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.ciarfield-county.com
Small Temporary Employee Housing
Administrative Checklist
GENERAL INFORMATION — Submit 1 paper 81 CD copy of the completed application to Planning Department wfin 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 35-T7S-R96W Well Pad Number: SG 13-35
Tax Parcel Number for Parcel Containing Housing Site: 2409-353-00-130
GPS and/or Lat-Long Coordinates of Housing Facility Site (Often
included in APD): Lat: 39.390836 Long: -108.083278
Zone District: Rural
Maximum Number of Occupants at
Permitted Site (e.g. well pad): Tess 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 400083971
Date of Installation: November 17`h 2011
Date of Removal: January 17`h 2012
Name of Landowner: Basely Spring Creek Ranch LLLC
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:
Brvan.Hotard(a�william
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 Cheddist must be received by the Gafaeld County Planning Department
hours following occupancy of the Small Facility.
within 48
be delivered to
within 48 hours
Office and
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'sreceipt)
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
Sheriffs 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 County Sheriff's 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 one (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:
30-3321
Manufacture Year: 2008
Size of Unit (Square Feet):
14X56
Unit 2
Make: ATCO Structures
Serial Number or Unit ID Number:
354085938
Manufacture Year: 2008
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: Submitted 11-16-11 - Requested and have not received as of 11-17-11
SP+- aar4-
Signature of Operator's Compliance
Officer: ��'/�)
this checklist is correct and accurate to
(By signing this form, 1 verify that all informa on provided in
the best of my knowledge)
Print Name: Bryan S. Hotard
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 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.
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.
I. 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 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.
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.
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 a(�wiiliams.com Bob.Caughlin(a�williams.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
PE Stamp
See
Summary
Date of Inspection See Summary
Print Name and Title: David Fox of Fox
Engineering Solutions
Signature See Form
8
Inspection Report for:
Prepare for:
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 13-35 Well Pad - Small Temporary Employee Housing
Williams Production RMT Company
NW 1/4 SW 1/4 of Section 35, T7S, R96W, 6th P.M. Garfield County
David Fox, P.E.
November 17, 2011
Garfield County
Article 7-808(0)(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)
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
remove& 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.
Page 1 of 5
Inspection Comments
Colorado Division of Housing certifications noted on
Driller's trailer, Unit ID. 30-3321 with FBNR
Certification No. 20533 manufactured by Ameritech
Building Systems on October 13, 2008; and
Company trailer, Unit ID. 354085938 with FBNR
Certification No. 19708 manufactured by ATCO
Structures on July 14, 2008. 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.
SG 13-35 inspection Fox Engineering Solutions LLC
Williams Production RMT Company November 17, 2011
1
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 (0).
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 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.
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.
Page 2 of 5
Not subject to visual inspection and certification by
third party Professional Engineer.
No recreational vehicles observed on site.
One potable water tanks of approximately 4000
gallons and one 4000 -gallon sewage holding tank
onsite. All 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 each 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 detector located in all factory
built non-residential structure (FBNR).
Fire extinguishers observed in all structures.
SG 13-35 Inspection Fax Engineering Solutions LLC
Williams Production RMT Company November 17, 2011
11 Domestic animals are prohibited at all Small Facilities.
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 Sheriffs 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 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.
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
No domestic animals observed on-site.
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 13-35 Inspection Fox Engineering Solutions LLC
Williams Production RMT Company
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; 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.
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) 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.
19(b)
Individual Sewage Disposal System (1505): If an ISDS is Facility (eight
or less individuals) and shall otherwise be permitted and operated in
accordance with the Garfield County 1505 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-136.
