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HomeMy WebLinkAbout1.0 ApplicationGARFIELD COUNTY Building and Planning Department 108 8th Street, Suite 401 Glenwood Springs, Colorado 81601 Telephone: (970) 945-8212 Facsimile: (970) 384-3470 www.ciarfeld-county.com RECEIVEO [IC 9 2f]11 GARFIELD COUNTY BUILDING & PLANNING %a-/J-7C�9� Small Temporary Employee Housing Administrative Checklist GENERAL INFORMATION — Submit 1 paper & 1 CD copy of the completed application to Planning Department wlin 48 hours following occupation (To be completed by the Small Facility Operator — e.g. well pad operator) Section/Township/Range Location of Housing Site: Sec 23-T7S-R96W Well Pad Number: SG 14-23 Tax Parcel Number for Parcel Containing Housing Site: 2409-232-00-096 r GPS and/or Lat-Long Coordinates of Housing Facility Site (Often included in APD): Lat:39.418160 Long: -108.086346 Zone District: Rural Maximum Number of Occupants at Permitted Site (e.g. well pad): less than 8 Cumulative Amount of Time (in Days) The Facility Will be at Location: 60days State or Federal Permitting Agency Overseeing Reclamation, Restoration and Revegetation and Relevant Permit Number: COGCC 400143875 Date of Installation: December 9th, 2011 Date of Removal: February 9'h 2011 Name of Landowner: Strait Bottom Ranch LLLP Street Address: PO Box 26 Telephone: (970)923-8999 Email: City: Woody Creek State: CO Zip Code: 81656 Name of Operator's Compliance Officer: Williams Production RMT Company LLC Bryan S. Hotard Street Address: PO Box 370 Telephone: 970-285-9377 ext 2754 Email: Bryan.Hotard a(7william s.com City: Parachute State: CO Zip Code: 81635 Company 24 -Hour Emergency Contact: Williams Production RMT Company LLC Phone Number: 970-285-9377 This Administrative Checldist must be received by the Garfield County Planning Department hours following occupancy of the Small Facility. within 48 be delivered to within 48 hours Office and receipf) or verified is the Operator's been received by A copy of this completed Administrative Checklist and all associated submittals shall the Garfield County Sheriffs Office and relevant Fire Protection District (if applicable) following occupancy of the Small Facility. Additionally, the Garfield County Sheriff's relevant Fire Protection District (if applicable) must be notified in writing (return email (return receipt) within 48 hours following removal of the Small Facility. It responsibility to confirm and obtain verification that the Administrative Checklist has 1 Fire Suppression Requirements (Per Performance Standard L) "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: 500BBLI 21,000 gallons A. Outline of Process. The Small Temporary Housing Facility(ies) Review process shall consist of the following procedures as more fully outlined in Section 4-109 of Article IV of the Unified Land Use Resolution of 2008. 1. Application to relevant protection districts and the Garfield County Sheriffs Office. 2. Application to the County B. Review Process. Prior to submittal of any forms to the Planning Department, the applicant shall submit all documents to the relevant fire protection district(s) and the Garfield County Sheriff's Office. All forms shall be accurately completed, signed, dated and submitted to the Garfield County Planning Department within 48 hours following occupation of the Small Facility. C. Submittal Requirements. The application submitted to the County shall contain the following information: i. 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. ii. 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. (See Section 4-502 (C )(3) for site plan definition) iii. 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. iv. Name, address and phone number of surface owner of the subject lot. v. Name, address and phone number, including a 24-hour emergency response number of at least two persons responsible for Operator's emergency field operations; contact numbers for local hospitals, emergency response, fire protection 2 districts, Garfield ,ounty Sheriffs Office, Life/Care Flight, and applicable regulatory agencies; site safety/evacuation plan; and any other written response plan for potential emergencies at the Permitted Site. vi. Identification of the anticipated dates of installation and removal of the Small Facility. The site plan shall include a notation of the total cumulative length of time (number of days) that the Small Facility will be installed at the Permitted Site. ELIGIBILITY Requirement (Section 7-808 (D)(3) -- All Requirements Must be Satisfied to be Eligible as a Small Facility Applicant Planning Department Complies (Y/N) Complies (YIN) The Small Facility and any associated infrastructure must be completely contained within a state or federally permitted parcel (such as a Colorado Oil and Gas Conservation Commission (COGCC) approved oil/gas well pad) in which reclamation and revegetation are secured with the permitting agency (Permitted Site); and, YES The Small Facility is located at the Permitted Site for less than a cumulative of ane (1) year and at the end of the utilization period, all structures, foundations and associated infrastructure are completely removed; and, YES The Small Facility shall have an occupancy of eight (8) or fewer people within a Permitted Site (e.g. well pad) who are employees, contractors or sub-contractors of the operator of the small facility and are needed for onsite safety of the related commercial, industrial, extraction or highway operation. Temporary employee housing facilities that do not have the three characteristics listed above, or consist wholly or in part of Recreational Vehicles as defined above, are subject to the administrative permit requirements or the Major Impact Permit process, standards and requirements contained in this document. YES 3 Building Information (Per Unit) Unit 1 Make: ATCO Structures (USA) Inc Serial Number or Unit ID Number: 354085940 Manufacture Year: 2008 Size of Unit (Square Feet): 14X56 Unit 2 Make: AmeriTech Building System Serial Number or Unit ID Number: 11-100810 Manufacture Year: 2010 Size of Unit (Square Feet): 14X56 Unit 3 Make: Serial Number or Unit ID Number: Manufacture Year: Size of Unit (Square Feet): Unit 4 Make: Serial Number or Unit ID Number: Manufacture Year: Size of Unit (Square Feet): Unit 5 Make: Serial Number or Unit ID Number: Manufacture Year: Size of Unit (Square Feet): ISDS Permit ISDS Permit Number: SEPT -9-11-2228 Signature of Operator's Compliance..' Officer: .....',4, ,!- (By signing this form, 1 verify that all informati the best of my knowledge) Print Name: Bryan S. Hotard provided in t fiv checklist is correct and accurate to Title: Attorney -In -Fact 4 Eligibility, Submittal and Performance ;Standards Certification Section 7-808(D)(3) - Small Temporary Employee Housing Facilities (Small Facility(ies)) in Article VII — Standards, requires the that the following performance standards be met with each facility: Small Facilities, in the nature of Factory Built Nonresidential Structures [as defined under C.R.S. 24-32-3302(a)] but NOT recreational vehicles [as defined under C.R.S. 42-1-102 (61), including truck, truck tractor, motor home or camper trailer], may be utilized for housing of workers on projects related to commercial, industrial, mineral extraction or highway operations, pursuant to the standards for Small Facilities contained in sub- section (2), below. Such facilities are not subject to Garfield County building and fire codes (building code, fire code). However, Small Facilities are subject to all pertinent state (i.e. electrical permits), federal permits and relevant fire protection district(s) code requirements. Small Facilities shall have all of the following basic characteristics: A. The Small Facility and any associated infrastructure must be completely contained within a state or federally permitted parcel (such as a Colorado Oil and Gas Conservation Commission (COGCC) approved oil/gas well pad) in which reclamation and revegetation are secured with the permitting agency (Permitted Site); and, B. The Small Facility is located at the Permitted Site for less than a cumulative of one (1) year and at the end of the utilization period, all structures, foundations and associated infrastructure are completely removed; and, C. The Small Facility shall have an occupancy of eight (8) or fewer people who are employees, contractors or sub -contractors of the operator of the small facility and are needed for onsite safety of the related commercial, industrial, extraction or highway operation. Temporary employee housing facilities that do not have the three characteristics listed above, or consist wholly or in part of Recreational Vehicles as defined above, are subject to the administrative permit requirements or the Major Impact permit process, standards and requirements contained in this document. The Small Facility shall adhere to the following Standards: All required submittals (as outlined in (2), above) shall be submitted to the Planning Department within 48 hours following occupation of the Small Facility. Enforcement shall be in accordance with this Resolution. The Small Facility shall demonstrate and certify compliance with the following standards: A. Small Facility must comply with all applicable federal, state and local laws and regulations. B. The Small Facility shall NOT contain recreational vehicles as defined in Section 7- 808 (D). 