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.garfield-county.com
- t 11 -may
Small Temporary Employee Housing
Administrative Checklist
GENERAL- INFORMATION — Submit 1 paper & 1 CD copy of the completed application to Planning Department wlin 48 hours following
occupation
(To be completed by the Small Facility Operator — e.g. well pad operator)
Section/Township/Range Location of Housing Site: Sec 36-T6S-R94W Well Pad Number: RWF 32-36
Tax Parcel Number for Parcel Containing Housing Site: 2175-363-00-062
GPS and/or Lat-Long Coordinates of Housing Facility Site (Often
included in APD): Lat: 39.485383 Long: -107.835544
Zone District: Rural
Maximum Number of Occupants at
Permitted Site (e,g. well pad): less than 8
Cumulative Amount of Time (in Days) The Facility Will be
at Location: 60days
State or Federal Permitting Agency Overseeing Reclamation, Restoration
and Revegetation and Relevant Permit Number: COGCC 400153252
Date of Installation: November 7th, 2011
Date of Removal: January 7th, 2012
Name of Landowner: Susanna M. Hoeppli
Street Address: PO Box 8531
Telephone: (970)379-0681
Email:
City: Aspen
State: CO
Zip Code: 81612
Name of Operator's Compliance Officer: Williams Production RMT Company LLC Bryan S. Hotard
Street Address: PO Box 370
Telephone: 970-285-9377 ext
2754
Email:
Bryan.Hotard(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 Garfield 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 Sheriffs 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: 500BBL/ 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 Sheriffs Office, Life/Care Flight, and applicable regulatory
agencies; site safety/evacuation plan; and any other written response plan for
potential emergencies at the Permitted Site.
vi. Identification of the anticipated dates of installation and removal of the Small Facility.
The site plan shall include a notation of the total cumulative length of time (number of
days) that the Small Facility will be installed at the Permitted Site.
ELIGIBILITY
Requirement (Section 7-808 (D)(3) — All Requirements
Must be Satisfied to be Eligible as a Small Facility
Applicant
Planning
Department
Complies (Y/N)
Complies (YIN)
The Small Facility and any associated infrastructure must
be completely contained within a state or federally
permitted parcel (such as a Colorado Oil and Gas
Conservation Commission (COGCC) approved oil/gas
well pad) in which reclamation and revegetation are
secured with the permitting agency (Permitted Site); and,
YES
The Small Facility is located at the Permitted Site for less
than a cumulative of 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:
354085433
Manufacture Year: 2008
Size of Unit (Square Feet):
14X56
Unit 2
Make: ATCO Structures (USA) Inc
Serial Number or Unit ID Number:
354063907
Manufacture Year: 2007
Size of Unit (Square Feet):
14X56
Unit 3
Make:
Serial Number or Unit ID Number:
Manufacture Year:
Size of Unit (Square Feet):
Unit 4
Make:
Serial Number or Unit ID Number:
Manufacture Year:
Size of Unit (Square Feet):
Unit 5
Make:
Serial Number or Unit ID Number:
Manufacture Year:
Size of Unit (Square Feet):
ISDS Permit
ISDS Permit Number: SEPT -11-11-2275
Signature of Operator's Compliance
��
/41r i��Officer: �,11771'
( By signing this form, 1 verify that all infor
the best of my knowledge)
Print Name: Brvan S. Hotard
ation prove• -d in
this checklist is correct and accurate to
Title: Attorney -In -Fact
4
Eligibility, Submittal and Performance Standards Certification
Section 7-808(D)(3) - Small Temporary Employee Housing Facilities (Small Facility(ies))
in Article VII — Standards, requires the that the following performance standards be met
with each facility:
Small Facilities, in the nature of Factory Built Nonresidential Structures [as defined under
C.R.S. 24-32-3302(a)] but NOT recreational vehicles [as defined under C.R.S. 42-1-102
(61), including truck, truck tractor, motor home or camper trailer], may be utilized for
housing of workers on projects related to commercial, industrial, mineral extraction or
highway operations, pursuant to the standards for Small Facilities contained in sub-
section (2), below. Such facilities are not subject to Garfield County building and fire
codes (building code, fire code). However, Small Facilities are subject to all pertinent
state (i.e. electrical permits), federal permits and relevant fire protection district(s) code
requirements.