Page4of5
November 17, 2011
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 13-35 Inspection Fox Engineering Solutions LLC
Williams Production RMT Company
November 17, 2011
1 hereby attest that 1 am a Licensed Professional Engineer in the State of Colorado. l 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: No. 25420 (Colorado
Date of Inspection: November 17, 2011
Print Name and Title: David J. Fox, Princi al Engineer
Signature: -r
Page 5 of 5
PE Stamp
Williams Production RMT Company
SG 13-35 Well Pad
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e - - - - nerr1YnaTiOr
0 mi.1LLcarrial r.1aD
t lietah lineincari.=- 1..nd Surveying
,1.9,710.2•117 - VA.., cases -r-...s
XX 11.1.1.1\ii PRODUCTION R\Tr ('OMP NY
N SG 13-35
SECTION A<. T7` R90 6110 P.\I.
Tri P (1 G 1t .L 1' IC
NI .l t•
03
TIT
Djce_ctions to Site'
WILLIAMS PRODUCTION RMT COMPANY
PLAT #4_TYPICAL RIG LAYOUT FOR SC 13-35
SECTION 35, 175, R96W, 61h P.M.
SCALE, ep'
Ii VkAWi: Je 1e,3
n.4—.1-11 113 -.
a
la
Approximate Drill Rig
6 Equipment Ares
E
M
PRDUCIION
EOUlPtrENT AREA
(t5250)
-'x
Thee Portable
Toilets
Identification & Location K.o
1. Wastewater Aboveground Tank (4000 gal.)
2. Potable Wates Aboveground Tank (4000 gal)
3. Tutee Portable Tait,
4. W ildefe-proof drnnpstor
5. Company Man Offi<»Aldairg
6. Onllers Officee4or,wrg
7. Shed
Subject to relocetron for construction activities.
.Eo)ltgenlev Contact Litt;
Main Omoe- 970-285.9377 answered 24 Hours
Lyn Cass Wiilams Production 970-755-0083 Cell
Scott Brady- Williams Drilling Sup -070-270-9187 Cef
Kevin McGowan.- Wilpams Satery-970300,1105 Cell
Mark Murnby - Spill Contractor 970.260-1578 Cell
0 50
Ft. Ft.
100 150
Ft. Ft.
Williams.
The well pad site is located in the NW 114 SW 174 of Section 35, T75. R96W.
6th P.M. (NAD83 N39.3909° W108.0633°)
The site will temporarily office and house up to a maximum of four individu3 0
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.
One aboveground sewage holding tank with 4000 -gallon capacity on-site.
Sewage flows estimated to be 300 gallons/day (4 individuals x 75 good).
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 be 300 gallons/day (4
individuals 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 4002 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 Uintah Engineering and Land Surveying. Site features
including housing trailers, water and wastewater tanks. portable toilets and
dumpster were field located. 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.
All Factory -Built Nonresidential Structures (Office/Housing) have a minimum
separation distance of 28 ft.
SG 13-35 Site Plan
Garfield County, Colorado
Small Temporary Employee Housing and
Septic Permit Application
Applicant: Williams Production RMT
Date: November 17. 2011 Checked: [If
Fox Engineering Solutions LLC
670 Canyon Creek Drive, Grand Junction, CO 81507
Ph: (910) 250-5505 f Fax' (1129) 78443567
Fr1ta'I: coloradofox@brssnan.nst
Verori 071
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 BASE FEE
Vacating Public Roads & Rights -of -Way $400
Sketch Plan $325
$675 + application agency
review fees and outside
Preliminary Plan / Conservation Subdivision consultant review fees, as
authorized pursuant to the
Regulations, such as the
Colorado Geologic Survey
Preliminary Plan Amendment $325
Final Plat $200
Final Plat Amendment / Correction Plat $100
Combined Preliminary Plan and Final Plat $1,075
Minor Exemption / Amendment $300 / $300