5 C. In no case shah unsafe water be used for drinking nu, shall raw sewage or contaminated water be discharged on the ground surface. The operator shall conduct monthly tests (or quarterly if an on-site disinfection system is installed) and maintain records of stored potable water samples specific for coil form bacteria. Any tests indicating coli form contamination must be disclosed to the Garfield County Board of Health or designee within 72 hours from the time the contaminated water was tested. D. 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. E. At least one thirty (30) gallon (4 cubic feet) wildlife -proof refuse container shall be provided for each Factory Built Non -Residential Structure unit. Said container(s) must be durable, washable, non-absorbent metal or plastic with tight -fitting lids. F. Refuse shall be disposed of weekly, at a minimum. Operators must keep appropriate records, to be provided to the County or any interested third party upon request, to demonstrate that refuse is collected in a timely fashion and disposed of at a licensed facility. G. Outdoor food storage is prohibited. H. Factory Built Non -Residential Structures equipped by the manufacturer with a fire sprinkler system, fire detection system, and/or alarm system shall be inspected, tested, and maintained in accordance with the requirements of the relevant fire protection district(s) and the Colorado Division of Housing. Single -station carbon monoxide alarms shall be placed in each Factory Built Non - Residential Structure. J. One (1) or more approved fire extinguisher(s) of a type suitable for flammable liquids, combustible materials and electrical fires (Class ABC), or dry chemical, shall be located in each Factory Built Non -Residential Structure and placed in accordance with applicable fire protection district and/or Colorado Division of Housing codes. K. Domestic animals are prohibited at all Small Facilities. L. 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 within each Permitted Site for a Small Facility. M. The operator shall document all emergency situations requiring action by any government agency or fire protection district, in writing, and such documentation shall be presented to the Planning Department within 24 hours of the occurrence. N. All required Access Permits shall be obtained from the Garfield County Road and Bridge Department or the Colorado Department of Transportation. 6 O. The Garfield Coin qty Sheriffs Office and relevant fire protraction district(s) shall be notified and provided with all documentation as outlined in these regulations, within 48 hours following occupation of each Small Facility. In addition, the Garfield County Sheriffs Office and relevant fire protection district(s) shall be notified either by hard -copy or electronically within 48 hours following removal of all Small Facilities. The Planning Department shall be copied on all such notification, whether hard copy or electronic. P. The Operator shall maintain records identifying workers, whether employees, contractors or sub -contractors, and document the dates that each worker is housed at the Small Facility. Such records shall be provided to the County or any additional third party upon request. Q. The Operator shall obtain a certification inspection conducted by a third -party Professional Engineer Licensed in the State of Colorado. The certification shall verify that at the time of inspection the identified Small Facility meets or exceeds the standards set forth in Article 7.808 D. 2. of the Garfield County Land Use Code of 2008, as amended. This certification shall be on forms provided by the Garfield County Planning Department. The certification shall be provided to the Garfield County Planning Department within 48 hours following occupation of the Small Facility. R. The Operator shall accurately complete all required forms provided by the Garfield County Planning Department identifying the location of the facility (Section/Township/Range, relevant Tax Parcel Number, and GPS coordinates or Latitude/Longitude coordinates); relevant zone district; maximum number of occupants; cumulative amount of time (in days) that the Small Facility will be at the specified location; identification of the State or Federal permitting agency overseeing reclamation, rehabilitation and revegetation of the Permitted Site and relevant permit number; date of installation; date of removal; name and contact information of the landowner; name and contact information of the Operator's Compliance Officer; 24-hour emergency contact information for the Operator; building information (make, manufacture year, serial number, size (square feet)); signature and contact information of the Operator's Compliance Officer. S. Wastewater Disposal: 1) Vault System: All vault systems shall be designed and installed to accommodate the maximum number of persons (eight or less individuals), who will inhabit the Small Facility. In addition, all vault systems shall be equipped with an overflow alarm device. Vault systems shall be designed to accommodate a minimum of 75 gallons of wastewater per person per day. If a vault system is proposed or has been approved, the Operator must: a. Demonstrate that year-round vehicular access is available and maintained for safe and regular access for sewage hauling vehicles. b. Maintain all sewage disposal records including but not limited to trip logs/reports and landfill receipts as public records, available to the County and/or any other interested third party upon request. c. (b) Individual Sewage Disposal System (ISDS): If an ISDS is proposed, then it shall be designed, installed and operated to accommodate the maximum number of persons who will inhabit the Small 7 Facility (eight or less individuals) and shall otherwise be permitted and operated in accordance with the Garfield County ISDS regulations as contained in BOCC Resolution Number 1994H-136. I hereby attest that I am the designated Compliance Officer for the aforementioned Small Temporary Employee Housing Facility(ies). I attest that I have read and understand the standards to which the Facility(ies) shall be installed and operated. I attest that the Facility(ies) will be constructed and maintained in accordance with all applicable Garfield County, State of Colorado and Federal regulations and standards. In addition, I attest that I have read and understand the enforcement provisions as described in Article 12 of the Garfield County Unified Land Use Resolution of 2008. Further, I understand that non-compliance with any of the provisions as outlined in Article 7-808 (D) (3) of the Garfield County Unified Land Use Resolution of 2008 shall be enforced in accordance with Article 12. Ao- „IF Signature of Operator's Compliance Officer: Print Name: Bryan S. Hotard Title: Attorney -In- Fact Phone Number: 970-285-9377 ext 2754 Email: Bryan.Hotard(c�williams.com Bob.Caughlin(c�williams.con7 1 hereby attest that I am a Licensed Professional Engineer in the State of Colorado. I attest that I have conducted a visual inspection of the Small Facility identified in this Administrative Checklist, as installed, and, based on information from that inspection I certify that the Small Facility complies with the standards set forth in Article 7-808 (D) (3) of the Unified Land Use Resolution of 2008. PE Certification Number PE Stamp See Summary Date of Inspection See Summary Print Name and Title: David Fox of Fox Engineering Solutions Signature See Form 8 yes Inspection Report for: Client: Location: Conducted By: Date Conducted: Paragraph Reference Fox Engineering Solutions LLC 670 Canyon Creek Drive, Grand Junction, CO 81507 Ph: (970) 250-5505 / Fax: (626) 784-0667 Email: coloradofox@bresnan.net SG 14-23 Small Temporary Employee Housing Williams Production RMT SW 1/4 SW 1/4 of Section 23, T7S, R96W, fith P.M. Garfield County David Fox, P.E. December 9, 2011 Garfield County Article 7-808(D)(3) Land Use Resolution 2008 Characteristic or Standard Description 3.a. Small Facilities, in the nature of Factory Built Nonresidential Structures [as defined under C.R.S. 24-32-3302(a)] but NOT recreational vehicles [as defined under C.R.S. 42-1-102 (61), including truck, truck tractor, motor home or camper trailer], may be utilized for housing of workers on projects related to commercial, industrial, mineral extraction or highway operations, pursuant to the standards for Small Facilities contained in subsection (2), below. Such facilities are not subject to Garfield County building and fire codes (building code, fire code). However, Small Facilities are subject to all pertinent state (i.e. electrical permits), federal permits and relevant fire protection district(s) code requirements. 