Small Facilities shall have all of the following basic characteristics:
A. The Small Facility and any associated infrastructure must be completely contained
within a state or federally permitted parcel (such as a Colorado Oil and Gas
Conservation Commission (COGCC) approved oil/gas well pad) in which reclamation
and revegetation are secured with the permitting agency (Permitted Site); and,
B. The Small Facility is located at the Permitted Site for less than a cumulative of one
(1) year and at the end of the utilization period, all structures, foundations and
associated infrastructure are completely removed; and,
C. The Small Facility shall have an occupancy of eight (8) or fewer people who are
employees, contractors or sub -contractors of the operator of the small facility and are
needed for onsite safety of the related commercial, industrial, extraction or highway
operation.
Temporary employee housing facilities that do not have the three characteristics listed
above, or consist wholly or in part of Recreational Vehicles as defined above, are subject
to the administrative permit requirements or the Major Impact permit process, standards
and requirements contained in this document.
The Small Facility shall adhere to the following Standards: All required submittals (as
outlined in (2), above) shall be submitted to the Planning Department within 48 hours
following occupation of the Small Facility. Enforcement shall be in accordance with this
Resolution. The Small Facility shall demonstrate and certify compliance with the following
standards:
A. Small Facility must comply with all applicable federal, state and local laws and
regulations.
B. The Small Facility shall NOT contain recreational vehicles as defined in Section 7-
808 (0).
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
Togs/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.
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.Hotardtc'7 .williams.com Bob.Caughlin(a7williams.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:
Client:
Location:
Conducted By:
Date Conducted:
Paragraph
Reference
Fox Engineering Solutions LLC
670 Canyon Creek Drive, Grand Junction, CO 81507
Ph: (970) 250-5505 / Fax: (626) 784-0667
Email: coloradofox@bresnan.net
RWF 32-36 Small Temporary Employee Housing
Williams Production RMT
SW 1/4 NE 1/4 of Section 36, T6S, R94W, 6th P.M. Garfield County
David Fox, P.E.
November 7, 2011
Garfield County
Article 7-808(D)(3) Land Use Resolution 2008
Characteristic or Standard Description
3.a. Small Facilities, in the nature of Factory Built Nonresidential
Structures las defined under C.R.S. 24-32-3302(a)] but NOT
recreational vehicles las defined under C.R.S. 42-1-102 (61), including
truck, truck tractor, motor home or camper trailer], may be utilized
for housing of workers on projects related to commercial, industrial,
mineral extraction or highway operations, pursuant to the standards
for Small Facilities contained in subsection (2), below. Such facilities
are not subject to Garfield County building and fire codes (building
code, fire code). However, Small Facilities are subject to all pertinent
state (i.e. electrical permits), federal permits and relevant fire
protection district(s) code requirements.
3.a.(1)
3.a.(2)
3.a.(3)
1
The Small Facility and any associated infrastructure must be
completely contained within a state or federally permitted parcel
(such as a Colorado Oil and Gas Conservation Commission (CQGCC)
approved oil/gas well pad) in which reclamation and revegetation
are secured with the permitting agency (Permitted Site); and,
The Small Facility is located at the Permitted Site for less than a
cumulative of one (1) year and at the end of the utilization period, all
structures, foundations and associated infrastructure are completely
removed: and.
The Small Facility shall have an occupancy of eight (8) or fewer
people who are employees, contractors or sub -contractors of the
operator of the small facility and are needed for onsite safety of the
related commercial, industrial, extraction or highway operation.
Small Facility must comply with all applicable federal, state and local
laws and regulations.
2 The Small Facility shall NOT contain recreational vehicles as defined
in Section 7-808 (D).
Page 1 of 5
Inspection Comments
Colorado Division of Housing certifications noted on
Company trailer, ATCO Structures USA,Unit ID.
354085433 with Certification No. 19200
manufactured in 2008; and Driller's trailer, ATCO
Structures USA, Unit ID. 354063907 with
Certification No. 21940 manufactured in 2007. All
other aspects not subject to visual inspection and
certification by third party Professional Engineer.
Not subject to visual inspection and certification by
third party Professional Engineer.
Not subject to visual inspection and certification by
third party Professional Engineer.
Not subject to visual inspection and certification by
third party Professional Engineer.
Not subject to visual inspection and certification by
third party Professional Engineer.
No recreational vehicles observed on site.
RWF 32-36 Inspection Fox Engineering Solutions LLC
Williams Production RMT November 7, 2011
3 In no case shall unsafe water be used for drinking nor shall raw
sewage or contaminated water be discharged on the ground surface.
The operator shall conduct monthly tests (or quarterly if an on-site
disinfection system is installed) and maintain records of stored
potable water samples specific for coli form bacteria. Any tests
indicating coli form contamination must be disclosed to the Garfield
County Board of Health or designee within 72 hours from the time
the contaminated water was tested.
