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HomeMy WebLinkAbout1.0 ApplicationOLSSON ASSOCIATES December 8, 2010 Garfield County Building & Planning Department 108 8th Street, Suite 401 Glenwood Springs, CO 81601 Subject: Small Temporary Employee Housing Permit Application — Well Pad 32A=24D To Whom It May Concern: Enclosed please find one (1) copy of the subject Small Temporary Employee Housing Permit Application along with the required application fee. Petroleum Development Corp. (PDC) is seeking permission to install temporary employee housing to support drilling operations on a well pad in Garfield County. As stated in the enclosed application, the need for the temporary employee housing at this well pad is dictated by the remote location of PDC's operations and the hazards associated with having employees routinely driving on the relatively primitive roads accessing these operations. The installation of this housing will reduce the daily traffic to and from these well pads and enhance the safety of PDC's operations. In addition, temporary employee housing is needed for each drilling rig because long-term, affordable is housing is not readily available in Garfield County. If you or Garfield County staff have any questions regarding this application, please contact me at 970-263-7800, ext. 2013. Sincerely, Mike Markus Project Scientist Olsson Associates Enclosure — As Stated 826 211/2 Road TEL 970.263.7800 Grand Junction, CO 81505 FAX 970.263.7456 www.oaconsulting.com SMALL TEMPORARY EMPLOYEE HOUSING APPLICATION WELL PAD 32A -24D SUBMITTED TO: GARFIELD COUNTY PREPARED FOR PETROLEUM DEVELOPMENT CORP. DECEMBER 2010 OA PROJECT No. 010-0205 OLSSON ASSOCIATES GARFIELD COUNTY Building and Planning Department 108 8th Street, Suite 401 Glenwood Springs, Colorado 81601 Telephone: (970) 945-8212 Facsimile: (970) 384-3470 www.garfield-countv.com N- -10-604 � Small Temporary Employee Housing Administrative Checklist GENERAL INFORMATION — Submit 1 paper & 1 CD copy of the completed application to Planning Department /in 48 hours following occupation (To be completed by the Small Facility Operator — e.g. well pad operator) Section/Township/Range Location of Housing Site: Well Pad Number: 32A -24D SWNE Sec24 TWP6S Rng97W Tax Parcel Number for Parcel Containing Housing Site: 2411013 00001 GPS and/or Lat-Long Coordinates of Housing Facility Site (Often included in APD): 39 50861468 N 10816829813 W Zone District: Resource Lands : Plateau Maximum Number of Occupants at Permitted Site (e.g. well pad): 8 Cumulative Amount of Time (in Days) The Facility Will 115 days be at Location: State or Federal Permitting Agency Overseeing Reclamation, COGCC, API 05 045 16214 00 Restoration and Revegetation and Relevant Permit Number: Date of Installation: December 8, 2010 Date of Removal: April 1, 2011 Name of Landowner: Puckett Land Company Street Address: 5460 South Quebec St. Telephone: Email: City: Englewood State: CO Zip Code: 80111 Name of Operator's Compliance Officer: Steve Trippett Street Address: 1775 Sherman St, Ste 3000 Telephone: 303-860-5800 Email: strippett@petd.com City: Denver State: CO Zip Code: 80203 Company 24 -Hour Emergency Contact: PDC 24HR Emergency Pager Phone Number:970-350-823° This Administrative Checklist 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 receipt) or verified is the Operator's been received by A copy of this completed Administrative Checklist and all associated submittals shall the Garfield County Sheriff's 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 the Sheriff's Office and Fire Protection District. 