HomeMy WebLinkAboutApplicationGarfield 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 Facil ity. I n addition, documents shall b e
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: WPX Energ y R ocky Mountain, LLC Phone: ( 970 ) 285-9377
Mailing Address: PO Box 370
City: Parachute State: CO Zip Code: 81635
E-mail: April.Mestas@wpxenergy .com
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: Bryan.Hotard@wpxenergy.com
PROJECT NAME AND LOCATION
Location of Housing Site (Section/Township/Range): S 04 T 07S R 96W
Well Pad Number: GM 41-4 Assessor's Parcel Number: 21733200019
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): State (Relevant Permit Number): API # 05-045-22880-00
Date of Installation: 06/08/2015 Date of Removal: 08/07/2015
24-Hour Emergency Contact (1): VVt-' J<.. t:nergy Phone Number: ~I U £tj!:>-~J I I
24-Hour Emergency Contact (2): Phone Number:
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 otheiwise 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:
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
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
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.
The application submitted to the County shall contain the following information:
Complies Y/N
Yes
Yes
Yes
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 CDP HE 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 BBU21,ooo 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.
Make:
Brito Strociures 2014
Division of Housing Insignia (provide copy)
Unit2
Make:
Brito Structures 2014
Division of Housing Insignia (provide copy)
Unit3
Make:
ATCOStructures 2010
Division of Housing Insignia (provide copy)
Serial Number/Unit ID#:
360141907
Square feet of unit:
[ Serial Number/Unit ID#:
32141934
Square feet of unit:
Serial Number/Unit ID#:
355106849
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 statemel).ts"iii)O\te and have provided the required attached information
which is correct and accurate to {e best ol my knowledge.
Signature of Compliance Officer CSate
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
25420
Date of Inspection:
06/11/2015
Name and Title:
David J. Fox, Principal Engineer
Signature
~ a-
F ox E ngineering Solutions, Inc.
670 Canyon Creek Drive, Grand Junction, CO 81507
Ph: (970) 250-5505
Email: co/oradofox@bresnan.net
In spection Report for:
Client :
GM 41-4 Small Temporary Employee Housing
WPX Energy Rocky Mountain, LLC
Location :
Conducted By:
NE 1/4 of Section 4, T7S, R96W, 6th P.M. Garfield County
David Fox, P.E.
Date Conducted: June 11, 2015
Garfield Co u n t y
Paragra ph A rticle 7-707 Land Use& Devel opme nt Code (7/15/13 )
Reference Characteristic or Standard Description
A. Within 48 hours following occupation o f t h e Small Facility,
documentation shall be provided to the Community Development
Department, Sheriff's Office, and r el evant fire
B.
c.
D
p r otection district(s) that demon strates and certifi es compliance with
the followi ng standards. Notice shall also be provided to these
entities within 48-hours following
r emoval of a Small Facility.
Ge n era l Information reguirements
Small Facilities shall comply with all applicable Federal, State {I.e.
Building Codes and el ect rical permi ts), and loca l laws and regula tions
(I.e. fir e code), but are not subject to County Building Permit.
Water systems shall comply with standards set forth In section 7-
705.B.
Page 1 of3
Inspection Co m ments
Not subject to visua l inspection and certification by third party
Pro fessional Engineer.
No t su bject to vis ual inspect i on and certifi ca t ion by third party
Prof ess i ona l Engineer.
Colorado Division of Housing certifications noted on Company
housi ng trailer, Unit ID. 360141907 with Certification No. 25965,
manufactured by Brito Struct ures in 2014; Company office trai ler,
Unit ID. 32 141934 wi t h Certification No. 26446, manufactured by
Bri t o St ruct ures in 2014; Dr iller's trailer, Unit ID. 3 55106849 with
Certification No. 24102, manufactured by ATCO Structures i n
2010; and the directional engineer's trailer, Unit ID. 360148403,
w ith Certification No. 26322, manufactured by ATCO St rcu t ures i n
2014; an d the geol ogist's t ra i ler, Un it ID. 354085522, with
Ce rt ifica ti on No. 19043, manufactured by ATCO Strcutur es in
2008. All other aspects not subject to visual inspection and
cert ification 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 &
Envi ronment -WQCC Regu l at ion No. 11. It is not subject to Sta t e
pe rm itting requi rements. Two po t able water tanks wit h a
capac ity of approximately 3500 gallons ea ch are located at t he
permitted site. Water meters were installed on each potable
water tank.
GM 41-4 Inspection
WPX Energy Rocky Mountain LLC
E.
F.
G.
H.1
H.2
I.
J.
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 Facl!ity for operational or
security reasons must be managed in accordance with all applicable
Federal, State, and focal 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.
Single-station carbon monoxide alarms must be placed in each
Manufactured Home or Recreational Vehicle unit.
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
Fox Engineering Solutions, Inc.