4 Each Small Facility shall be maintained in a clean, safe and sanitary
condition, free of weeds and refuse. Any hazardous or noxious
materials that must be stored at the Small Facility for operational or
security reasons must be managed in accordance with all applicable
federal, state and local laws and regulations.
5 At 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{sj 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
districts) 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
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 onsite. Individual
refuse containers in each office/housing structure.
Not subject to visual inspection and certification by
third party Professional Engineer.
No outdoor food storage observed on-site.
No active fire sprinkler systems observed in any of
the factory built non-residential structures. Smoke
detectors observed in all factory built non-
residential structures. Colorado Division of Housing
(CDH) compliance tags on all factory built non-
residential structures stating compliance with
nonresidental construction standards of the State of
Colorado.
Carbon monoxide detectors could not be located at
the time of inspection in both the company's and
driller's factory built non-residential structures.
Williams has provided written confirmation that
carbon monoxide detectors have been installed in
both factory built non-residential structures.
Fire extinguishers observed in all structures.
RWF 32-36 Inspection Fox Engineering Solutions LLC
Williams Production RMT November 7, 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 Sheriff's Office and relevant fire protection
district(s) shall be notified and provided with all documentation as
outlined in these regulations, within 48 hours following occupation of
each Small Facility. In addition, the Garfield County Sheriff's Office
and relevant fire protection district{s) shall be notified either by hard-
copy or electronically within 48 hours following removal of all Small
Facilities. The Planning Department shall be copied on all such
notification, whether hard copy or electronic.
16 The Operator shall maintain records identifying workers, whether
employees, contractors or sub -contractors, and document the dates
that each worker is housed at the Small Facility. Such records shall be
provided to the County or any additional third party upon request.
17 The Operator shall obtain a certification inspection conducted by a
third -party Professional Engineer Licensed in the State of Colorado.
The certification shall verify that at the time of inspection the
identified Small Facility meets or exceeds the standards set forth in
Article 7.808 D. 2. of the Garfield County Land Use Code of 2008, as
amended. This certification shall be on forms provided by the
Garfield County Planning Department. The certification shall be
provided to the Garfield County Planning Department within 48
hours following occupation of the Small Facility.
Page 3 of 5
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.
RWF 32-36 Inspection Fox Engineering Solutions LIC
Williams Production RMT November 7, 2011
i8 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 (ISDS): If an ISDS is Facility (eight
or less individuals) and shall otherwise be permitted and operated in
accordance with the Garfield County ISDS regulations as contained in
BOCC Resolution Number 1994H-136. proposed, then it shall be
designed, installed and operated to accommodate the maximum
number of persons who will inhabit the Small Facility (eight or less
individuals) and shall otherwise be permitted and operated in
accordance with the Garfield County ISDS regulations as contained in
BOCC Resolution Number 1994H-136.
Page 4 of 5
Not subject to visual inspection and certification by
third party Professional Engineer.
One aboveground sewage holding tank with 4000 -
gallon capacity on-site. Sewage flows estimated to
be 300 gallons/day (4 individuals x 75 gpcd).
Sewage holding tanks need to be emptied
approximately every 13.3 days (4000 gallons / 300
gallons per day). Wastewater vault equipped with
overflow alarm device.
Not subject to visual inspection and certification by
third party Professional Engineer.
Not subject to visual inspection and certification by
third party Professional Engineer.
Not subject to visual inspection and certification by
third party Professional Engineer.
RWF 32-36 Inspection Fox Engineering Solutions LLC
Williams Production RMT November 7, 2011
1 hereby attest that l am a Licensed Professional Engineer in the State of Colorado. l attest that l have conducted a
visual inspection of the Small Facility identified in this Administrative Checklist, as installed, and, based on
information from that inspection l 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 (0) (3) of the Unified Land Use
Resolution of 2008, for Garfield County, Colorado.
PE Certification Number: No. 25420 (Colorado
Date of Inspection: November 7, 2011
Print Name and Title: vid J. Fox, Principal Engineer
Signature:
Page 5 of 5
PE Stamp
Williams Production RMT
RWF 32-36 Well Pad
Aeeras OPECRIFMON,
ERON THE INTEN0EOTION OF STATE HIGHWAY 3 AND couNTY RCMOTI00O3 NOR at 3 NULISO0 ount:.SOUlimPety
08010800
Al ONG 0?o2.Y ROAD 773 11,1 MR FS TO THE NTFRSFCTION AM COUNTY ROAD to PROCEEDI.E0T 1N AN EASTF.RLT
DIRECTION 12.3 8065 TO TME INTERSECTION WRY COVNIN ROM 320, PROCEED R0;0r IN AN EASTERLY [ERECTIONION
MED TO THE INTERSECTION WITH COUNTY ROAD 713 S9a+•—G000 NNW). PROCEED R[d1T IN A SOl1n1ERLY DIRECTION
1.1 MILES TO TRE INTERSECTION Wins ADIRTON.400L ROAD, PROCEED RIP/win AN wESIERLY DIRECTION sa,L PILED
TO THE EXISTING RWF S2.N DRILL PAD LOCATION AS CHOPIN HEREON.