Major Exemption / Amendment $400 / $300
Rural Land Development Option Exemption / Amendment $400 / $300
General Administrative Permit $250
Floodplain Development Permit $400
Pipeline Development Plan / Amendment $400 / $300
Small Temporary Employee Housing $50
Minor Temporary Employee Housing $250
Limited Impact Review / Amendment $400 / $300
Major Impact Review / Amendment $525 / $400
Rezoning: Text Amendment $300
Rezoning: Zone District Amendment $450
Planned Unit Development (PUD) / Amendment $500 / $300
Comprehensive Plan Amendment $450
Variance $250
Interpretation $250
Takings Determination NO FEE
Planning Staff Hourly Rate
• Planning Director $50.50
• Senior Planner $40.50
• Planning Technician $33.75
• Secretary $30.00
County Surveyor Review Fee (includes review of Amended Determined by Surveyor$
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 Bosely Spring Creek Ranch LLLC
Property Owner (hereinafter OWNER) agree as follows:
1. OWNER has submitted to COUNTY an application for
SG 13-35 pad location STEH &1SDS (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 HORIZED REPRESENTATIVE)
Signat e
Bryan S. Hotard
Print Name
Mailing Address:
Dat
Williams Production RMT Company LLC
PO Box 370, Parachute, CO 81635
Page 4
Bonuales, Gia
From: Bonuales, Gia
Sent: Friday, November 18, 2011 10:04 AM
To: 'Rob Ferguson'; 'Julie Taylor'
Cc: Reed, Gary
Subject: SG 13-35 Rig Move On Notification
Attachments: SG 13-35 GVFPD Letter & Map dated 11-17-11.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 35-T75-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.
Have a great weekend!
bib Bonu&lcz�
Land Data Technician 1
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@williarns.com
1
Willi ms®
Williams Production RMT Company LLC
1058 CR #215
P.O. Box 370
Parachute, CO 81635-0370
970/285-9377
9701285.9573 Fax
November 17th, 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 13-35 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 13-35 pad.
Should you have any further questions or concerns regarding this notification, feel free to
contact me at (970)263-2754.
Sincerely,
Bryan S. Hotard
Field Land Team Lead-Piceance District
gb
Williams Production RMT Company
SG 13-35 Well Pad
5_1:01:1811
LEGEND:
•-Ivr.rrnre
9 L'11.,LL CA/MS c:i'.tab
I lintah y:ngmrcring Land 5urva;'in6
N t; 1335
SECTION 35. Tis. R96W. 6tft P-\1.
Ntil.1.I.\ 1S PRAM l4 I'IOV Rill' t'O11P\N\
i1-1.11 •6.7
Y}Lr'i'•Zs, I PRAtt\041'1.11 1 RF1•11.15Is.1.1 t•t...t
t'11YU GRAPHIC
51.51
03112
10
Directions to Site'
1
WILUAMS PRODUCTION RMT COMPANY
PIAT 414_T0'1001. RIG LAYOUT FOR SG '3-35
SECTto5 35, T7S, R96W. 6th P -u.
11111 SfaLE • - 80'
3e7E, 07-te--0
lthArd. al 04.4.8
w;e.J •c -1.1 -"Li ).PI!
+ w. --.c11 14-"1-11 n4 a
r--------
gia
Nal
r
1 s';
1
i
s .a -•rt
r'7
Appo /male 04,11 Rig 0 O
d Eg4/pmerr, Arm •rw
PRDU PON
EAPPrrEN AREA
(rw,so)
Three Portable
Toilets
Fn'•w
.8He -ed.
Identification 6 Location Key'
1 Wastewater Aboveground Tank 14000 gal.)
2 Potable Water Aboveground Tank {41700 gal)
3, Twee Portable Toilets
L Wildlife -pouf dumpster
5. Company Men OffeatHousirg
6.
Grillers Of0oelHousirg
7. Shed
Subject to relocation for construction activities,
Lamrvencv Contact 1.151'
Main Office 970-7A5-0377 anpvered 21 Hdlrs
Lyn Cass Wuliann Production 970-155-0083 Cell
Scott Brady- Williams Dnnirlg Sup -970-270-9197 Cell
Kevin McOennoe- Williams Safely -970-309-l' g5 Ce11
Mark Mumby - 5911 Contractor 970.2601578 Cell
0
Ft.
50
Ft.
100
Ft. Ft.
