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HomeMy WebLinkAboutApplicationGar.field County Community Development Department 108 81h Street, Suite 401 Glenwood Springs, CO 81601 (970) 945-8212 www.garfield-county.com ONSITE WASTEWATER TREATMENT SYSTEM (OWTS) PERMIT APPLICATION TYPE OF CONSTRUCTION x New Installation I D Alteration I D Repair WASTE TYPE X Dwe l ling I D Transient Use I D Comm/Industrial I D Non-Domestic D Other Describe INVOLVED PARTIES Property Owner: WPX Energy Rocky Mountain, LLC Phone:{970)285-9377 Mailing Address: PO Box 370, Parachute, CO 81635 Contractor: WPX Energy Rocky Mountain, LLC Phone: {970) 285-9377 Mailing Address: PO Box 370 Parachute CO 81635 Engineer: David Fox Phone: {970) 250-5505 Mailing Address: PO Box 370 Parachute co 81635 PROJECT NAME AND LOCATION Job Address: GM 41-4 -See the attached 12lat for descri[!tion Assessor's Parcel Number: 217133200019 Sub. Lot Block -- Building or Service Type: Tem12ora!}'. 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 D Septic Tank I D Aeration Plant I X Vault I D Vault Privy I D Composting Toilet D Recycling, Potable Use D Recycling I D Pit Privy I D Incineration Toilet D Chemical Toilet X Other Hauled to Down Valle','. Waste for their disgosa l Ground Conditions Depth to 151 Ground water table NA I Percent Ground Slope NA Final Disposal by D Absorption trench, Bed or Pit I D Underground Dispersal I D Above Ground Dispersal D Evapotranspiration D Wastewater Pond I D Sand Filter X Other Hauled to Down Valle','. Waste for their disgosal Water Source & Type 0 Well I D Spring I D Stream or Creek I D Cistern X Community Water System Name Down Valle','. Segtic and Waste Effluent Will Effluent be discharged directly into waters of the State? D Yes X No 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 t o 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 falsificat ion 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. I hereby acknowledge that I have r a d understand the Notice and Certification above as well as ich is correct and accurate to the best of my knowledge. ~~~-1--:..__:; OFFICIAL USE ONLY Special Conditions: Perk Fee: Total Fees: Fees Paid: ~ ~u-oo ~r:, O(J Balance Due: ~ . 00 High level Ala rm II lig ht or Alarm Is Prese nt Tank Is Full 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 t o be 300 gallons/day (4 indiv iduals 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 cert ified treatment/disposal facility . One potab le aboveground water tank of app roximately 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- lons/day (4 ind ividuals x 75 gpcd). Required minimum fire suppression demand is 2500 gallons . Total potable and fire suppression demand is est imated 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 e DRAIN TANK BEFORE MOVING = GM 41-4 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 ind ividuals will occupy two indiv idual trailer offices/ houses located on the well pad . Office /houses have Colorado Divis ion of Housing compliance tags . Ill M'.i.1'~1lv,',~U. rllit rrr1r 1;1rrw.1r+r.fi!i"r. lr\~,Hl·i 111111 Reception~: 81~004 02127/2012 12 ,18:11! Pl1 Jean Alberico 1 of 7 Rao F"ae :$16 .00 Ooo Fee:ll .00 G~RFIELD COUNTY CO LIMITED POWER OF ATTORNEY V\'PX ENERGY ROCKY MOUNTAIN, LLC ("Company") a Delaware limited liability company, having its principal place of business in the City of Tulsa, County of Tulsa, Slate of Oklal10ma , 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, authori zed and empowered on behalf of the Company and in th e Company's name, and for the sole and exclusive benefit of the Company and not on behal f of any other person , corporation or assoc iation, 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 Rev iews , 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, pemiits 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 aod relocation of Company facilities; 8. Rental or lease agreements for surface use or other swfacc use agreements and all notices related to the pipeline agreements; 9. Agreements for the purchase or saJe ofreal 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 MOUNf AIN, 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. Ill ~?,i. l'm1l'tNl.tU, rw r!l~l1W!+\i:l'1r:rill l-t~.~I~ 1111 ReoeptlonH : 815004 0212712012 12 '1 8 : 10 PM J .. n Rlberlco 2 or 2 flee Fe~:S 1 6 .60 Doc Fe.,:ll .0il GRRFiao COU11TY CO IN WITNESS WHEREOF, WPX Energy Rocky Mountain, LLC has c?.used this Limited Power of Attorney to be signed by one of its Vice Presidents, duly authorized by its Management Conunittee to grant powers of attorney th is l't day of January, 2012 . AJN,LLC ACKNOWLEDGMENT STATE OF OKLAHOMA ) ) SS. COUNTY OF TULSA ) BEFORE ME, the undersigned autho rity , a Notary Public in and for said County and State, on this day persona\ly 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, the2.o/h dayof..J'.~2012. Fe.1.Yuruf My Commission Expires: After Recordation Please Return To: WPX Energy Rocky Mountian, LLC Attn: Land Dept. PO Box 370 Parachute, CO 81635 2 Section 4 T. 7 S., R. 96 W (, - Exist. Valve Set y\, ;- fj W#58 y C0.3' c ~---),. (,..___,, ESTIMATED EARTHWORK QUANTITIES (cy) ITEM CUT PAD 5870 PIT 0 OTALS 5870 136 East Third Street Rifle, Colorado 81650 Ph. (970) 625-2720 Fax (970) 625-2773 4000 690 1180 0 4000 690 1180 SCALE: 1 " = 100' 100 GRAPHI C SCALE IN FEET 1 INCH =1 OOFEET Construction Plan Prepared for: WPX ENERGY . WPX Energy Rocky Mountain , LLC DATE: ~2~!~2~4~/~1~5----i----------------------l PLA T: -'2"-o'-'[_7 ______ 1 PROJECT: -'V'""a""ll"'e.,_11 _____ 1 DFT: _,c'-"s-------1 GM 41-4 Dn'll Pad -Plat 2 CONSTRUCTION LAYOUT Legend • Known Well Locatio ns 0 Proposed Drill ing Locatio n --Existing Road c::J One Mile Rad iu s WPX Energy Rocky Mountain , LLC Plat 58 GM 41-4 Exisiting Well Locations within One-Mile-Radius February 12 , 2015 T:I Pro·ectsl PIC IGrandValle 115102 12 GM 41-4 2A Fi ures\Radiu s.mxd mre nold 2/12 /20 15 8 :58 :13A M WPX ENERGY.