by the local department of health in evaluating the same for purposes of issuing the permit applied for herein. I further understand that any falsification or misrepresentation may result in the denial of the application or revocation of any permit granted based upon said application and legal action for perjury as provided by law. OFFICIAL l!ISE ONLY Special Conditions: Permit Fee: Perk Fee: $;;2 nd understand the Notice and Certification above as well as hich is correct and accurate to the best of my knowledge. Total Fees: ~ ~/Z?.. Issue Date: Due: a:J 1-11 --201? DATE One aboveground sewage holding tank with 4000-gallon capacity on-site. The Vault System is displayed in both of the pictures. Sewage flows esti- mated to be 300 gallonslday (4 individuals x 75 gpcd). Sewage holding tank needs to be emptied approximately every 13 days (4000 gallons/ 300 gallons per day). Wastewater vault is equipped with overflow alarm device. Williams utilizes the services of a licensed contractor to removed and haul the wasterwater to a state certified treatmentldisposal facility. One potable aboveground water tank of approximately 4000 gallons ca- pacity on-site. Posted on the front of the Tank there is a Sign that states "Potable Water Only". Potable water demand is estimated to be 300 gal- lonslday (4 individuals x 75 gpcd). Required minimum fire suppression demand is 2500 gallons. Total potable and fire suppression demand is estimated to be 4000 gal- lons. Road access to the site is maintained year round through the services of pri- vate road maintenance and construction contractor. • SEPTIC ,, RU 44-7 Pad Vault System Description The site will temporarily office and house up to a maximum of four individu- als 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. LIMITED POWER OF ATTORNEY WPX ENERGY ROCKY MOUNTAIN, LLC ("Companyt') a Delaware limited liab ility company, having its principal place of business in the Cily of Tulsa, County of Tulsa, Slate of Oklahoma, docs hereby make, constitute and appoint Bryan S. HotArd with the full authority hereinafter provided~ the trUe and lawful AUomey-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. AppJications and documentation associated with Garfield County or Rio Blanco permitting requirements for including, but not limited to, Independent Sewage Disposal Systems, Small Tcmponuy Employee Housing, Major Impact Reviews, Limited Impact Reviews, Oil and Gas well permitting, Driveway Access, County Road Maintenance, Tempormy Living Quarters, Temporary Use Permits, Surface Use Pennits, Surface Use Licenses, Uh1ities, Snow .Removal and Private Construction of County Roads; 2. Agreements and other documentation that grant easements, rigbls of way, licenses, or pcnnits to Company and aJso instruments where the Company grants such rights to others; 3. Agreements that assign easements, rights of way, licenses, permits or surface leases in COMCction with the Company's opcrationsj 4. Releases and Partial Releases of easements and rights of way; S. Agreements allowing encroachments onto easements and rights of way owned by Company and landowner instrument& and conveyances on others casements; 6. Agreements subordinating mortgage righlS to casement or lease ; 7. Agreements relating to the modification aod 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 lC<lSC ofrcaJ property for residential or commercial pwposes 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 evCl}' act, mailer and thing which shall be given, made and done by Bryan S. Hotard in connection with the exercise of any or nll of the aforesaid powers shall be as good, valid and effectual to all intents and purposes as if the same bad 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 Limilcd Power of Attorney shall remllin in full force and effect until tenninatcd by Company. IN WITNESS WHEREOF, WPX Energy Rocky MoWllain, LLC has caused lhis Limited Power of Attorney to be signed by one of its Vice Presidents, duly authori1.ed by ils Management Committee to grant powers of attorney lhis 111 day of Jenuacy, 2012 . :AJN, LLC ACKNOWLEDGMENT STATEOFOKLAHOMA ) ) SS. COUNTY OF TULSA ) BEFORE ME, the undersigned aulhority, a Notal)' Public in and for said County and State, on this day personally appeared, Jeny D. Barnes personally Jcnown 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 ATIORNEY authorized by Company's Management Committee. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my notary seal, thctaJ,h day of.ltmlm,-;2012. F~j My Commission Expires: After Recordalion Please Return To: WPX Energy Rocky Mountian, Lt.C Attn: Land Dept POBo"370 Parachute, CO 81635 e IQMllRVJ.DEHT _,,,._ .......... --------- 2 Section 7 T. 7 S., R. 93 W. r-- -Dayl~ht '-_!.ne_ "}__---. --. ---------------GRAPHIC SCALE IN FEET -.. , , 1 INCH •~ FEET --A---+-+----~-~-18~:.~-~--~-~-~-~-16~5-._~-~-~-~~N~~~#i-~------="""-~-18~5.~--~~~FN_E_17.-~s-1 ·---~~' _ -1go0! F 17:§ --~ --=~=~\-_C}--~ ... -o:i ~ -t"'--~ -~ I~ I 6200 OTALS 37110 24690 6120 6300 J36 East Third Street SCALE: ,.. 80' Rifle, Colorado 81650 DATE: 4114114 Ph. (970} 625-2720 PLAT: 2of7 Fax (970) 625·2773 PROJECT: Valley DFT: cws Section 7 T. 7 s., /?. 93 w. 1000 0 2000 ------G R ... PHIC SC "1.E IN FEET ACCESS DESCRIPTION: 1 INCH :: 2000 FEET FROM THE INTERSECTION OF STATE HIGHWAY 6 AND COUNTY ROAD 323 (RULISON ROAD) NORTH OF RULISON, PROCEED SOUTHERLY ALONG COUNTY ROAD 323 (RULISON ROAD) ±1 .1 MILES TO THE INTERSECTION WITH COUNTY ROAD 309 (RULISON PARACHUTE ROAD), PROCEED LEFT IN AN EASTERLY DIRECTION ±2 .3 MILES TO THE INTERSECTION WITH COUNTY ROAD 320 (RIFLE RULISON ROAD), PROCEED RIGHT IN AN EASTERLY DIRECTION ±6 .2 MILES TO THE INTERSECTION WITH COUNTY ROAD 317 (BEAVER CREEK ROAD), PROCEED RIGHT IN A SOUTHERLY DIRECTION ±3 .6 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD, PROCEED LEFT IN AN EASTERLY TO NORTHEASTERLY DIRECTION :1:2.0 MILES TO AN INTERSECTION WITH A DIRT/GRVEL ROAD, PROCEED RIGHT IN A SOUTHEASTERLY DIRECTION i0.7 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD . PRoce:o RIGHT IN A SOUTHERLY DIRECTION :t0.3 MILES TO THE fil!M:L DRILL PAD LOCATION, AS SHOWN HEREON .