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: 2 , 5 0 0 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 Sheriff's 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) Hi. 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 Sheriffs 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 County 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 (Y/N) 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, Y 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, Y 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. y 3 Unit 1 Make: ATCO Serial Number or Unit ID Number: 20565 Manufacture Year: 2006 Size of Unit (Square Feet): 14 x 48 (672 sq. ft.) Unit 2 Make: ATCO Serial Number or Unit ID Number: 21524 Manufacture Year: 2007 Size of Unit (Square Feet): 13 x 54 (702 sq. ft.) Unit 3 Make: ATCO Serial Number or Unit ID Number: 21526 Manufacture Year: 2007 Size of Unit (Square Feet): 13 x 54 (702 sq. ft.) Unit 4 Make: Serial Number or Unit ID Number: 23592 Manufacture Year: 2010 Size of Unit (Square Feet): Unit 5 Make: ATCO Serial Number or Unit ID Number: 19041 Manufacture Year: 2008 Size of Unit (Square Feet): 13 x 54 (702 sq. ft.) ISDS Permit ISDS Permit Number: if py _12_10_ /k6 —) Signature of Operator's Compliance Officer: (By signing this form, t verify that all information provided in the best of my knowledge) Print Name: this checklist is correct and accurate to Title: 4 Building Information (Per Unit) Unit t 6 Make: /1tcri +Cc_h Serial Number or Unit ID Number: .z d S 27 Size of Unit (Square Feet): Manufacture Year: 2o Unit 2 Make: Serial Number or Unit ID Number: Manufacture Year: Size of Unit (Square Feet): 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: L.Ee"% /2— /61— l x-67 Signature of Operator's Comply Officer: StA-.�74 (By signing this fond, l verify that a 1 information provided in the best of my knowledge) Print Name: Steve Trippett this checklist is correct and accurate to Title: Asset Mana• er 4 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. 4---� Signature of Operator's Compliance Officer: Print Name: Steve Trippett Title: Asset Manager Phone Number: 303-860-5800 Email: strippett@petd.com I 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 Date of Inspection Print Name of d Title D40-/ , Signature 8 1 owl ev. HIS INSIGNIA IS THE:PROPERT , STATE OF COLORAD DIVISION OF HOUSING TNI5 NONRE610E7/TIA L STRUCTURE COMPLIES WITH ENE FACIQAT LAM NONRESIDENTIAL CONSTRUCTION STAMOARBS Of TNI{ STATE OF eCLORAOO MANUFACTURERIIII NAM ! _ PLAN APPROVACO. UN'tT DE A DAT[ DLHLT CD TIi1CATIWH R6. FINN MANUFACTURER CERTIFIES THE FOLLOWING: HOOF DI$ Q$ LOAD 1111161 SPUD • n.0011 MUM Loan`, rim NAT IN0 L7.TWOR Wh LLI sin RATION l94R ,niE woo camp PEP 18'11 fir NE NR 11R AtcwttM'AL uscTmgAl 11111.111111111111.11 jnow04 mainim •UAMEE ' Ift-f f.1Q 11 ie 64,79.01 THIS INSIGNIA IS THE PROPERTY OF TtGE STATE OF COLORADO DIVISION OF HOUSING THIS NO writes:minim. ern UOTURE COMFLIES WI7N THE 7RCTORT BUILT ONREJIOENTEAL OC•NSTRUCTION BTANOAAOE CIF THE STATE OF