150
Rolex
The well pad site is located in the NW 114 SW 114 of Section 35. T7S, R98W,
6th P,M. (NADB3 N39.3909' W108,08331
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. OffiCelhouses have Colorado Division of Housing
compliance tags.
One aboveground sewage holding tank with 4000 -gallon capacity on-site.
Sewage Bows estimated to be 300 gallonslday (4 individuals x 75 gpcd).
Sewage holding tank 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 l0
remove and haul the wastewater to a Stale certified treatmenUdisposal facility.
One potable aboveground water tank of approximately 4000 gallons capacity
on-site. Potable water' demand is estimated to be 300 gallons/day (4
individuals x 75 gpcd). Required mimmum 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 Uintah Engineering and Land Surveying. Site features
including housing trailers, water and wastewater tanks, portable toilets and
dumpster were field located. Site features including housing trailers. water and
wastewater tanks. portable toilets and dumpster surveyed with Trimble Geo•1(f
GPS equipment. Please note that this is a construction site and that the
locations of drill equipment and other items are subject to change.
ASI FaClory-Built Nonresidential Structures (Office/Housing) have a minimum
separation distance of 28 ft.
SG 13-35 Site Plan
Garfield County, Colorado
Small Temporary Employee Housing and
Septic Permit Application
Applicant: Williams Production RMT
Date. November 17. 2911
Checked- OF version, 00t
Fox Engineering Solutions LLC
570 Canyon creek Drive, Greed J/arctan, CO 81507
Ph. 1670253-5506 r Fan:1825) 784-0887
Ener. eoforadafox0bresnan.nel
Bonuales, Gia
From: Bonuales, Gia
Sent: Friday, November 18, 2011 10:02 AM
To: 'jsears@garcosheriff.com'; 'Julie Taylor'
Cc: Reed, Gary
Subject: SG 13-35 Rig Move On Notification
Attachments: SG 13-35 Sheriff Letter & Map dated 11-17-11. 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 1 will notify you of the removal of the Employee
housing.
This notification is per the GARCO Regulations for our pad located in Sec 35-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.
616 Bonu 1-$
Land Data Technician 1
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.bonualest williams.com
1
November 17th, 2011
Garfield County Sheriff's Office
Emergency Operations
Attn: Jim Sears
108 8th Street
Glenwood Springs, CO 81601
Ph: 970-945-0453
RE: Emergency Response Notification
SG 13-35 pad
Dear Jim:
Willia s®
Williams Production RMT Company LLC
1058CR#2!5
PO. Box 370
Parachute, 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 13-35 pad.
Should you have any further questions or concerns regarding this notification, feel free to
contact me at (970)263-2754.
Sincerely,
Bryan S. Hotard
Field Land Team Lead-Piceance District
gb
Williams Production RMT Company
SG 13-35 Well Pad
R
?fl,
96
•
1
.\Y
s'0
1%S
T8
it
r
K'ATION:'
% T'
PROPOSED L(
� i SG 13.30
MOB
s,
0110045110 400151 40.
areo s.A(eerr9rrey
Ieaanan wncr
3.
DETAIL ".A"
ti
LEGEND:
ge
■ r
eerier
El Lti".LL
rvr
1E010* F:spark-Her & Lend Oorvevree
V 11.1.1.\111 PROD[ l("1'IO\ 11311' ['O\(P.1N1
N 1( .13-35
SECTION .35. T75,,1196W, rich P.31.
rrIPo C10 FIdie
41 .SP
gig 1OI 5
Cs11142 • iv..1R�J6339[lf'IiClAMMO ry-s1
Directions to Site.
0
c,
WILLIAMS PROI3UC'IION RMT COMPANY
PLAT 4.4_T1QICA1. RIC LAYOUT FOR 5C 13-35
SECTION 35, 17S. R96W, 6th P.N.