June 11, 2015
Waste\vater disposal at the pern1itted site will be a vault-and-haul
systen1. Two 4000-gallon sewage holding tanks onsite. Sewage
flo\vs estin1ated to be 300 gallons/day (4 individuals x 75 gpcd).
Se\vage holding tanks need to be emptied approxirnately every
26.7 days (8000 gallons/ 300 gallons per day). Waste\vater vault
equipped with overflow alarn1 device.
Site appeared to be maintained in dean, safe and sanitary
condition, free of \veeds and refuse.
One wildlife-proof trash recepacle \vith 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 mlnimun1 separation distance of
20 ft. Two potable aboveground \vater tanks of approximately
3500 gallons capacity each 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 tanks.
Single-station carbon monoxide detectors located in all factory
built non-residential structures
No don1estic 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 41-4 Inspection Fox Engineering Solutions1 Inc.
WPX Energy Rocky Mountain LLC June 11, 2015
Professional Engineer's Attestation
I hereby attest that I am a licensed Professional Engineer in the State of Colorado. I attest that I 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) PE Stamp
Date of Inspection: June 11, 2015
Print Name and Title: David J. Fox, Principal Engineer
Signature: U ~ 4 r-::r:
Page 3 of 3
WPX Energy Rocky Mountain,LLC
GM 41-4 Well Pad
p jreciioos lo Site· Emerge ncy Contact List·
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GM 41-4 Site Plan
Garfield County, Co!ocado
Small Te mporary Employ ee H ou sing a nd
Septic Permit Applicatio n
App:ic..Jnt \".'PX Enet gy Rocky ~!ounta"n ,l LC
o;~JJ•1 1 ,2-J15 O"..Otd.OJ
Fox Enginee ring SoluUons, Inc.
610 Carir..nOc'!.11. Di.·~.~ >.rdcn. COl1 ~)1
F't\'. (i70) 3HSVS
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---·"'"' ) ~--------------------~
WPX Energy
1058 County Road 215
P.O. Box 370
Parachute, Colorado 81635
(970) 285-9377
June 18 , 20 15
Grand Vall ey Fire Protection Di strict
Emergency Operations
Attn: Rob Ferguson
0124 Stone Quarry Rd
Parachute, CO 81635
Ph: 970-285-9119
RE: E mergency Re sponse Notification
GM 41-4 pad
Dear Rob:
This letter is to inform the Grand Valley Fi re Protect ion District that WPX Energy will soo n
co mmence drilling operations on the above mentioned drilling location. WPX will provide rig
sit e housin g accommodations for the duratio n of the drilling op erat ion approximately 60 da ys.
Jn accorda nce with Garfield County Planning and Zoni ng Regul ations, the attached
docum entation provides emergency re spo nse information and driving direct ions for th e WPX
GM 41-4 pad.
Should you have any further qu es tion s or concerns regarding this notification, feel free to contact
me at (720) 202-J 068.
Sincerely,
Kinzie Beav e rs
Drilling Engineer -Piceance
K in z ie.Beave rs@w pxen e rgy .co m
WPX Energy Rocky Mountain,LLC
GM 41-4 Well Pad
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GM 41-4 Site Plan
Garfield County, Co~OladO
Small Temporary Em ployee Housing and
Septic Permit Application
Appr:c.ant: \'."PX Energy RcQ.-y Mounla'.n,LLC
ON.V•11.~15 (.t.ecloj OJf'
Fox Engineering Solutions, Inc.
El\lC...piOt<.\~.~.GrYd.JoJ"do\0011~1
Rl'(i'N)250-S50S
~lc.cb'"~Cltl-6~.MIJ-et
WPX Energy
1058 County Road 215
P.O. Box 370
Parachute, Colorado 81635
(970) 285-9377
June 18, 2015
Garfield County Sheriff's Office
Emergency Operations
Attn: Jim Sears
108 81h Street
Glenwood Springs, CO 8160 I
Ph: 970-945-0453
RE: Emergency Response Notification
GM 41-4 pad
Dear Jim:
This letter is to inform the Garfie ld County Sheriff's Department tha t WPX Energy will soo n
commence drilling operations on the above mentioned drilling location. WPX will provide rig
site housing accommodations for the duration of the drilling operation approximately 60 days .
In accordance with Garfield County Planning and Zoning Regula tio ns, the attached
documentation provides emergency response information and driving direction s for the WPX
GM 41-4 pad.
Should you have any further questions or concerns regarding this notification , feel free to contact
me at (720) 202-1068.
Sincerely ,
-ef<'ur,l 1 C· ~6Q('.) vc 11.)