3.a.(1) 3.a.(2) 3.a.(3) 1 The Small Facility and any associated infrastructure must be completely contained within a state or federally permitted parcel (such as a Colorado Oil and Gas Conservation Commission (COGCC) approved oil/gas well pad) in which reclamation and revegetation are secured with the permitting agency (Permitted Site); and, The Small Facility is located at the Permitted Site for less than a cumulative of one (1) year and at the end of the utilization period, all structures, foundations and associated infrastructure are completely removed: and. The Small Facility shall have an occupancy of eight (8) or fewer people who are employees, contractors or sub -contractors of the operator of the small facility and are needed for onsite safety of the related commercial, industrial, extraction or highway operation. Small Facility must comply with all applicable federal, state and local laws and regulations. 2 The Small Facility shall NOT contain recreational vehicles as defined in Section 7-808 (D), Page 1 of 5 Inspection Comments Colorado Division of Housing certifications noted on Company trailer, Unit ID. 354085940 with Certification No. 19710, manufactured by ATCO Structures USA Inc. on 7-17-2008; and Driller's trailer, Unit ID. 11-100810 with Certification No. 23591, manufactured by Ameritech Industries on 3- 18-2010. All other aspects not subject to visual inspection and certification by third party Professional Engineer. Not subject to visual inspection and certification by third party Professional Engineer. Not subject to visual inspection and certification by third party Professional Engineer. Not subject to visual inspection and certification by third party Professional Engineer. Not subject to visual inspection and certification by third party Professional Engineer. No recreational vehicles observed on site. SG 14-23 inspection Fox Engineering Solutions LLC Williams Production RMT December 9, 2011 3 In no case shall unsafe water be used for drinking nor shall raw sewage or contaminated water be discharged on the ground surface. The operator shall conduct monthly tests (or quarterly if an on-site disinfection system is installed) and maintain records of stored potable water samples specific for coli form bacteria. Any tests indicating coli form contamination must be disclosed to the Garfield County Board of Health or designee within 72 hours from the time the contaminated water was tested. 4 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. 5 At feast one thirty (30) gallon (4 cubic feet) wildlife -proof refuse container shall be provided for each Factory Built Non -Residential Structure unit. Said container(s) must be durable, washable, non- absorbent metal or plastic with tight -fitting lids. 6 Refuse shall be disposed of weekly, at a minimum. Operators must keep appropriate records, to be provided to the County or any interested third party upon request, to demonstrate that refuse is collected in a timely fashion and disposed of at a licensed facility. 7 Outdoor food storage is prohibited. 8 Factory Built Non -Residential Structures equipped by the manufacturer with a fire sprinkler system, fire detection system, and/or alarm system shall be inspected, tested, and maintained in accordance with the requirements of the relevant fire protection district(s) and the Colorado Division of Housing. 9 Single -station carbon monoxide alarms shall be placed in each Factory Built Non- Residential Structure. 10 One (1) or more approved fire extinguisher(s) of a type suitable for flammable liquids, combustible materials and electrical fires (Class ABC), or dry chemical, shall be located in each Factory Built Non - Residential Structure and placed in accordance with applicable fire protection district and/or Colorado Division of Housing codes. 11 Domestic animals are prohibited at all Small Facilities. Page 2 of 5 One potable water tanks of approximately 4000 gallons and one 4000 -gallon sewage holding tank onsite. AH tanks and piping located above ground. No on-site disinfection systems installed. Site appeared to be maintained in clean, safe and sanitary condition, free of weeds and refuse. One wildlife -proof trash recepacle with a capacity of approximately 20 cubic yards onsite. Individual refuse containers in each office housing structure. Not subject to visual inspection and certification by third party Professional Engineer. No outdoor food storage observed on-site. No active fire sprinkler systems observed in any of the factory built non-residential structures. Smoke detectors observed in all factory built non- residential structures. Colorado Division of Housing (CDH) compliance tags on all factory built non- residential structures stating compliance with nonresidental construction standards of the State of Colorado. Carbon monoxide detectors located in all factory built non-residential structures. Fire extinguishers, Class ABC, observed in all structures. No domestic animals observed on-site. SG 14-23 Inspection Fox Engineering Solutions LLC Williams Production RMT December 9, 2011 12 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 within each Permitted Site for a Small Facility. 13 The operator shall document all emergency situations requiring action by any government agency or fire protection district, in writing, and such documentation shall be presented to the Planning Department within 24 hours of the occurrence, 14 All required Access Permits shall be obtained from the Garfield County Road and Bridge Department or the Colorado Department of Transportation. 15 The Garfield County Sheriff's Office and relevant fire protection district(s) shall be notified and provided with all documentation as outlined in these regulations, within 48 hours following occupation of each Small Facility. In addition, the Garfield County Sheriff's Office and relevant fire protection district(s) shall be notified either by hard- copy or electronically within 48 hours following removal of all Small Facilities. The Planning Department shall be copied on all such notification, whether hard copy or electronic. 16 The Operator shall maintain records identifying workers, whether employees, contractors or sub -contractors, and document the dates that each worker is housed at the Small Facility. Such records shall be provided to the County or any additional third party upon request. 17 The Operator shall obtain a certification inspection conducted by a third -party Professional Engineer Licensed in the State of Colorado. The certification shall verify that at the time of inspection the identified Small Facility meets or exceeds the standards set forth in Article 7.808 D. 2, of the Garfield County Land Use Code of 2008, as amended. This certification shall be on forms provided by the Garfield County Planning Department. The certification shall be provided to the Garfield County Planning Department within 48 hours following occupation of the Small Facility. Page 3 of 5 One potable aboveground water tank of approximately 4000 gallons capacity on-site. Potable water demand is estimated to be 300 gallons/day gallons (4 individuals x 75 gpcd). Required fire suppression demand is 2500 gallons. Total potable and fire suppression volume required is estimated to be 4000 gallons. Water supply appears adequate with 4000 gallons of storage with refills scheduled at 5 -day intervals. Dry hydrant observed on water tank. Not subject to visual inspection and certification by third party Professional Engineer. Not subject to visual inspection and certification by third party Professional Engineer. Not subject to visual inspection and certification by third party Professional Engineer. Not subject to visual inspection and certification by third party Professional Engineer. This inspection was conducted by a third -party Professional Engineer licensed in Colorado and certifies compliance only with applicable standards set forth in Article 7.808 D. 3. of the Garfield County Land Use Code of 2008, as amended, that are subject to visual inspection. SG 14-23 Inspection Fox Engineering Solutions LLC Williams Production RMT December 9, 2011 18 The Operator shall accurately complete all required forms provided by the Garfield County Planning Department identifying he location of the facility (Section/Township/Range, relevant Tax Parcel Number, and GPS coordinates or Latitude/Longitude coordinates); relevant zone district; maximum number of occupants; cumulative amount of time (in days) that the Small facility will be at the specified location; identification of the State or Federal permitting agency overseeing reclamation, rehabilitation and revegetation of the Permitted Site and relevant permit number; date of installation; date of removal; name and contact information of the landowner; name and contact information of the Operator's Compliance Officer; 29 -hour emergency contact information for the Operator; building information (make, manufacture year, serial number, size (square feet)); signature and contact information of the Operator's Compliance Officer. 