23,IT' r '
1304300 K N.,.,, Yo
Directions to Site -
1:F .00.4N+
Sheds -
Drilling Contractor
Office/Housing
(2-bdrm.).
4000 -gallon above -
ground Wastewater
Vault
Enrr Lend
aruaalew,°a
ROa� r
Three Fodeble
Toilets
Cxx1`-
4
III Edon. o7 577S7
4000 -gallon Above ground _,^I
Potable Water Cistern with
Dry Fire Hydrant
Williams Representative'
Office/Housing (2-bm111 )
kale Venn
L!�
EUAa mE.:e
• M4 --��
Booxc
•• SunryServices, Inc.
Wildlife -proof
Dumpster
AATS• ,
4
rum' •ent%
n,
Conatruetion Plan Prepared for:
Wiiljams Production, RMT
RWF,Y2-36 2o071+.d- PMr 4
18171. RIG 7.AAt'LVU7'
Emergency Contact List;
Main Office', 970-285-9377 answered 24 Hours
Bob Brown- Dulling 970.309.5479 Cell
Scott Brady- Williams Drilling Sup -970-279-9187 Cell
Kevin McDermott- Williams Safety -970-308-1195 Cell
Mark Mumhy - Spill Contractor 970-260.1076 Cell
Willis s4
The wel! pad site is located in the SW 1/4 NE 1/4 of Section 30, TES, R94W,
61h P.M. (NAD83 N39.4853° W107.8355°)
The site will temporarily office and house up to a maximum of four individuals
during natural gas drilling activities and is expected to be completed in one
year or less. The individuals will occupy two individual trailer offices/houses
located on the well pad. Office/houses have Colorado Division of Housing
compliance tags.
One aboveground sewage holding tank with 4000 -gallon capacity on-site.
Sewage flows estimated to be 300 gallons/day (4 individuals x 75 gpcd).
Sewage holding tank needs to be emptied approximately every 13.3 days
(4000 gallons 1300 gallons per day). Wastewater vault equipped with overflow
alarm device. Williams utilizes the seryices of a licensed contractor to
remove and haul the wastewater to a State certified ireatmenl/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 geed(. Required minimum fire suppression demand is 2500
gallons. Total potable and fire suppression volume required is estimated to be
4000 gallons. Water supply appears adequate with 4000 gallons of storage
with refills scheduled at 5 -day intervals. Dry hydrants observed on water tank,
Road access to the site is maintained year-round through the services of
private road maintenance and construction contractors.
Factory -Built Nonresidential Structures (Office/Housing) have a minimum
separation distance of 33 ft.
Base mapping by Bookcliff Surveying Services. Inc.. Site features including
housing trailers, water and wastewater tanks, portable toilets and dumpster
located with Trimble Geo -XT GPS equipment. Please note that this is a
construction site and that the locations of dull equipment and other items are
subject to change.
RWF 32-36 Site Plan
Garfield County, Colorado
Small Temporary Employee Housing and
Septic Permit Application
Applicant: Williams Production RMT
Date: November 7, 2011 Checked: DJ
Fox Engineering Solutions LLC
670 Carron Creek Drive. Grand Junction, CO 81507
Ph: 070250-55051 Fax (626) 784-0667
Email: coieradafax0bresnan.net
Version, 001
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 Susanna M. Hoeppli
Property Owner (hereinafter OWNER) agree as follows:
1. OWNER has submitted to COUNTY an application for
RWF 32-36 pad location STEH &ISDS (hereinafter, THE PROJECT).
2. OWNER understands and agrees that Garfield County Resolution No. 98-09, as
amended, establishes a fee schedule for each type of subdivision or land use review
applications, and the guidelines for the administration of the fee structure.
3. OWNER and COUNTY agree that because of the size, nature or scope of the
proposed project, it is not possible at this time to ascertain the full extent of the costs
involved in processing the application. OWNER agrees to make payment of the Base Fee,
established for the PROJECT, and to thereafter permit additional costs to be billed to
OWNER. OWNER agrees to make additional payments upon notification by the COUNTY
when they are necessary as costs are incurred.