_ATE Or -'U
TWO: dY axa
keeled. •e -l.1-.•0 J.11 il
sa_ _ 1 " -
0
7-
Apposimale Drill Rig
&
& Eglapmerd Area 7.7
vPrWCPW
4'at(1up7 Apr/
41x8! arae
Ara
•
Three Portable
Toilers
r+
5777150 pet
-.1
•
Identification & Location Key
I. wastewater Aboveground Tank (4000 gel.)
2. Potable W atm Aboveground Tank (4000 oat)
3. Three Portable Toilets
4. Wildlife-oroof dumpster
5. Company Man abcelHotnmg
6. Drillers Office/Housing
7. Shed
` • Subject to reiocaIIOf for construction 84.11.1as.
f rneraencs Contort L101
Main Office_ 570.285.8377 answered 24 Hours
Lyn Cass Williams Production 970-755-0083 Gell
5000 Wady- Williams Drtllitlg Sup.970-2750187 Cell
K evin MrDennert- WiIliams Safety -570-3041'85 Cell
Made Mlwabr - Spill Contractor 870-250-1570 Cell
0 10 100 150
Ft, Fl. Ft. Ft.
Willis s..
Rates:
The well pad site is located in the NW 174 SW 1 f4 of Section 35. T7S. R96W.
6th P.M. (NAD83 N39.3909° W106.0833°)
The site will temporarily office and house up to a maximum of four indlviduais
during natural gas drilling activities and is expected to be completed in one
year or less. The individuals will 000upy 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 flows estimated to be 300 gallons/clay (4 individuals x 75 geed).
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 lank of approximately 4000 gallons capacity
on-site. Potable water demand is estimated to be 300 gallons/day (4
individuals x 75 gpcd). Required minimum fire suppression demand is 2500
gallons. Total potab4e 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 Uintah Engineering and Land Surveying. Site features
including housing trailers, water and wastewater tanks, portable toilets and
dumpster were field located. Site features including housing trailers, water and
wastewater tanks, portable toilets and dumpster surveyed with Trimble Geo -X1
GPS equipment. Please note that this is a construction site and that the
locations of drill equipment and other items are subject to change.
All Factory -Built Nonresidential Structures (Office/Housing) have a minimum
separation distance of 28 ft.
SG 13-35 Site Plan
Garfield County, Colorado
Small Temporary Employee Housing and
Septic Permit Application
Applicant Williams Production RMT
Date: November 17,2011
Checked' D.F Version: 001
Fox Engineering Solutions LLC
870 Carryon Creek ()eve, Grand Juneton. CO 81507
P11: (070) 250.5505/ Fax. (628) 784-0657
Erred: csloradefo,lbrasnan. net
WILLIAMS PRODUCTION RMT COMPANY
PLAT #2_CONSTRUCTION LAYOUT FOR SG 13-35
SECTION 35, T7S, R96W, 6th P.M.
3
/ CO/
40
F-4.4'1 .y Reserve Pit Backfill
El. 374.3' ....:.& Spoils Stockpile
SCALE: 1" = 60'
DATE: 03-12-10
DRAWN BY: D.R.B.
Rev: 07-16-10 D.R.B.
Rev: 10-13-10 D.R.B.
Rev: 04-11-11 D.R.B.
x
C-2.8'
n-.
El. 381.5
• •
Sta. 3+65
F-10.0'
/El. 368.7./r
In
n
N
N El. 379.0'
iV
Z /
CurnNG PIT
rota! Pit Capacity
W/2' of Freeboard
= 17,850 8b1s.
Total Pit Volume
= 4,540 Cu. Yds.
C-2.9'
E!. 381.6'
, x ••
•
'•h
F-59'
El. 3728'.
7
N
i
Approx.
Toe of
Fill Slope '.
Sta. 2+68
F-0.9'
Proposed SG 13-35 0
E1. 377.8'
Proposed SG 23-35 ci :5,i
Proposed 50 313-35 p7 5S
roposed SG 323-3 O
Proposed SG 413-3�5 07.'5':
150' Proposed SG 423–'350'. 5.
Et.