19(a) Vault System: All vault systems shall be designed and installed to accommodate the maximum number of persons (eight or less individuals), who will inhabit the Small Facility. in addition, all vault systems shall be equipped with an overflow alarm device. Vault systems shall be designed to accommodate a minimum of 75 gallons of wastewater per person per day. If a vault system is proposed or has been approved, the Operator must: 19(a}(1) Demonstrate that year-round vehicular access is available and maintained for safe and regular access for sewage hauling vehicles. 19(a)(2) 19(b) Maintain all sewage disposal records including but not limited to trip logs/reports and landfill receipts as public records, available to the County and/or any other interested third party upon request. Individual Sewage Disposal System (ISDS): If an ISDS is Facility (eight or less individuals) and shall otherwise be permitted and operated in accordance with the Garfield County ISDS regulations as contained in BOCC Resolution Number 1994H-136. proposed, then it shall be designed, installed and operated to accommodate the maximum number of persons who will inhabit the Small Facility (eight or less individuals) and shall otherwise be permitted and operated in accordance with the Garfield County ISDS regulations as contained in BOCC Resolution Number 1994H-135. Page 4 of 5 Not subject to visual inspection and certification by third party Professional Engineer. One aboveground sewage holding tank with 4000 - gallon capacity on-site. Sewage flows estimated to be 300 gallons/day (4 individuals x 75 gpcd). Sewage holding tanks need to be emptied approximately every 13.3 days (4000 gallons / 300 gallons per day). Wastewater vault equipped with overflow alarm device. Not subject to visual inspection and certification by third party Professional Engineer. Not subject to visual inspection and certification by third party Professional Engineer. Not subject to visual inspection and certification by third party Professional Engineer. SG 14-23 Inspection Fox Engineering Solutions LLC Williams Production RMT December 9, 2011 1 hereby attest that l am a Licensed Professional Engineer in the State of Colorado. 1 attest that 1 have conducted a visual inspection of the Small Facility identified in this Administrative Checklist, as installed, and, based on information from that inspection 1 certify that the Small Facility complies with the standards, subject to and limited to visual inspections items as identified above; set forth in Article 7-808 (D) (3) of the Unified Land Use Resolution of 2008, for Garfield County, Colorado. PE Certification Number: Date of Inspection: Print Name and Title: Signature: No. 25420 (Colorado December 9, 2011 id J. Fox, Prin al Engineer Page 5 of 5 PE Stamp Williams Production RMT SG 14-23 Well Pad ~KS SCALE TY'SET rM71.20 eFEET ACCESS DEIC4ISTIOHI ,R0A1 T•IE wTFNSECION Or 1ST STREET AHO COV., now 215 AT',whewTE spesss0 M A SOJn Mr13TE3Lv INSECT -CPI THROUGH THE TOWS Of PARAPIUIE ALO1401ST WREST WITCH TRMaMOHsncTO 579'3 HxaWr9"9 & 2'. e)a SP -ES :O&YINTERSEOr1OS 0110* DISTSWWELRMAI,PROCEEDRx;R1 .1 AAORn1E,,Cr OHEC710H RROD+O 1O TRE SC1-200rrRI. 740 LOCAIWR. IS 97 ! A2REOH. MT* PLu Pr1uFY.Y a.m•,vrk� Construction Plan Prepared for: Wr7Rair s. Williams Produclion, RMT SG 1,-23 m,IJPO - Phu. S ACCESS ROAD MAP Directions to Site: /' )1S, A.SS S- r,;,._ 7� J j�o.wla.o EMI LP.r DIVIIMISTO C 30 ft. � J • re■ 3 O 1 zra 1 CCC = Approximate Drill Rig & Equipment Area Mow ray LILY, Naas SPS. ; srm owery T,wrs Okik14a e+se ar DAMP, Law 1 J_ / r4„dry _ r N. I~ I i' S./.1 P.m_uw - mo Conabractren Plan Prepared f or: MRP aft �Williams Production, RMT R[N}ffi2.L:,1/ri ltwt ••srr SC 1,.2.7 O MPod- Piet -r DAV. RIG L1 F2TL7 merae'icy Contact List: Main Case: 970-2554377 answered 24 Hours Bob Coughlin- Williams Drilling 970-599-0573 Cell Scott Brady- Williems Drilling Sup -970-270.8187 Cell Kevin McDermott- Williams Safety -970.309-1195 Cell Mark Mumby - Spill Cennactor 970-260-1576 Cel IdentFficetlon 8 Location Key' 1. Wastewater Aboveground Tank (4000 1 Potable Water Aboveground Tank 0000 gal) 3. Three Portable Toilets 4. Wildlife -proof dumpster 5. Company Man OffloelHousing 6. oniters OfficMooring 7. Sheds ' Subject 10 relo*anOn for ronswctron activities Williamsa Notes; The well pad site is located In the SW 1/4 SW 1/4 of Section 23 T7S. RS6W, 6th P.M. (NADB3 N39.4161° W108.0E1631 The site will temporarily once and house up to a maximum of four individuals during natural gas drilling activitles 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. One aboveground sewage holding tank with 4000 -gallon capacity on-site. Sewage Bows estimated to be 300 gallons/day (4 individuals x 75 gpcd). Sewage holding tank needs to be emptied approximately every 13.3 days (4000 gallons 1300 gallons per day). Wastewater vault equipped with overflow alarm device. Williams utilizes the services of a licensed contractor to remove and haul the wastewater to a State certified treatment/disposal facility. One potable aboveground water tank of approximately 4000 gallons capacity on-site. Potable water demand is estimated to be300 gallons/day (4 individuats x 75 gpcd). Required minimum fire suppression demand Is 2500 gallons. Total potable and fire suppression volume required is estimated to be 4000 gallons. Water supply appears adequate with 4000 gallons of storage with refills scheduled at 5 day intervals. Dry hydrants observed on water tank. Road access to the site is maintained year-round through the services of private road maintenance and construction contractors. Base mapping by Del -Mont Consutants,inc. Site features including housing trailers, water and wastewater tanks, portable toilets and dumpster surveyed with Trimble Geo -XT GPS equipment. Please nate that this is a construction site and that the locations of drill equipment and other Items are subject to change. Factory -Built Nonresidential Structures (Office/Housing) have a minimum separation distance of 30 ft. SG 14-23 Site Plan Garfield County, Colorado Small Temporary Employee Housing and Septic Permit Application Applicant: Williams Production RMT Dale: December 9. 2011 Checked: 0.1F Version: 001 Fox Engineering Solutions LLC 670 Canyon Creek Drive, Grand Junction, CO 51507 Ph: (970)250.5505 Fax: (626) 784.0867 Envil: coloradofoxabresnan.net GARFIELD COUNTY BUILDING AND PLANNING DEPARTMENT FEE SCHEDULE Garfield County, pursuant to Board of County Commissioners ("Board") Resolution No. 98-09, has established a fee structure ("Base Fee") for the processing of each type of subdivision and land use applications. The Base Fee is an estimate of the average number of hours of staff time devoted to an application, multiplied by an hourly rate for the personnel involved. The Board recognized that the subdivision and land use application processing time will vary and that an applicant should pay for the total cost of the review which may require additional billing. Hourly rates based on the hourly salary, and fringe benefits costs of the respective positions combined with an hourly overhead cost for the office will be used to establish the actual cost of County staff time devoted to the review of a particular project. Actual staff time spent will be charged against the Base Fee. After the Base Fee has been expended, the applicant will be billed based on actual staff hours accrued. Any billing shall be paid in full prior to final consideration of any land use permit, zoning amendment or subdivision plan. If an applicant has previously failed to pay application fees as required, no new or additional applications will be accepted for processing until the outstanding fees are paid. Checks, including the appropriate Base Fee set forth below, must be submitted with each land use application, and made payable to the Garfield County Treasurer. Applications will not be accepted without the required application fee. Base Fees are non-refundable in full, unless a written request for withdraw from the applicant is submitted prior the initial review of the application materials. Applications must include a Payment Agreement Form ("Agreement") set forth below. The Agreement establishes the applicant as being responsible for payment of all costs associated with processing the application. The Agreement must be signed by the party responsible for payment and submitted with the application in order for it to be accepted. The following Base Fees shall be received by the County at the time of submittal of any procedural application to which such fees relate. Such Base Fees shall be in addition to and exclusive of any cost for publication or cost of consulting service determined necessary by the Board for the consideration of any application or additional County staff time or expense not covered by the Base Fee, which have not otherwise been paid by the applicant to the County prior to final action upon the application tendered to the County. GARFIELD COUNTY BUILDING