COLORAOS YARIIEACTURBNEJ' JULY AP $OVAL MO. MAT( 'was MANUFACTURER CERTIFIES THE FOLLOWING: ROOT MEM LOAD unite Limo RDOR E1cuck Rllll RitlMc CRTtll001 WALLS E'1U1 RA.SItlL FLOOR ISIS RATERS COLAS WHAMS Lail :11111Ii' 111J^1I' THLS INSIGNIA is Alipbriv OF'THE STATE OF COLORAD DIVISION OF MOUSING THIS NONRESIDENTIAL STRUCTURE common WITH THE FACTO DyILT NONRESIDENTIAL tONSTRUCTION STANDARDS Of TINE STATE OF COLORADO YADIUF,ACTURtTAISY MI UR PLAN A11WVAL$0. - UNIT EDI,EDI,`STT r T 1 _ Miff WICATION N0. ff RR MANUFACTURER CERTIFIES THE FOLLOWING: Roo! DECO LOAD WIMP SPEW MOO cum t4 D - nu lam amnion taus Mit i LMis0 rum noir ammo coma I01CP11Ai4aa t1.1MfICAL rturna 1111111111111""1 2)11:1 II STATE OF COLORADO DIVISION OF HOUSING THIS NO 141WHDEMTI*L tTAUrfa9CCOUPLI Et WTN INN FACTORS 1tONFI SIgthttAL CONS TilUCTIOh 1TtY171sbI OI TW [TI+I CI COt WA. ISASIUFwoTUR W 11f A1Y! PTAH MrncwAytTa tui[ WILT CIA I NILATSON MO. PIM U IHUFACTUkER CERTIFIES THE FOLLOWING SOOT C:tI WI LOAD !MOO IIEL* !LOOS TII=IGN LTT; _ Ftlt! IATN* tit UA W% W111.31 Md. RATN{D moon FIR4 scamp TiR ANO:+'. 1. THIG INSIGNIA IS THE PROPERTY OF THE STATE QF COLORADO DIVISION OF HOUSING THIS NUNFESIDEINTI A L STPUCTUFE COMPLIES WITH THE FAC TCIRY BUILT NON FlESIDENTIAL COriSTRIJCTION STANDARDS OF THE STATE QF CI:MCRACO MATIUFACTUREROT NAME111 t y PLAN APPROVAL DATE BUILT - LIfLLIT IDN CFNITIFNCAT1ON Mb. FRNR MANUFACTURER CEFITiWJES THE FOLLOW1NG: • ROOF DESIGN LOAD WIND NEED FLOOR D($ION OCCUPANCY FIRE AXIOM EXTERIOR WALLS FIRE RATING CEM. p G G�-. P C% t ' PSE MHO PSF NN HA MECWANICAL ELECTRICAL MINIMUM' "ell" 11.4111.1100M0110L1941 22 4 THIS INSIGNIA IS THE PROPERTY OF THE STATE OF COLORADO DIVISION OF HOUSING THIS NONRESIDENTIAL STRUCTURE COMPLIES WITH TNM FACTORY aim T NONfi[7IDENTIAL uUNSTRUCTIOiI STANDARDS OF THE STATE OF CDLaPADQ MAP WFACTUREfilsr MANI KAM APPROYA DOTE BUILT unIT MP CCRTIPIOATFON NO. TOM 20529 MANUFACTURER CERTIFIES THE FOLLOWING: NOOK DUMB LOAD ps, TM WU AIrN PLOD 011144N LOA& _ PSF mamma ttXTMUOR WALLA NR WII FLOO Pin NROTATING COtFNW=WI WI / RG 101 ammo" 10'QQ1f '11 29 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 199411-136. I hereby attest that 1 am the designated Compliance Officer for the aforementioned Small Temporary Employee Housing Facllity(ies). I attest that I have read and understand the standards to which the Facility(les) shall be installed and operated. I attest that the Facillty(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 1 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 hi accordance with Article 12. Signature of Operator's Compliance Officer: Print Name: Steve Trippett 1 Title: Asset Manager Phone Number: 303-860-5800 Email: strippett@petd.com I 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 Date of Inspection Print Name afid Title Signature I PE Stamp 8 GARFIELD COUNTY BUILDING AND PLANNING DEPARTMENT PAYMENT AGREEMENT FORM (Shall be submitted with application) GARFIELD COUNTY (hereinafter COUNTY) and Petroleum Development Corp. Property Owner (hereinafter OWNER) agree as follows: 1. OWNER has submitted to COUNTY an application for small Temporary Employee Housing Facility (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 AUTHORIZED REPRESENTATIVE) /2/2/7-0/0 Signature Date Steve Trippett Print Name Mailing Address: 1775 Sherman