Proposed SG 523-35 _
GRADE N7T33'40"E
187•
Cut/Fill
Transition Line
90'
C-3.8'
El. 382.5'
5
I C-28'
EL 381.5',
7A
F-3.0'
El. 375.7'
0
to
C-4.7'
El. 383.4'
PRDUC11ON.
EQUIPMENT AREA
(.200'x60) Round Corners
as Needed
Sta. 0+00
60'
Sta. 1+00
Flare Pit
7
Proposed Access C-2.3'
Road \ \EI. 381,0'
Existing s
Drainage `
Existing
Fenceline
5374
5372
Buried Pipeline�153�"��
Elev. Ungraded Ground At Loc. Stake = 5378.7' UINTAH ENGINEERING & LAND SURVEYING
FINISHED GRADE ELEV. A T LOC. STAKE = 5378.7\ 85 So. 200 East ; Vernal, Utah. 84078 * (485) 789-1017 —
x
� x
'Sta. 1+93 x
C-7.4'
. El. 386.1'
Existing
Fenceline
Approx.
Top of
Cut Slope
i
x
x
x
1 x
rn x
C-9.4' \K
El. 388.1'
NOTE: \
Flare Pit is to
be located a min.'
of 100' from the
Well Head.
Existing
able Line
•
•
•
•
a
a
m
1 d
Wit I
J
•' §/14
;
•
!.
-5700
j g. •.
v i
l �L
PROPOSE() LOCATION:
SG i3-:
V",
•
•
0.6MI.r!-
1T7SJ
T8S
r*S
r
II I
-„ fir •
'r,.
./. .•S •• ,.•r' .. taco. •\\ .'. I , j \ f \
LEGEND:
EXISTING ROM)
PROPOSED ROAD
• • • •
••• — EXISTING UTILITY
11 M K N EXISTING FENCE
[# INSTALL CATTLE GUARD
Uintah Engineering & Land SuFw'eying
88 South 200 Ens. \'eva■nl, L7eoh 84078
(435) 789-1017 * FA_Y (438) 789-1813
N
i.0
��ti
J:-•..•
1
`EXISTING PENCE &
.OVERREAD POWERLIN
PROPOSED ACCESS 60' +1 -
(BURIED TELEPHONE LINE c"I"+
(EXISTING PEHCE� } i `�
DETAIL "A"'IRC— ti __
\-��"Niter'_ {�C
WILLIAMS PRODUCTION RMT COMPANY
SG 13-35
SECTION 35,175, R96W, 6 h P.M.
T(}P0GRAP111C
M A P
r
03
ROMA
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1 of 1 R 6.08 .10 . O CARFIELD COUHTY CO
STATEMENT OF AUTHORITY
NAME OF ENTITY: The name of the entity to which This Statement relates is Bosely
Spring Creek Ranch LLC.
TYPE OF ENTITY: The entity Is a Limited Liability Company formed under the laws of the
State of Colorado.
MAILING ADDRESS: The mailing address for the entity is P. 0. Box 26, Woody Creek,
Colorado 81656.
AUTHORIZED PERSON: The names and positions of the person authorized to execute
instruments conveying, encumbering or otherwise affecting title to real property an behalf
of the entity are as follows:
Name Position
Mary Anne Basely Manager
LIMITATIOS: None.
Dated this 1st day of July , 2005.
STATE OF COLORADO )
ss,
COUNTY OF GARFIELD )
The foregoing Instrument was subscribed, sworn to and acknowledged before me
this 11t day of , ,ful Y , 2005, by Mary Anne Basely as Manager of Basely
Spring Creek Ranch LLC.
WITNESS my hand and official seal.