AND PLANNING DEPARTMENT BASE FEES TYPE OF LAND USE ACTION Vacating Public Roads & Rights -of -Way Sketch Pian Preliminary Plan / Conservation Subdivision Preliminary Plan Amendment Final Plat Final Plat Amendment / Correction Plat Combined Preliminary Pian and Final Plat Minor Exemption / Amendment Major Exemption / Amendment BASE FEE $400 $325 $675 + application agency review fees and outside consultant review fees, as authorized pursuant to the Regulations, such as the Colorado Geologic Survey $325 $200 $100 $1,075 $300/$300 $400 / $300 Rural Land Development Option Exemption / Amendment $400 / $300 $250 $400 $400/$300 $50 $250 $400 / $300 $525 / $400 $300 $450 $500 / $300 $450 $250 $250 NO FEE General Administrative Permit Floodplain Development Permit Pipeline Development Plan / Amendment Small Temporary Employee Housing Minor Temporary Employee Housing Limited Impact Review / Amendment Major Impact Review / Amendment Rezoning: Text Amendment Rezoning: Zone District Amendment Planned Unit Development (PUD) / Amendment Comprehensive Plan Amendment Variance Interpretation Takings Determination Planning Staff Hourly Rate • Planning Director • Senior Planner • Planning Technician • Secretary $50.50 $40.50 $33.75 $30.00 County Surveyor Review Fee (includes review of Amended Determined by Surveyor$ Plats, Final Plats, Exemption Plats) $ 1 1 — Mylar Recording Fee st $10 each additional page Page 2 The following guidelines shall be used for the administration of the fee structure set forth above: 1. All applications shall be submitted with a signed Agreement for Payment form set forth below. 2. County staff shall keep accurate record of actual time required for the processing of each land use application, zoning amendment, or subdivision application. Any additional billing will occur commensurate with the additional costs incurred by the County as a result of having to take more time that that covered by the base fee. 3. Any billings shall be paid prior to final consideration of any land use permit, zoning amendment, or subdivision plan. All additional costs shall be paid to the execution of the written resolution confirming action on the application. 4. Final Plats, Amended or Corrected Plats, Exemption Plats or Permits will not be recorded or issued until all fees have been paid. 5. In the event that the Board determines that special expertise is needed to assist them in the review of a land use permit, zoning amendment, or subdivision application, such costs will be borne by the applicant and paid prior to the final consideration of the application. All additional costs shall be paid prior to the execution of the written resolution confirming action on the application. 6. If an application involves multiple reviews, the Applicant shall be charged the highest Base Fee listed above. 7. Types of "Procedures" not listed in the above chart will be charged at an hourly rate based on the pertinent planning staff rate listed above. 8. The Planning Director shall establish appropriate guidelines for the collection of Additional Billings as required. Page 3 GARFIELD COUNTY BUILDING AND PLANNING DEPARTMENT PAYMENT AGREEMENT FORM (Shall be submitted with application) GARFIELD COUNTY (hereinafter COUNTY) and Strait Bottom Ranch LLLP Property Owner (hereinafter OWNER) agree as follows: 1. OWNER has submitted to COUNTY an application for SG 14-23 pad location STEH &ISDS (hereinafter, THE PROJECT). 2. OWNER understands and agrees that Garfield County Resolution No. 98-09, as amended, establishes a fee schedule for each type of subdivision or land use review applications, and the guidelines for the administration of the fee structure. 3. OWNER and COUNTY agree that because of the size, nature or scope of the proposed project, it is not possible at this time to ascertain the full extent of the costs involved in processing the application. OWNER agrees to make payment of the Base Fee, established for the PROJECT, and to thereafter permit additional costs to be billed to OWNER. OWNER agrees to make additional payments upon notification by the COUNTY when they are necessary as costs are incurred. 4. The Base Fee shall be in addition to and exclusive of any cost for publication or cost of consulting service determined necessary by the Board of County Commissioners for the consideration of an application or additional COUNTY staff time or expense not covered by the Base Fee. If actual recorded costs exceed the initial Base Fee, OWNER shall pay additional billings to COUNTY to reimburse the COUNTY for the processing of the PROJECT mentioned above. OWNER acknowledges that all billing shall be paid prior to the final consideration by the COUNTY of any land use permit, zoning amendment, or subdivision plan. PROPERTY OWNER (OR A ,'LRIZED REPRESENTATIVE) Bryan S. Hotard Print Name Mailing Address: Date Williams Production RMT Company LLC PO Box 370, Parachute, CO 81635 Page 4 Bonuales, Gia From: Bonuales, Gia Sent: Friday, December 09, 2011 3:00 PM To: 'jsears@garcosheriff.com', 'Julie Taylor'; 'Vola Mercer' Cc: Reed, Gary Subject: SG14-23 Rig Move On notification Attachments: SG 14-23 Sheriff Letter & Map dated 12-9-11.pdf I am notifying you on the attached pad location 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 27- T7S-R96W. Attached please find a map with directions to the pad, a pad lay out and emergency contact information. Should you have any questions please let me know. (11n :1 01)(IMWA Land Data Technician 1 Williams Production RMT Company LLC 1058 County Road 215/P0 Box 370 Parachute, Co 81635 970.263.2746 -Office 970.216.8537 -Cell 970.285 -2047 -Fax gia.bonuales@williams.com 1 December 9th, 2011 Garfield County Sheriffs Office Emergency Operations Attn: Jim Sears 108 8th Street Glenwood Springs, CO 81601 Ph: 970-945-0453 RE: Emergency Response Notification SG 14-23 pad Dear Jim: Williams. Williams Production RMT Company LLC 1058 CR 4215 BO. Box 370 1'arachure, CO 81635-0370 970/285-9377 970/285-9573 Fax This letter is to inform the Garfield County Sheriff's Department that Williams Production RMT Company LLC will soon commence drilling operations on the above mentioned drilling location. Williams will provide rig site housing accommodations for the duration of the drilling operation approximately 60 days. In accordance with Garfield County Planning and Zoning Regulations, the attached documentation provides emergency response information and driving directions for the Williams SG 14-23 pad. Should you have any further questions or concerns regarding this notification, feel free to contact me at (970)263-2746. Sincerely, Gia Bonuales Land Data Technician I gb Williams Production RMT SG 14-23 Well Pad Swivel Al 775, A!N N' CRAP!ACSG,1EW FFFT I loNn1 •n:Oreer A04:ES OESORIPnONW FRO5 THE iNTERSECTIO5 0r lar STREET ANO COu NTT Reno 2t5 AT P,wAGIVTE, PR000LO INA SCAM rwea0ERLT DIRECTION-TR/Mollie THE TOWN OF PARACHLITE nLONO 1ST ol'REET WRICN TRNN5moN91NTO 210Te N16HwAT e a n. 23.5 MILES TO r l INTERSECTION PATH A DIRTlWnt1 ROAD, PROCEE05IG41 IN A NeRTmERLT CIRECTION AROLMO TO INE SG 1400 ORILL PAO LOCAn0H. AS SKARN HEREON. SON, _LICILID_ pyre Construction Plan Prcpercd for: ,tv it s WJGams Pmduction, RMT PLAT !1 r.t..n.-r OFT SC 1,23 CPC/ Pod- Pk, 7 ACCESS ROADMAP Directions to Site: 23 r. E.. * 4 ary Ea lyre / AtEkNisesese 778 a= ■a■ f c _Uo 130ft, Approximate Drill Rig & 21 i Equipment Area Aldo PAPA Oita Pima s Orem • +0x21.12 (.N0 ry1 i�r 1 0\ `Mm�v rims n �.?rir, Construetioa Ptd. Prepared for: tvNkair Williams Production, RMT SC 7,2,7 Dprl Pad- Plaid err DRILL RIC LAYOUT Emeraencv Contact List - Main Office: 970-265-0377 answered 24 1-lo1xs Bob Caughiin• Williams Chilling 970.589-0973 Cell Scott Brady- Williams Orlhirg SUP070-270-8187 Cell Kevin McDermott. Williams Salary -970-309-1195 Cell Mark Mumby - Spill Conbeclor 970-2W-1570 Cell Identification & Location Nee' 1 wastewater Aboveground Tank 11000 gal.) e. Potable Water Aboveground Tank (4000 gal) 3. Three Portable Toilets 4. Wildlife -proof dumpster 5. Company Man OffrcelHousing 6. Dnners Ofrrc 41n05rg 7. Sheds " 5ublect to relocation for construction activities. Notes: The well pad site es located in the SW 174 SW 174 of Section 23 T7S, RS6W, 61h P.M. (NADB3 N39.4101° W100.0863°) The site will temporarily office and house up tea maximum of four indlvlduals during natural gas drilling activities and Is expected 10 be completed In one year or less. The individuals will occupy two individual trailer offices/houses located an the well pad. Office/houses have Colorado Division of Housing compliance lags. One aboveground sewage holding tank with 4000 -gallon capacity on-site. Sewage flows estimated to be 300 gallons/day (4 individuals x 75 gpcd). Sewage holding lank needs to be emptied approximately every 13.3 days (4000 gallons / 300 gallons per day). Wastewater vault equipped with overflow alarm device. Williams utilizes the services of a licensed contractor to remove and haul the wastewater to a State certified treatment/disposal facility. One potable aboveground water tank of approximately 4000 gallons capacity on-site. Potable water demand Is estimated to be300 gallons/day (4 indlviduais x 75 gpcd). Required minimum fire suppression demand is 2500 gallons. Total potable and fire suppression volume required is estimated to be 4000 gallons. Water supply appears adequate with 4000 gallons of storage with refills scheduled at 5 day intervals. Dry hydrants observed on water tank. Read access to the site is maintained year-round through the services of private road maintenance and CMStruction COMM Base mapping by Del -Mont Consulanrs.Inc. Site features including housing traders, water and wastewater tanks. portable toilets and dumpster surveyed with Trimble Geo -XT GPS equipment. Please note that this is a construction site and that the locations of drill equipment and other items are subject to Change. Factory -Built Nonresidential Struclures (Office/Housing) have a minimum separation distance of 30 ft. SG 14-23 Site Plan Garfield County, Colorado Small Temporary Employee Housing and Septic Permit Application Applicant: Williams Production RMT Cate- December 9. 