St, Ste 3000 Denver, CO 80203 Page 4 I01 Petroleum Development Corporation February 1, 2010 Garfield County Building 04 Planning Department 108 = 8" Street, Suite 401 °Leawood Springs, CQ 81601 Re: Principal Agent and Authority to Sign Ladies and Gantietnen; This letter shall serve as formal notice that Petroleum Development Corporation (hereafter "PDC"), as Operator, hereby directs and designates Steven W. T rippett, Asset Director Central, DS a representative and principal agent of PDC, authorized to sign and submit all permit npplications to Garfield County, Colorado on behalf of PDC, Furthermore, Steven W Trippett is authorized to accept and bo served With all notices From C;3nrtield County regarding any applicable permit applications and permits, Sincerely, Petroleum Development Corporntlou /7a1"1 MOIL Schaff (VINE President l-,alld p URI OL;EPoRt OFFICE: Petroleum Development Corporation 0.20 Genesis 6ouloverd a PA Cox 26 Orlegeport, Wept Virginia 20330 (304) 042-3607 CORPORATE OFFICE: I'otrolaum Development ODe rotlan 2770 Sheraton Street Suite 3000 Denver, Colorado 60203 (2O3) 860-6000 EVANS OFFICE: Petroleum navelopment Cerparatlen 3001 Demon Avenue Moe, Colorado 60020 (170) 600,0272 (�; ?�� �I(i .IS I 'II II 1 and Company September 1, 2010 Garfield County Building and Planning Department 108 81h Street, Suite 401 Glenwood Springs, CO 81601 Re: Limited Review Process Minor Temporary Housing Permit Garfield County, Colorado To Whom It May Concern: This letter is to inform concerned parties that Puckett land Company ("Puckett") has authorized PDC Energy ("PDC") to pursue a Minor Temporary Housing Permit at a site location in Section 24 of Township 6 South, Range 97 West. Should there be any questions regarding PDC's capacity, please call me at (303) 763-1000. Sincerely, PUCKFTT LANF) COMPANY By: Zir' l"itle: Date: 4 oiof0 I, I DRIVING DIRECTIONS PETROLEUM DEVELOPMENT CORP. TEMPORARY HOUSING SITE PLAN FOR PUCKETT #32A -24D, #32B -24D, #32C -24D, #32D -24D, #42B -24D, #42C -24D, #42D -24D & #43A -24D SECTION 24, T6S, R97W, 6th P.M. SW 1/4 NE 1/4 FROM THE TOWN OF PARACHUTE, COLORADO, TAKE PARACHUTE AVE. TO THE NORTHWEST, PROCEED ALONG THIS ROAD APPROXIMATELY 0,4 MILES TO THE JUNCTION OF THIS ROAD AND COUNTY ROAD #215. PROCEED IN A NORTHWESTERLY, THEN NORTHERLY DIRECTION ALONG COUNTY ROAD #215 APPROXIMATELY 7.1 MILES TO THE JUNCTION OF THIS ROAD AND AN EXISTING ROAD TO THE WEST. THIS ENDS THE USE OF PUBLIC ROADS FOR THE REMAINDER OF THE ROUTE TO THE LOCATION. TURN LEFT ONTO THIS ROAD AND PROCEED IN A WESTERLY, THEN NORTHERLY DIRECTION APPROXIMATELY 0.3 MILES TO THE JUNCTION OF THIS ROAD AND AN EXISTING ROAD TO THE WEST. TURN LEFT ONTO THIS ROAD AND PROCEED IN A WESTERLY, THEN NORTHWESTERLY, THEN SOUTHWESTERLY, THE WESTERLY, THEN SOUTHERLY, THEN EASTERLY, THEN SOUTHERLY, THEN SOUTHEASTERLY, THEN NORTHWESTERLY, THEN WESTERLY DIRECTION APPROXIMATELY 6.2 MILES TO THE JUNCTION OF THIS ROAD AND AN EXISTING ROAD TO THE SOUTHWEST. TURN LEFT ONTO THIS ROAD AND PROCEED IN A SOUTHWESTERLY DIRECTION APPROXIMATELY 1.1 MILES TO THE JUNCTION OF THIS ROAD AND AN EXISTING ROAD TO THE SOUTH. TURN LEFT ONTO THIS ROAD AND PROCEED IN A SOUTHERLY, THEN SOUTHWESTERLY DIRECTION APPROXIMATELY 0.2 MILES TO THE JUNCTION OF THIS ROAD AND AN EXISTING ROAD TO THE SOUTHEAST. TURN LEFT ONTO