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Home My WebLink About1.1 Supplemental Application Info—C Garfield County Community Development Department 108 81h 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: Encana Oil and Gas (USA) Mailing Address: City. Denver E-mail: 370 17th Street, Suite 1700 Operator's Compliance Officer Name: Scott Canonico, LINN Operating Mailing Address: City: Denver 1999 Broadway, Suite 3700 E-mail: scanonico@linnenergy.com Phone: ( 303 ] 623-2300 State: CO Zip Code: 80202 State: CO Phone: ( 303 ) 999-4058 Zip Code: 80203 PROJECT NAME AND LOCATION Location of Housing Site (Section/Township/Range): S 21 T 6s R 96w Well Pad Number: A-21 Assessor's Parcel Number: 213527300015 Zone District: R -L Maximum Number of Permitted Occupants: 8 Number of Days the Facility will be at Location: Estimated 120 State or Federal Permitting Agency Overseeing Reclamation, Restoration and Revegetation (Name): (Name): (Relevant Permit Number): 400478371 Date of Installation: 1/5/2015 Date of Removal: Estimated 4/1/2015 24 -Hour Emergency Contact (1): Stan bencn, tzHb Kep Phone Number: 4.i5-tSL,i-"I tSLU 24 -Hour Emergency Contact (2): Derek Johnson, Field Superird Phone Number: 970-274-3335 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 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. 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 7-705.8. 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: 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. 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: L 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: 3,000 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: ATCO Structures USA Division of Housing Insignia (provide copy) Unit 2 Make: ATCO Structures USA Division of Housing Insignia (provide copy) Unit 3 Make: Division of Housing Insignia (provide copy) OWTS PERMIT Permit #: Not applicable, vault and haul for wastewater Serial Number/Unit ID #: 234106698/234106698 Square feet of unit: 442 Serial Number/Unit ID #: 348074402/348074402 Square feet of unit: 702 —TSerial Number/Unit ID #: Square feet of unit: 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 best of my knowledge. 1 I'2 D I 15 Sin ure of Compliance Officer Date CXXrf 0Y1 A G O 1 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: Colorado Registration No. 25420 Date of Inspection: January 14, 2015 Name and Title: David J. Fox, Professional Engineer Signature OFFICIAL USE ONLY PE Stamp File Number: - Fee Paid: $_ 25420 ust rums,,.., .. ATCO S,puclupgs (USA) Inc. 1106 North Temple Drive, Diboll, Texas 15941 U.S.A. 1-800-575-2826 Registration No. _ State Decal No. r ' sta 3 7� Model�•�� IW=alNo. 2 4 T O r 6 9 - Constructed On /M 0` 0 /Y roorLive Loads 0 PSF Volts 1201.". 0 Roof Loads PSF Hz Wind Load PSF Phase. Wind Speed MPH Amps 0 Gas Type 1 N Seismic Zone ri Seismic Design Category Occupancy Group Construction T This unit nit co ,r l� mplies with the: 2008 uiIdirtJ Re `, Date of Coh9ulation$ in...._ 4i- ILIA THIS INSIGNIA IS THE PROPERTY OF THE STATF. Ul�"t;u'LU-`-KAU.1 DIVISION OF ROUSING - THIS NONRESIDENTIAL STRUCTURE COMPLIES WITH THE FA.C"TORY' BUILT NONRESIDENTIAL CONSTRUCTION STANDARDS OF_THE STATE-O'F COLdRADO MANUFACTURERS)' NAME * - PLAN APPROVA! -*O. UNIT ID# DATE BUILT CERTIFICATION NO. FBNR MANUFACTURER CERTIFIES THE FOLLOWING: ROOF DESIGN LOAD PSF WIND SPEED Nola= FLOOR DESIGN LOAF) PSF OCCUPANCY FIRE RATING EXTERIOR WALLS HR FIRE RATING CEILING HR .t SEAL NUMBER MECHANICALBUILDING op T THIS INSIGNIA IS THE PROPERTY F .. O THE ST"AT_E OF COLORADO HOUSING THIS NONRESIDENTIAL STRUCTURE COMPLIES WITH THE---ACTORY BUILT NONRESIDENTIAL CONSTRUCTION STANDARDSOFTHE STATE OF COLORADO MANUFACTURER(S)l NAME PLAN APPROVAId, NO. DATE BUILT UNIT ID# CERTIFICATION NO. FBNR MANUFACTURER CERTIFIES THE FOLLOWING: ROOF DESIGN LOAD pgF. WIND SPEED MPH FLOOR DESIGN LOAD pgF FIRE RATING EXTERIOR WALLS HR ' FIRE RATING FLOOR HR FIRE RATING CEILING HR IECHANICAL ELECTRICAL PLUMBING BUILDING tructuresr ATCO Stpuctupes (USA) Inc. 1106 North Temple Drive, Oiholl, Texas 15941 U.S.A. 1-800-575-2826 istration too! State Decal No... Serial No. Constructed On Floor Live Loads Roof Loads Wind Load Wind Speed Gas T pe 1 c �• - •..ismic,,Zone 0 aismic Design Category C' -cupancy Group 'nstruction Type s unit complies with the: PSF PSF PSF MPH