2411 Checked: 0.1E Fox Engineering Solutions LLC 670 Canyon Creek Drive. Grand Jungian. CO 81507 Ph: (970)250-55051 Farr (628) 784-0607 Bove zoloradolosabresnan.Tet Version . 001 Bonuales, Gia From: Bonuales, Gia Sent: Friday, December 09, 2011 2:59 PM To: 'Rob Ferguson'; 'Julie Taylor', 'Vola Mercer' Cc: Reed, Gary Subject: SG 14-23 Rig Move On notification Attachments: SG 14-23 GVFPD Letter & Map dated 12-9-11.pdf I am notifying you on the attached pad location we will be commencing drilling operations in the next few clays and these operations will continue for approximately 60 clays. At which time l will notify you of the removal of the Employee housing. This notification is per the GARCO Regulations for our pad located in Sec 27- T7S-R96W. Attached please find a map with directions to the pad, a pad lay out and emergency contact information. Should you have any questions please let me know. (Trim tinntInk! Land Data Technician I Williams Production RMT Company LLC 1058 County Road 215/PO Box 370 Parachute, Co 81635 970.263.2746-0ffice 970.216.8537 -Cell 970.285 -2047 -Fax gia.bonuales()williams.com 1 Williams. Williams Production RMT Company LLC 1058 CR #215 P.O. Box 370 Parachute, CO 81635-0370 970!285-9377 970/285-9573 fax December 9th, 2011 Grand Valley Fire Protection District Emergency Operations Attn: Rob Ferguson 1777 S. Battlement Parkway Parachute, CO 81635 Ph: 970-285-9119 RE: Emergency Response Notification SG 14-23 pad Dear Rob: This letter is to inform the Grand Valley Fire Protection District that Williams Production RMT Company LLC will soon commence drilling operations on the above mentioned drilling location. Williams will provide rig site housing accommodations for the duration of the drilling operation approximately 60 days. In accordance with Garfield County Planning and Zoning Regulations, the attached documentation provides emergency response information and driving directions for the Williams SG 14-23 pad. Should you have any further questions or concerns regarding this notification, feel free to contact me at (970)263-2746. Sincerely, Gia Bonuales Land Date Technician 1 gb Williams Production RMT SG 14-23 Well Pad -,1 1: TS -x mW Mac 21100 CRAPMC SCALE NFEET ll-at1Tf1fi FCLES50 INLmP8CN' aOar Trr HR EVIC. Or iST S=MET ILI?011161,1Orr3 aTv°papTTErwcMsI, INa 50nlwczrEr, o0j Mn.SN THROW. THETQ0N 13 rnw5TluTE µo1,4?1sT STPFET WPM,. TRw5mON5 INTO 5158E°0ON00121i Is. �x30,l TO NI INTERACriow MMINSp0TWCWRFOI. .vN procNl IN a r.orrmen,. owed -now amnlpn lO 1,1E SC :T-21CML PAO LOCATION, PS SNOwN rEAEba, BOOKWFF SP, (V). /NC Construction Plan Prepared for: _Wi5( is Wlfians Production, RMT ! erS 21.26(.11-1P," FIAT raarrx7, rvanom 2Pmr ort. SU 14.23 p,r'Il Pod - 21 ' 5 ACCESS ROAD MAP Directions to Site: T. r S..re s0rt. 5ivl 1 a'Chi9t.Na n.1, Ewsr so=re Rm. CM1p rrmrr • 4167sr7 114091 Cy Approximate 13611 Rig & Equipment Area 1 \ J ' _ rrw.awe x1.17'sJn: 3,71/ a 1 Conztruetiot. Plan Prepared for: srxu.--ir Ni7paifr/ Williams Production, RMT perm 2,tti 11 j' rrrur All, ° SO 14.27 Dart Pad . Plot nc-r n� DR/LL RIG LA YOUT / IIOOKWFF .4riri .lirnirel, fur. in, TO Emergency Contact List. Main Office: 070-265-B377 answered 24 Hours Sob Ca6ghlin- Williams Onllirg 970-5W-0673 Cell Sone Brady- Williams Dnl5rg 064-010.270-0167 Cell Kevin MODermon- Wdllams Salety-670-3091105 Cell Mark Mumby- Spill Contractor 070.260-1574 Cell Identiecntion d Locetlon Kar' 1 Wastewater Aboveground Tank i 4000 g31.j 2. Potable Water Aboveground Tank (4000 gal) 3. Three Portable Toilets 4. Wildlife -proof domed er 5. Company Man Offix1Hnusirg 6. Drillers Off eohlausing 7. Sheds - Subten to ,81000ter, for carutruction activities, Notes: The well pad site is located in the SW 1/4 SW 1/4 of Section 23 T7S, R9SW, 6th P.M. (NAD63 N39.4181* W106.0863°) The site will temporarily office and house up to a maximum of four Individuals 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 lags. One aboveground sewage holding tank with 4000 -gallon capacity on-site. Sewage Flows estimated to be 300 gallons/day (4 individuals x 75 gpcd). Sewage holding tank needs to be emptied approximately every 13.3 days (4000 gallons 1 300 gallons per day). Wastewater vault equipped with overflow alarm device. Williams utilizes the services of a licensed contractor to remove and haul the wastewater to a State certified treatment/disposal facility. One potable aboveground water tank of approximately 4000 gallons capacity on-site. Potable water demand Is estimated to be300 gallonslday (4 individuals x 75 gpod). Required minimum fire suppression demand is 2500 gallons. Total potable and fire suppression volume required is estimated to be 4000 gallons. Water supply appears adequate with 4000 gallons of storage with refills scheduled at 5 day intervals. Dry hydrants observed on water tank. Road access to the site is maintained year-round through the services of p112516 road maintenance and constrycbon contractors. Base mapping by Del -Mont Consutants.lnc, Site features including housing trailers, water and wastewater tanks. portable toilets and dumpster surveyed with Trimble Geo -XT GPS equipment, Please note that this Is a construction site and that the locations of drill equipment and other items are subject to change. Factory -Built Nonresidential Structures (Office/Housing) have a minimum separation distance of 30 ft. SG 14-23 Site Plan Garfield County, Colorado Small Temporary Employee Housing and Septic Permit Application Applicant: Williams Production RMT Osle. December 0, 2011 Checked: 0-F version. 001 Fox Engineering Solutions LLC 670 Canyon Greek Onve, Grand Jundian, CO 81507 70:(970) 250.55051 Fax. (026) 794-0667 F,rranl_ eeloradofaxabresnan.net Section 23 T. 7 S, R 96 W 5064 Exist. Limit of Disturbance 0 411 Sectt on 2 -----S-ection 2 Daylight Line off 50' 0/S Thy Ss p- Sf00AP/eq da as 90' ~ N##1 F 1.5' /' 105' NW #8'` Edge of Exist. Pad rl Exist. Pad El. .= 5070.1 NAz. 197.04° C 2.4' F 3.9' ' ly h 41, Jii #5 150' 150' {Proposed SG 344-22 • Proposed SG 444-22 *Proposed SG 44-22 -11-Proposed SG 544-22 )4"76 T I .1ISt 5G 14.23 w II bE.cIsl. SG 514-23 G 0.0' ,�- Isl. SG 314-23 -2i.ExIsL SG 414-23 cC▪ 1' 75' Move Prod. j Equip Area SE #4 — P+�, 50'x20' 035 151 :90' C 0.9' ! 3D 0 60 GRAPHIC SCALE IN FEET 1LNCR= 50 FEET C 0 U1 H Exist. Above Ground Utility AAI Proposed Cuttings Trench 40'x60x12 (1400 cy) I/— Daylight Line NE q.#2 90' I1 C3.5' \\ X X • V 0 o 3B' F 6.7' Ex)syn9 Road ESTIMATED EARTHWORK QUANTITIES (cy) ITEM CUT FILL TOPSOIL EXCESS PAD 2554 1862 600 92 PIT 400 400 TOTALS 2954 1862 600 492 ~500/ --RE NT. 'NATE: — — 1.) TOPSOIL VOLUME BASED ON 12" SOIL DEPTH. 1 2 ) TOTAL DISTURBED AREA = 3.79 ac, REVISED.' 3/21/1I 0y BB" ✓ f r Exist. Limit of Disturbance CC lib ru.e 212.d N•1,1 Rif, CNa.