THIS ROAD AND PROCEED IN A SOUTHEASTERLY, THEN NORTHEASTERLY, THEN SOUTHEASTERLY DIRECTION APPROXIMATELY 0.4 MILES TO THE JUNCTION OF THIS ROAD AND AN EXISTING ROAD TO THE SOUTH. TURN RIGHT AND PROCEED IN A SOUTHERLY DIRECTION APPROXIMATELY 290' TO THE WELL LOCATION TOTAL DISTANCE FROM PARACHUTE COLORADO TO THE WELL LOCATION IS APPROXIMATELY 15.7 MILES. SURFACE OWNERSHIP PUCKETT LAND COMPANY 5460 SOUTH QUEBEC STREET Englewood, CO 80111 INSTALLATION & REMOVAL DATES Installation Date, December 1, 2010 Removal Date, April 1, 2011 Duration on Site, 122 Days 24 HOUR RESPONSE CONTACT INFORAMTION 1. PDC 24 Hour Emergency Pager (970) 350-8230 2. PDC Drilling Manager (303) 860-5800 3. Garfield County Dispatch (970) 625-8095 4. St. Mary's CareFlight Helicopter (970) 332-4923 5. Poison Control Hotline (800) 222-1222 6. CHEMTREC (800) 424-9300 NOTE: GARFIELD COUNTY REQUIRES 20' SPACING BETWEEN SKID HOUSES. Wirerope 100' T BOP'S Elevators 0 xN --0 2 0 0 N — 0 0 U VICINITY MAP SCALE: 1"=2000' 0 SCALE DATE: 12-06-10 DRAWN BY: C.H. Directional Tub Directional Tub DC Tub C) #32B -24D 0 #32C -24D #32A -24D in A o #32D -24D 0 #43 Ing 0 #42 -O #42C -24D n A 1 C C) #42B -24D a° #2 Pump' Boiler 0E 0 E 0 0 E 0 0 Q Mud Tank Q Mud Tank 0 0 N 0 E 0 0 BP Tub 00 0I 0 Anchor (7:41) LW 0 DP Tub Company Man Water Vault n Directional Driller Sewer Vault Mud Logger Water Vault 1 0 N) N 125' ,D Do Dry Mud Storage Additives 0000 [7'11m LW 0� 00 IBit House Tool Pusher •• 42- .0 c'\STE' • eA. ` • , •i i TF OF •CO.pc �o •••••...••.••• Proposed Access Road Sewer Vault n 0 E 0 0 t 0 Air Water Vault n in r N Future Rig Hand Camp'/ Water Vault n Sewer Vault n Change Out (No Living Quarters Water Vault n / J UINTAH ENGINEERING & LAND SURVEYING 85 So. 200 East * Vernal, Utah 84078 * (435) 789-1017 Project Address Garfield County Building & Planning Department 108 8th Street Suite 401 Glenwood Springs, CO 81601 - Phone: (970)945-8212 Fax: (970)384-3470 Parcel No. Ala SEPT -12-10-1867 Pe it Type: Septic Permit Work Classification: New Permit Status: Active r' Subdivision Issue Date: 12/7/2010 Section Expires: 12/07/2011 Township Range DEBEQUE, CO 241101300001 Owner Information Address Phone Cell Puckett Land Company 5460 Quebec ST Greenwood Village CO 80111 303-773-1094 Contractor(s) Phone Primary Contractor Petroleum Development Corporation (303)860-5800 Yes Proposed Construction / Details TEH for well pad: Puckett 32A -24D FEES DUE Fee Amount Septic Fee - New $73.00 Total: $73.00 Valuation: Total Sq Feet: $ 0.00 0 FEES PAID Inv Total Paytype Amt Paid Amt Due Inv # SEPT -12-10-20731 $ 73.00 Credit Card $73.00 $ 0.00 Required Inspections: For Inspections call : 1(888)868-5306 Inspection IVR See Permit Record Building Department Copy Tuesday, December 7, 2010 2 Puckett 32A -24D GARFIELD COUNTY SEPTIC PERMIT APPLICATION 108 8'f Street, Suite 401, Glenwood Springs, Co 81601 Phone: 970-945-8212 / Fax: 970-384-3470 / Inspection Line: 970-384-5003 WV w.onrtirld-cuu •.cnm I Parcel No: (this information Is available al the assessors office 970.945.9134) 24110 1300001 2 Job Address: (if an address has not been assigned, please provide Cr, Hwy or Street Name & City) or and legal description App. 8.6 miles NW of Town of Parachute, 7 Section 24, T6S, R97W, 6th P.M. 3 Lot Size: Lot No: BIodt?No: Subd./ Exemption: Acres N/A