My Commission expires: 10/32/2007
0.4.4u.4iM1 MOI# 1t
Notary Public
MYI:1t KIC[Ylall F(1 iirri'fl$ i[l. SP IRJ(, WCP41 # IIM17 \iT}ll
102 'Brio Hi•., 1,1,N. 730. (3L11.YWO1111 HI.RINfill, CC) h10f41
September 21't, 2011
Mr. Fred Jarman, Director
Garfield County Building and
Planning Department
108 8'" Street, 4th Floor
Glenwood Springs, CO 81601
RE: SG 43-27, 5G 13-35
Drilling Pad Locations,
Garfield County, Colorado
Dear Mr. Jarman:
This letter authorizes 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,
osQ�
Spring Creek
By: --•---
Title:
SMI V%MA 111114fflifinlin i
en lh°.r a w �^ow''1".�p;1eh�ierhex a ori MVV m
uncrrED POWER OF ATTORNEY
WILLIA?&I PRODUCTION RMT COMEANY LLC ("Company") s Delaware
limited liability company, having ha principal place of badinage in the Citi of litlse, Cowrie, of
Ulu, Stet. of Oklahoma, does hereby make, aaasnitote and eppoirt Roan S. Huard with the
full authority hereinafter provided, the true and lawful Ate rney--inPact of the Company,
eat prized and empowered on behalf of the Company and in tho Company's name, and &t tha
sola and exclusive benefit of the Company and not on behalf of any other person, corporation or
association, in whole or in pat, to enter into, womuta, deliver, Ste end accept all hoslnunarts and
documents affecting the real property or reel carte rights of the Connolly inc]udiog bid not
limited to, the lbilowing described inanimate and doapnyits;
1, Applications and doe uaentedon associhhrad with Garfield County err Rio Blanco
peanlntng requirements, iauludiag, but not 'index! to, Independent Sewage Disposal
Systems, Small Tzporaly Employee Souring, Major Impact Reviews, Limited impact
Reviews, Oil and Gu well permitting, Driveway Atoms, Calmly Road Maintecmne,
Temporary Living Qom, Temporary Use Permit", Suthec Use Permits, Sixtus Use
Lieceses, Utilities, %ow Removal end Private Connived= of County Ronde;
2. Apeman and other documentation ibat grant eaaemenn, tights of way, licer>scs, or
permits to Company and ilia inaItvrnerds where the Company grub such rights to
otherm
3. Agreement' and assign eascreeeotr, rights of wan, licenses, pectens or surface leased in
coaaeetioa with the Company'a operations;
4. Releases and Partial R+ele ssea of easements end rights awry;
5. Avernus& allowing enorotehmeeds mato essearoda sad tights of way owned by
Company and landiovner instruments and couveyenees on others wasernends;
6, Agreements aabordinatiug easement or lease to mortgage sigh*
7. Agreements relating to the modiliration and relocation of Company Scabies;
ti. Renal or lease agrearhents far surface use or other surface use agreements and all notices
relatcdto the pipeline agreemer ts;
9. Aglow eons for the puraMaa or ale egged property and for the teams dila! property fur
residential purposes or othci use in connection with the Consp 's awaken;
s
10. Agra:mann to obtain watax ecnloat, electrloal, gas or ell services or the prvvisia a of
other utUlty services ut!lised by Company's ihcilitiea;
11. Agreements modifying, amending, mewing, a handing, rat ung ibrfeiting, canceling
and terminating any and all of the aforementioned typal of instruments and decease:a.
The Company hereby declares that each end every act, matter and thing which
shall be given, made and done by Bryan 8. Rand In unneetioa with the aerobe of tiny or all
a the aforesaid powers dull be as good, valid and eilbc*uei to all interne sad purposes ea if the
acme had boas given, made add done by the Company in its limited liability company prompt
and it hereby retina whatsoever Anatomy -in -Pace shall laws dlyr do or canoe to be done by virtue
hereof This Limited power of Attorney shall mein in hall Race and east we terminated by
Company.
SI FirM1101401C1000110101.141.1
:. � r..•r a$"ooa r,.:.ea uwF�etu aaartr m
IN WrrNES8 WHEREOF, the Company hu caused this Limited Power of Attorney to
be signal by one ens Vice $iraidalts, duly authorized by it' MMolgaaent Comtttlttce to gtint
powers of attorney this , day of July, 2011.