°Ja MSM N. WO) 1175 411" P. faro, b+s.a`�` ,gend BOOKCLIFF Sury Services, Inc. SCALE: 1 " = 60' DATE: 2/28/11 PLAT: 2 of 7 PROJECT. WilliPons V,zlleu DFT cols Construction Plan Prepared for: Wilitams Williams Production, RMT SG 14-23 Drill Pad - Plat 2 CONSTRUCTION LAYOUT ACCESS DESCRIPTION: FROM THE INTERSECTION OF 1ST STREET AND COUNTY ROAD 215 AT PARACHUTE, PROCEED IN A SOUTHWESTERLY DIRECTION THROUGH THE TOWN OF PARACHUTE ALONG 1ST STREET WHICH TRANSITIONS INTO STATE HIGHWAY 6 & 24, ±3.8 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD, PROCEED RIGHT IN A NORTHERLY DIRECTION AROUND TO THE SG 14-23 DRILL PAD LOCATION, AS SHOWN HEREON. eke E ., 71..e fano rqw, C,iT,d, gJ& rn FW:gr.rno f r.,bi 6252771 Survey Services, Inc. SCALE: 7" = 2000' DATE: 2/28/ 11 PLAT` 5 of Construction Plan Prepared for: Williams Williams Production, RMT PROJECT` Williams Vallee DFT: mos SG 14-23 Drill Pad - Plat 5 ACCESS ROAD MAP 1I1111I IIIA II11111I111In111111 IIIIlll1111111111111111 686x45 et/e3/2P1e5 E7:45 B1t652 P21l6 h ill sII6ftF 1 of 1 R s. Be D B. Re GRRF!ELD cOUNTY co STATEMENT OF AUTHORITY NAME OF ENTITY: The name of the entity lo which this Statement relates Is Strait Bottom LLLP. TYPE OF ENTITY: The entity is a Limited liability Limited Partnership formed under the laws of the State of Colorado, MAILING ADDRESS: The mailing address for the entity is P. Q. Box 26, Woody Creek, Colorado 81656. AUTHORIZED PERSON.: The name and position of the person authorized to execute instruments conveying, encumbering or otherwise affecting title to real property on behalf of the entity are as follows: Wog Mary Anne Basely LIMITATIONS: None. Dated this 30th day of December, 2004. STATE OF COLORADO ) ) se. COUNTY OF GARFIELD ) The foregoing instrument was subscribed, sworn to and acknowledged before me this 30th day of December, 2004, by MaryAnne Bosely as General Partneraf Strait Bottom LLLP, Position General Partner sely, WITNESS my hand and official seal. My Commission expires: October 31, 2007 Notary Public ,W ®1 M140exv1M1 rui,'n,e 101 d,SieNA, 10004 3 0fl' 1"rrlr Pt= Niu Si„ est, 110, 01a1wo,lf, i me Ml,e, LC, NI., I September 214, 2011 Mr. Fred Jarraart, Director Garfield County Building and Planning Department 108 8th Street, 4th Floor Glenwood Springs, CO 81601 RE: SG 41-27, SG 14-23, SG 23-23, GV 18-23, SG 32-23 Drilling Pad Locations„ Garfield County, Colorado Dear Mr. Jarman: This letter authorizes Williams Production RMI Company LLC to represent me in the submittal and processing of the required Garfield County Small Temporary Employee /lousing (STEN) and Individual Sewage Disposal System (ISDS) permits on the above drilling pad locations, Sincerely, abf-v e?-s5c\o„. 1) -c -A , Li) Strait Bottom Rant By: Title: 6d 1110 Irs, Fniirei,RWAN1 �:;` � ,WAR h1111 �11P214k: 805429 1d Utr2&.2a P) Joon atEb®rino 1 a! 2 Roa fey %le a© Doc. F..:p i® CANFIELD COUNTY CO LIMJTED POWER OF ATTORNEY WILLIAMS PRODUCTION RMT COMPANY LLC ("Company") a Delaware limited liability company, having its principal place of business in the City of Tulsa, County of Tulsa, State of Oklabozrla, does hereby make, constitute and appoint Bryan S. Retard with the full authority hereinafter provided, the true and lawful Attorney -in -Pact 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 socept all instruments and documents affecting the real property or real estate rights of the Company including but not limited to, the following described instzvrneats and doetuncnts: 1. Applications and documentation associated with Garfield County or Rio Blanco permitting requirements, including, but not limited to, Independent Sewage Disposal Systems, Small Temporary Employee Rousing, Major Impact Reviews, Limited Impact Reviews, Oil and Gas well permitting, Driveway Access, County Road Maintenance, Temporary Living Quattera, 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 iustrurnents 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. Agreemauts allowing encroachments onto easements and rights of way owned by Company and iandnanier instruments and conveyances on others casements; 6, Agreemcats subordinating easement or lease to mortgage rights; 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 praroperty for residential 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 docnrrtents. The Company 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 sante bad been given, made and done by the Company 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. is ri rimirchnomr, it 111 R.cptii• 105422 m7fiBl2iaii 134;2B•2B PM lora PIb rlcw 2 Ci 2 Svc Fe.:i'if.NA Doc Fac,B.Bis CRSFISLO DOOM CO IN WITNESS WHEREOF, the Company has caused this Limited Power of Attorney to be signed by one of its Vice Presidents, duly authorized by its Management Committee to grant powers of attorney this, if -day of July, 2011. ACKNOWLEII GMENT STATE OF OKLAHOMA ) ' )ss. COUNTY OF TULSA ) BEFORE ME, the undersigned authority, a Notary Public in aad for said County and State, on this day persrmalty appealed, Jerry D. Barnes persoaally known to me to be the Vice President of WILLIAMS PRODUCTION RMT COMPANY 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 11 day of July, 2011. My Commission Expires; 2- 23 - 2 C14.- .4121 1Lf \MLLIAMS PRODUCTION CO RMT LLC ATTN: LAND DEPT. P.O. BOX 370 PARACHUTE, CO 81635 :h. ! 2 Garfield County Assessor Data Site Jim Yellico, 109 8th Street, Suite 207 (P) 970.945.9134 1(F) 970.945.3953 (E) jyellico@garfield-county.com Account Information Account: R260296 Parcel: 240923200096 Owner Name: STRAIT BOTTOM RANCH LLLP Owner Address: PO BOX 26, WOODY CREEK, CO, 81656 Property Address: , PARACHUTE Legal: Section: 23 Township: 7 Range: 96 SEC 14 SWSE (35.5A) LYING NWLY OF 1-70 SEC 23 ALL THOSE PORTIONS OF LOT 2 NENW, S1/2NW & NWSW CONT. 95A LYING NWLY OF 1-70 Tax Area: SEPT 12.66 AC. FOR 1-70 ROW Subdivision: Sales Information Date Deed Type Doc Number Grantor 11/13/1996 WD 12/29/1994 OCD Taxable Values History Grantee Amount 370,000 62,100 Year Land Actual 2011 780 2010 780 2009 780 Property Details Imp Actual Total Actual Land Assessed 780 230 780 230 780 230 Imp Assessed Total Assessed 230 230 230 Model Attribute Name Attribute Value LAND 0 ABSTRACT CODE GRAZING LAND -AGRICULTURAL AREA ACRES 117.84 AREA_SQFT 0 NEIGHBORHOOD UNA BRIDGE AREA - AG PARCELS AG Created on 12/12/2011 at 03:15 PM (MST) The data represented here is for informational purposes only. Research shou€d be performed at the appropriate office. This is not deemed a legal document. Project Address Garfield County Building & Planning Department 108 81h Street Suite 401 Glenwood Springs, CO 81601 - Phone: (970)945-8212 Fax: (970)384-3470 SG 14-23 PARACHUTE, CO Parcel No. rigillk Permit NO. SEPT -9-11-2228 240923200096 Owner Information Address STRAIT BOTTOM RANCH LLLP CO • An a • Subdivision Issue Date: 9/28/2011 Permit Type: Septic Permit Work Classification: New Permit Status: Active Expires: 09/2712012 Section Township Range Phone Cell PO BOX 26 Woody Creek CO 81656- Contractor(s) Phone Primary Contractor Williams Production RMT (970)285-9377 Yes Proposed Construction / Details temporary employee housing for well pad SG 14-23 FEES DUE Fee Septic Fee - New Total: Amount $73.00 $73.00 Valuation: Total Sq Feet: $ 0.00 FEES PAID 0 Inv Total Paytype Amt Paid Amt Due Inv # SEPT -9-11-21428 $ 73.00 Check # 30572378 $73.00 $ 0.00 Required Inspections: For Inspections can : 1(888)868-5306 Inspection IVR See Permit Record Building Department Copy Wednesday, September 28, 2011 2 GARFIELD COUNTY SEPTIC PERMIT APPLICATION 1088"'Street, Suite401, Glenwood Springs, CO 81601 Phone: 970-945-8212 / Fax: 970-384-34701 Inspection Line: 970-384-5003 n,earfield-countvcori �1 r Pcrk Fri: Parcel No:(this information is available at the assessors office 970-945-9134) 2409-232-00-096 2 Septic Permit #: 21 Pt - i - . • /+ Job Address: (if an address has not been assigned, please provide Cr,Hwy or Street Name & City) or legal description SG 14-23 See the attached plat for description. 3 APPRO. _,i t lip' 7T DATE Lot Size: Lot No: Block No: Subd/Exemption: See Attached Survey Plat 4 Owner: (property owner) Strait Bottom Ranch LLLP Mailing Address PO Box 26 Woody Creek, CO 81656 Ph: 970-923-8999 Alt Ph: 5 Contractor: Williams Production RMT Company LLC PO Box 370, Parachute, CO 81635 Ph: 970-285-9377 ext 2754 Alt Ph: 6 Engineer: N/A Mailing Address Ph: Alt Ph: 7 Permit Reauest For: (X 1 New Installation 1 1_Alteration ( 1 Reoair 8 Waste Type: (X ) Dwelling ( ) Tranient Use ( ) Commercial or Industrial ( ) Non- Domestic Wastes ( ) Other- Describe 9 Building Or Service Type: Number of Bedrooms: 2 Garbage Grinder ( ) Yes (X )No 10 Source & Type of Water Supply: ( ) Weil ( ) Spring ( ) Stream Or Creek ( ) Cistern If supplied by COMMUNITY WATER, give name of supplier: Down Valley Septic and Waste 11 Distance to Nearest Community Sewer Was there an effort to connect to the System: _N/A community System? N/A YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITH OUT A SITE PLAN 12 Ground Conditions: Depth to 1st Ground Water Table N/A Percent Ground Slope NIA 13 Type of Individual Sewage System (ISDS) Proposed: ( } Septic Tank ( )Aeration Plant ( X ) Vault ( ) Vault Privy ( )Composting Toilet ( ) Recycling, Potable Use ( )Recycling, Other use ( ) Pit Privy ( ) Incineration Toilet ( ) Chemical Toilet (X) Other- Describe: Hauled to Down Valley Waste for their disposal 14 Final Disposal By: ( ) Absorption trench, Bed or Pit ( ) Underground Dispersal ( ) Above Ground Dispersal ( ) Evapotranspiration ( ) Sand Filter ( ) Wastewater pond (X )Other -Describe Hauled to Down Valley Waste for their disposal 15 Wilt effluent be discharged into waters of the state? ( )Yes (X )No 16 Percolation Test Result: (to be completed Minutes per by Registered Professional Engineer, if the inch in hole No.1 in hole No.2 made soil absorption test: N/A Engineer does the Percolation Test) Minutes per inch in NIA hole No.3 No.4 Minutes per inch Minutes per inch in hole Name, address & telephone of RPE who Name, address & telephone of RPE responsible for design of the system:NMA 17 Applicant acknowldges that the completeness of the application is conditional upon such further mandatiory 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 the 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 retie. •n •y •cal department of health in evaluationg the same for purposes of issuing the permit applied for herin. I further unde tand that any falsification o ! e. - • sentaion may result in the denial of the appli atlon or revocation of any permit granted based upon said application d legal action for erju., = ed by taw. / Ow ers Si ature: Bryan S. `otard Date Pcrmtt rcc: 1-3;1 r Pcrk Fri: Total tees: Building Permit Yr- Septic Permit #: 21 Pt - i - . • /+ Issue Date: r -(C0( I �-6 Building do PI . . t: APPRO. _,i t lip' 7T DATE 6 Nigh level Alarm II IUfirt ar Alarm Is Ararat Tank Is Full One aboveground sewage holding tank with 4000 -gallon capacity on-site. The Vault System s displayed 'n both of the pictures. Sewage flows esti- mated to be 300 gallons/day (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 treatment/disposal 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- lons/day (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 0 SG 14-23 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. 