N/A N/A 4 Owner: (property goner) Puckett Land Company Mailing Address 2460 S Quebec St, suite 250 Greenwood Village, CO 80111 Ph: Alt Ph: 5 Contractor: Petroleum Development Corporation Mailing Address 1775 Sherean Street, Ste 3000 Denver, CO B0203 Ph: 1303) 860-5800 Alt Ph: 6 Engineer: N/A Mailing Address Ph: Alt Ph: 7 PERMIT REQUEST FOR: (x) New Installation ( ) Alteration ( ) Repair 8 WASTE TYPE: ( )Dwelling ( )Transient Use (?)Commercial or industrial ( )Non- Domestic wastes ( )Other - Describe 9 BUILDING OR SERVICE TYPE: sewage vaults associated with ternporary employee housing - -Prei 41— Garbage Grinder ( )Yes (X)No Number of bedrooms N/A 10 SOURCE & TYPE OF WATER SUPPLY: ( )WELL ( }SPRING ( )STREAM OR CREEK (X)CISTERN If supplied by COMMUNITY WATER, give name of supplier: Water hauled to location by Artesian Water Service I1 DISTANCE TO NEAREST COMMUNITY SEWER Was an effort made to connect to the Community System? SYSTEM: Town of Parachute - app. 8.6 miles to the South East No - di stance too g reat YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITH OUT A SITE PLAN 12 GROUND CONDITIONS: Depth to 1°' Ground Water Table app . so feet Percent Ground Slope < 1 o t 13 TYPE OF INDIVIDUAL SEWAGE DISPOSAL 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 ( )Other- Describe 14 FINAL DISPOSAL BY: ( )Absorption trench, Bed or Pit ( )Underground ( )Wastewater pond (X)Other-Describe Dispersal ( )Above Ground Dispersal ( )Evapotranspiration ( )Sand filter South Canyon or W. Garfield Landfill or other permitted facility 15 Will effluent be discharged directly into waters of the state? ( )YES (X)NO 16 PERCOLATION TEST RESULT: (to be completed by Registered Professional Engineer, if the Engineer does the Percolation Test) Minutes N/A per inch In hole No.1 Minutes N/A per inch in hole No.3 No._ Minutes N/A per inch in hole No.2 Minutes N/A per inch in hole Name, address & telephone of RPE who made Name, address & telephone of RPE responsible soil absorption test: N/A for design of the system: N/A 17 ---> Applicant acknowledges that the completeness of the local health department to be made and furnished issuance of the permit is subject to such terns and reports submitted herewith and required to be submitted and are designed to be relied on by the local department understand that any falsification or misrepresentation and legal action for perjury as provided by law. the application is conditional upon such further mandatory by the applicant or by the local health department conditions as deemed necessary to insure compliance by the applicant are or will be represented to of health in evaluating the same for purposes may result in the denial of the application or revocation and additional test and for purposed of the evaluation with rules and regulations be true and correct to the best of issuing the permit applied of any permit granted �z/2/Zo/r, reports as may be required by of the application; and the made, information and of my knowledge and belief for herein. I further based upon said application OWNERS SIGNATURE DATE SP 1 a•-Cr-�O vl�uj Z-1-3 STAFF USE ONLY Permit Fee: F3 Perk Fee: rnsitiF -E Total fees: 73 • Building Permit 11: Septic Permit #: SP1- - .. -) o -1 E & R-- Issue Date: G4)7-9,010 Bui 'ng &'i ing DLpt: /2` 7 - l . 114 6142.41 AI'11ROVA - DATE