ACKNOWLEDGMENT
TATS OF OKLAHOMA y
)as
COUNTY OF TULSA
BEFOREMB, the tmdasigncd authority, allotary Public in and lbr said County end State,
on this day personally appeased, hay D. Emus penmonally known In me to be the Vice Preaidost of
WJLUAMS PRODUCTION RMT COMPANY LLC a Delaware Ihnifed liability company, w5o
aaimowlredged to me that be has euautod the above LIMITED POWER OF ATTORNEY tlatboiized
by Company's Management Committee,
IN WITNESS WHBRBOF, I have hainunto set my band and &taut my notary real, the IL
day ofJuly, 2011.
My Cammiadah Heplroe: 2-2.3- 2314
�t
alcittEP4.1
AIMILELECOIWaritaigitmamatim
IMLLIAAIS PRODUCTION CO RMT LLC
ATTFk LAND DEPT.
P.O. BOX 370
PARACHUTE, CO 81835
2
Project Address
Garfield County
Building 8, Planning Department
108 8th Street Suite 401
Glenwood Springs, CO 81601 -
Phone: (970)945-8212 Fax. (970)384-3470
Parcel No.
Permit NO. SEPT -11-11-2287
Pemiit Type: Septic Permit
Work Classification: New
Permit Status: Active
Issue Date: 11/18/2011
Expires: 11/17/2012
Subdivision
Section
Township
Range
SG 13-35
PARACHUTE, CO
240935300130
Owner Information
Address
Phone
CeII
BOSELY SPRING CREEK RANCH LL CO
Contractor(s)
Phone
Primary Contractor
Williams Production RMT (970)285-9377
Yes
Proposed Construction 1 Details
Septic for STEH
FEES DUE
Fee
Amount
Septic Fee - New
Total:
$73.00
$73.00
Valuation:
Total Sq Feet:
$ 0.00
0
FEES PAID
Inv Total Paytype Amt Paid Amt Due
Inv # SEPT -11-11-21530
$ 73.00 Check # 00007185
$73.00
$ 0.00
Required Inspections:
For Inspections can : 1(888)868-5306
Inspection
IVR
See Perm it Record
Building Department
Copy
Friday, November 18, 2011 2
64,
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
www.earl field -county com
1
4)ci
Parcel No:(this information is available at the assessors office 970-945-9134) • ". r ' sr ' " l
2409-353-00-130
2
Job Address: (if an address has not been assigned, please provide Cr,Hwy or Street Name & City) or legal description
SG 13-35 See the attached plat for description.
3
Iii
Lot Size: Lot No: Block No: Subd/Exemption:
See Attached Survey Plat
4
/
Owner: (property owner)
Bosely Spring Creek
Ranch LLLC
Mailing Address
PO Box 26
Woody Creek, CO 81656
Ph:
970-923-8999
Alt Ph:
5
//// „ /I I
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 Request For: (X 1 New Installation f }Alteration ( 1 Repair
8
17 J ) DATE
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: ( ) Well ( } 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? NIA
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
Will 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
N/A
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: NIA
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 10 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 con'ons as deemed necessary to insure compliance with the rules and regulations made,
information and reports submitted herewith and required t...e subm tied by the applicant are or will be represented to be true and correct to the best of my
knowledge and belief and are designed to be relied on ' local -p. ment of health in evaluationg the same for purposes of issuing the permit applied for
herin. I further understand t any falsification or ' s - .: ntaimay result in the denial of the application or revocation of any permit granted based upon
said application and action for perju -' p .
...-
Girl.? %` -) // /4 ,
Owners Sign re: Bryan -. otard Dat
Permit f
4)ci
' Perk Fee:
Total ccs:
Iii
Building rcrn,lt t!_
Septic Permit #:
/
Pif
.1 B7
Issue Date:
//// „ /I I
Building Se Pi
nning
cpl:
APPROVAL..,.
17-
17 J ) DATE