Kinzie Beavers
Drilling Eng in eer-Piceance
Kinzie.Beavers@ \vpxenergy .com
WPX Energy Rocky Mountain ,LLC
GM 41-4 Well Pad
pjrcciioos to Site· Emergen cy Contact List ·
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GM 41-4 Site Plan
Garfield County, Co!oiado
Small Temporary E mployee Ho u sing and
Septic Permit Appli cation
A.pp .. 1Car1t \','PX En.e<gyRocJ..y Mounta·n,LLC
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Fox Eng;neenng Solulions, Inc.
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\'~001
Section 4
T. 7 S., R. 96 Iv.
PAD 5870
PIT 0
OTALS 5870
136 l!asl Tllird S!ree !
RijlP, Colorado 8 I 650
Ph. (970) 625-2720
Fax (970) 625-2773
4000
0
4000 690 1180
100
GRAPHIC SCALE IN FEET
1 INCH =100fEET
AA
1.) 10% Swell Factor Applied to Earthwork Cut Vol ume.
2.) Topsoil Volume Based on 12" Soil Depth.
3.) Total Disturbed Area = ±7.59 ac.
SCALE: 1" = 100'
DATE: 2/24115
PJ,A1': 2o[7
PROJECT: Valie r/
DF1: cs
Construction Plan Prepared for:
WPX ENERGY. . WPX Energy Roc ky Mountain, LLC
GM 41-4 Dtill Pad -Plat 2
CONSTRUCTION LAYOUT
Section 4
1: 7 S ., R. 9 6 IV.
ACCESS DESCRIPTION:
GRAPHIC SCALE IN FE ET
1 INCH= 2000 FEET
FROM THE INTERSECTION OF STATE HIGHWAY BAND COUNTY ROAD 215AT PARACHUTE, PROCEED NORTHERLY ALONG
COUNTY ROAD 215 ±2.1 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD, PROCEED LEFT IN A SOUTHWESTERLY
TO NORTHERLY DIRECTION ±1 .7 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD, PROCEED LEFT IN A
WESTERLY DIRECTION ±0.3 MILES TO THE EXISTING GM 41-4 DRILL PAD LOCATION , AS SHOWN HEREON.
REVISED: 6/ 4/ 15 Construction Plan Prepared for:
1--~~~~~~~~~~~~~~~~~~~-1WPX E N ER G~ .
scALE: 1 • ~ 2 0 0 0 · .........,~~ WPX Energy Rocky Mountain, LLC 136 East Tliird 51reet
Rifle , C-O lorado 8 J 650
Ph. (9 70) 6 25·2720
Fax (970) 625 -2773
rum: ~21~2 4~/1=5~~-1--~~~~~~~~~~~
PLAT: ...o:...5 ""-of.:_7 ___ 1
PROJECT: _,_,va=lle""--11 ---1
DFT: ...=CS ____ I
GM 41-4 Drill Pad-Plat 5
ACCESS ROAD & TOPO MAP
LIMITED POWER OF ATTORNEY
WPX ENERGY ROCKY MOUNTAIN, LLC ("Company") a Delaware limited
linbility company, hnving its principal place of business in the City of Tulsa, County of Tulsa,
Slate of Oklal1omu, does hereby make, constitute and appoint Bryau S. Hotard with the full
amhority hereinafter provided, the tme 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
associntion 1 in whole or in part, to enter into1 execute, deliver, file and accept all inslrun1cnts and
documents affecting the real property or real estate rights of the Company as more specifically
set forth below: :
l. Applications and documentation associated with Garfield County or Rio Blanco
pennitting 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 pennitting, Driveway Access, County Road Maintenance,
Temporary Living Quarters, Temporary Use Pcnnits, Surfuce Use Pennits, Surface Use
License.~, Utilities, Snow Removal and Private Construction of County Roads;
2. Agreements and other documentation that grant easements, righl~ of way, licenses, or
pem1its to Company and also instruments where the Company grants such rights to
others;
3. Agreements that assign easen1enls, rights of way, licenses, pennits 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 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 0U1er smfacc use agreements and all notices
related to the pipeline agreements;
9. Agreements for the purchase or sale of real property nod 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 or
oilier 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 nnd tl1ing 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 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 Limited Power of
Attomey shall remain in full force and effect until tenninated by Company.
JN WITNESS WHEREOF, WPX Energy Rocky Mountain, LLC has caused this
Limited Power of Attorney to he signed by one of its Vice Presidents, duly authorized by its
Management Conunittee to grant powers of attorney this l'' day of January, 2012.
TAIN,LLC
ACKNOWLEDGMENT
STATEOFOKLAHOMA )
) 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 pet~onally 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.
lN WITNESS WHEREOF, I have hereunto set my hand and affixed my notary seal, theit>Jh
day ofJ&t>uazy, 2012.
Fci>tuwy
Notary Public
My Commission Expires: 2--ZB-2-oli_/
After Recordation Please Return To:
WPX Energy Rocky Mountian, LLC
Attn: Land Dept.
POl!ox 370
Parachute, CO 81635
2