1 11 TA CU r 11112 DRAIN TANK BEFORE MOVING I Section 23 T. 7 S., R 96 W 5064 Exist. Limit of Disturbance Sectt on 23 W #7 erection 2� A F 1.5'r. 46, 0 B Daylight Line Existing Road 50' O/S RfrP: Phil; / / I .. EAres SrockP% any p d e Asea 90' ~ N#1 /1 105' NW #8 \ C 2.4' Edge of Exist Pad Exist. Pad Et. = 5070.1 N Az. 197.04° 150' 150' ESTIMATED EARTHWORK QUANTITIES (cy) ITEM CUT FILL TOPSOIL EXCESS PAD 2554 1862 600 92 PIT 400 400 TOTALS 2954 1562 600 492 Move Prod. Equip Area 50'x20' Z QIO 0 225' {}Proposed SG 344-22 *Proposed SG 444-22 -Proposed SG 44-22 *Proposed SG 544-22 / 1'Ex1st. SG 14-23 Z: 1I ;,i.Elsl. SG 514-23 C 0.0' j Exist. SG 314-23 4 i kif Exist. SG 414-23 0 0 60 GRAPHIC SCALE IN FEET 1,1NCH = 60 FEET C 5.1' Exist. Above Ground Utility AA Proposed Cuttings Trench 40'x60'x 12 (1400 cy) Daylight Line NE &#2 90' 1\ C 3.5' I� r y 38' v ` 75,/o'rC 1 1 1 1 #3 C 0.9' y I 39•X X ' W A SE #4 C 0.9' 50 0/8 -RrF.PNT. 90' 'NOTE: 1.) TOPSOIL VOLUME BASED ON 12" SOIL DEPTH. 2 ) TOTAL DISTURBED AREA = 3.79 ac. REVISED: 3/21/11 r3.1 rnal T fid $rn,et FIM. Cobmd, a 1650 Ph NM 673.1.730 /� flax (9 70] �ad�17i."''I��I�vJ�//� BODKCI.IFF SuraServices, Inc. SCALE: 1 " = 60' DATE: 2/28/11 PLAT: 2 of 7 PROJECT: Williams Vallee DI T. crus Exist. Limit of Disturbance BB cc Construction Plan Prepared for: Williams Williams Production, RMT SG 14-23 Drill Pad - Plat 2 CONSTRUCTJONLAYOUT Section 23 T7S.,R96W f �I • 31+ I r` y J1 9 a 1 50.5C' G :14 -23' -DRILL:. PAD, LbCA.TIONnk; ,. 7 1 b` i k i t: 1 iN l •�4_-,; 1 ,;' r /-i r l: i ( ;.----.....'-•:: ... 1 it i• rt t` r �' � i ;• loll'` ,'.ti, s. (l �C r;(E.1 I, 1!, 1000 0 2000 GRAPHIC SCALE IN FEET 1 INCH =2000FEET ACCESS DESCRIPTION: FROM THE INTERSECTION OF 1ST STREET AND COUNTY ROAD 215 AT PARACHUTE, PROCEED IN A SOUTHWESTERLY DIRECTION THROUGH THE TOWN OF PARACHUTE ALONG 1ST STREET WHICH TRANSITIONS INTO STATE HIGHWAY 6 & 24, 1.3.8 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD, PROCEED RIGHT IN A NORTHERLY DIRECTION AROUND TO THE SG 14-23 DRILL PAD LOCATION, AS SHOWN HEREON. 1361a<1 Me SFmY RiJ1•. CcImxdn RIGS] Ph f970)625.1.13/ F I9;a)a2.5-277,1 Survi ISer1 krs, SCALE: 1" = 2000' DATE: 2/28/ 11 PLAT. 5 of 7 PROJECT.: Williams Vallee DFT.• cws Construction Plan Prepared for: Williads Williams Production, RMT SG 14-23 Drill Pad - Plat 5 ACCESS ROAD MAP 3L110111111101imEgge1,1,1129111111011111111111112 P236 h RL.SOORF 1 of 1 R 6,98 rl 0.00 GARFIaD COUNTY CO STATEMENT OF AUTHORITY NAME OF ENTITY: The name of the entity to which this Statement relates is Strait Bottom LLLP. TYPE OF ENTITY: The entity is a Limited Liability Limited Partnership formed under the laws of the State of Colorado. MAILING ADDRESS: The mailing address for the entity is P. O. Box 26, Woody Creek, Colorado 81656. AUTHORIZED PgRSON: The name and position of the person authorized to execute instruments conveying, encumbering or otherwise affecting title to real property on behalf of the entity are as follows: Name Mary Anne Bosely LIMITATIONS: None. Dated this 30th day of December, 2004, STATE OF COLORADO ) ) ss. COUNTY OF GARFIELD ) positron General Partner Mary An sely, _ .1 Partner The foregoing instrument was subscribed, sworn to and acknowledged before me this 30th day of December, 2004, by Mary Anne Boselyas General Partner of Strait Bottom LLLP, WITNESS my hand and official seal. My Commission expires: October 31, 2007 Nota Public NYeq 30,tCK0,;a1 RETI1W 'ial tCIIVNq, ROkrr n DKNY\`rY 802 I r„ Sr, HYV.:] IIIA CO 10001 September 21't, 2011 Mr. Fred Jarrnan, Director Garfield County Building and Planning Department 108 8th Street, 4th Floor Glenwood Springs, CO 81601 RE: SG 41-27, SG 14-23, SG 23-23, GV 18-23, SG 32-23 Drilling Pad Locations, Garfield County. Colorado Dear Mr. Jarman: This letter authorize` Williams Production RMT Company LLC to represent me in the submittal and processing of the required Garfield County Small Temporary Employee Housing (STEN) and Individual Sewage Disposal System (ISDS) permits on the above drilling pad locations. Sincerely, SAS ii.),,,t_tkck L.A., LA) Strait Bottom Ranc By: Title: z 111! ti's P 11V,IN M NI Recipp1Ionki; 8415429 o7118f2011 04:28:23 PM Awl 0.Jkortao 1 ❑! 2 Rco Fea 578.418 pec Finale M =MELO COUNTY CO LIMITED POWER OF ATTORNEY WILLIAMS PRODUCTION RMT COMPANY LLC ("Company") a Delaware limited liability company, having its principal place of business in the City of Tulsa, County of Tulsa, State of Oklahauta, docs hereby make, constitute and appoint Bryan 5. Hotard with the full authority hereinafter provided, the true and lawful Attorney -in -Fact of the Company, authorized and empowered GB 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 including but not limited to, the following described instruments and docs ments: 1. Applications and documentation associated with Garfield County or Rio Blanco permitting requirements, including, but not limited to, Independent Sewage 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, Ternporary 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 easement or lease to mortgage rights; 7. Agreements relating to the modification and relocation of Company facilities; B. 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 purposes or otherwise in connection with the Company's operations; 10. Agreements to obtain water services, electrical, 1>s or oil services or the provision of other utility service a utilized by Company's facilities; 1.1. Agreements modifying, amending, renewing, extending, ratifying forfeiting, canceling and terrtrinating any and all of the aforementioned types of instruments and documents. The Company 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 bad been given, made and done by the Company in its limited liability cornpany 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 ruin In full force and effect until terminated by Company. 1111 lolireM litIrClitliMPili Xi 11111 R.ceptian*: B05403 77110I78i1 1;76.23 PM d..et Stb rio� 20 2 Nilo Feta: 18.P12 DOC Fso:a.0O GARFIELD mem Ed IN WITNESS WHEREOF, the Company has caused this Limited Power of Attorney to be signed by one of its Vice Presidents, duly authorized by its Management Committee to grant powers of attorney this j j r''day of July, 2011. W1L 'r MS ` tODiJ+ylilr is COMPANY LLC By: es cent STATE OF OKLAHOMA )' } ) COUNTY OF TULSA S9. ACKNOWLEDGMENT BEFORE ME, the undersigned authority, a Notary Public in and for said County and State, on this day personally appeared, Jerry D. Bames personally known to me to be the Vice President of WILLIAMS PRODUCTION RMT COMPANY 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 11 day of July, 2011. My Commission Expires: 2. — 23 _ 20 I LI- 1aMaEttr.RD 1T • ZLEILELRECCMDADDN2LaisE.RE URN TQ WILUAMS PRODUCTION CO RMT LLC ATTN: LAND DEPT. P.O. BOX 370 PARACHU 1 E, CO 81635 2 From: Bonuales, Gia To: Rob Ferguson; jsears(agarcosheriff.com; Julie Taylor; Vola Mercer Cc: Reed, Gary Subject: SG 14-23 Rig Move Off Notification Date: Thursday, December 29, 2011 4:43:33 PM This email is to inform The Garfield County Sheriff's Department and the Grand Valley Fire Protection District that Williams Production RMT Company LLC has almost completed drilling operations on the above mentioned drilling location. The rig associated with the drilling development will start moving off location Monday, January 21. 1, 2012, and will be moved to another location of which you will be notified. In accordance with Garfield County Planning and Zoning Regulations, we must notify you on the removal of the Small Temporary Housing Facility located on the SG 14-23 pad development. Should you have any further questions or concerns regarding this notification, feel free to contact me at the numbers listed below. Happy Holidays! Gia IBonu&l�� Land Data Technician I Williams Production RMT Company LLC 1058 County Road 215/PO Box 370 Parachute, Co 81635 970.263.2746 -Office 970.216.8537 -Cell 970.285 -2047 -Fax gia.bonuales@williams.com