4. The Base Fee shall be in addition to and exclusive of any cost for publication or
cost of consulting service determined necessary by the Board of County Commissioners for
the consideration of an application or additional COUNTY staff time or expense not covered
by the Base Fee. If actual recorded costs exceed the initial Base Fee, OWNER shall pay
additional billings to COUNTY to reimburse the COUNTY for the processing of the
PROJECT mentioned above. OWNER acknowledges that all billing shall be paid prior to
the final consideration by the COUNTY of any land use permit, zoning amendment, or
subdivision plan.
PROPERTY OWNER (O HORIZED REPRESENTATIVE)
�.. Aiezv
Signa ore OF Date
Bryan S. Hotard
Print Name
Mailing Address:
///:ba
Williams Production RMT Company LLC
PO Box 370, Parachute, CO 81635
Page 4
Bonuales, Gia
From: Bonuales, Gia
Sent: Tuesday, November 08, 2011 9:09 AM
To: 'jsears@garcosheriff.com'; 'Julie Taylor'
Cc: Reed, Gary
Subject: RWF 32-36 Rig Move On Notification
Attachments: RWF 32-36 Sheriff Letter & Map dated 11-08-11.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
housi ng.
This notification is per the GARCO Regulations for our pad located in Sec 36- T65-R94W. 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.
Thank you and have a great day!
Cin 3onualc�
Land Data Technician I
Williams Production RMT Company LLC
1058 County Road 215/PO Box 370
Parachute, Co 81635
970.263.2746 -Office
970.216.8537 -Cell
970.285 -2047 -Fax
gia.bonuales@williams.com
1
November 8th, 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
RWF 32-36 pad
Dear Jim:
Williams.
Williams Production RMT Company LLC
1058 CR #215
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 RWF 32-36 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
RWF 32-36 Well Pad
7tS.R
fit
T , RPP!
20 ;„
26
; rj
---
M1
}
- ILS. ��� • •'�
R irF7 3$ MYON "-IC I
PAP lQG1•T',ON'
PD 0 TRW
GRED Ac t AvowAE VFEET
Pcc<ss urwAPTON
FROM THE PTERSECflOH DF STATE leper. a Nr0 COUITV 20.02373 YDRTM Dc fortiSGI- PROCEED SDJTIEIts
450110 COUNTY ROAD 373 t+.irk FS TO 1115 anrsorescat Wt. Moan r*OA,9 300. PROCFFo L FP. te AR FA.S2FRLY
DREcrx)v z2.7 'ALES TO TME PRERSECJ15II NTN COUNTY ROM 320. PROCEE0 Rirf,T PI AN EASTERLY OSIEG1d1 vIt.•
1.5150 00 THE NTERSECT0M W11N COUNTY' ROAD312!sell+Cnrx AGRI). PROCEED RIORT INA SWTT EFO Y OKECYIOI
el ATILEA 'RE NTE ASCETION Wim A 0ITCTAVEL ROAD.PROCEED MOW IN n$WE STEELY DIREC1gN APA RILES
TO TRE v-esnrre. WF 223ecorm.PAOI,OcPTON AS E etrwri HErrECVO
SGV. yl
PA,RAT Jtcttf
I7wf.
Construction Plan Prepared for:
Waams Moms Production, RMT
Padra'rt.
yin �.
RWF.72-36 AAA' Pori - r.S
ACCCAS ROAD MAP
Directions to Site;
aSw.Ael an
r ns,,vv Ir
Sheds.
Dolling Corxraaor
D7ceiHousing
(2 -Mlle.(
l000 -gallon above
ground Wastewater
vault
er tam.
erC:
ria
Three Portable
Toilers
r
n
•
4000-gaIIDn Above ground —t—so :33
Potable Water Cistern with
Dry Fore Hydrant
wince Rcpeser51abve
Office/Hos3slrg (2-bdwa.)
Shed
l su
C...r In..,
B00KCLIFF
- t Sim+ry Serrrrcr, In.-
S1f (_(m
0.1112
Pur
EMMYr u .L
ABB/Ma-proof
twePeier
onatruetlon -Ian Prepared for:
klrrnlrif14 Williams Production, RMT
MVP 32,14 /704// Prod - Nat 4
nRILL RIO LA rvur
Emergency Contact List:
Main Orrwe: 970-265-6377 answered 24 Hours
Dob DIawtl- wit gems Onlhng 974309.5479 Cell
Scott Brady. Wapams Cniteg Sup670.2749197 Cdl
xevm MoPermOl• W iikams Safety -970-309-1195 C514
Marx MLmby • Srall Corefatter 570-260-1576 Cell
Williams.
Notes;
The well pad site is located in the SW 1/4 NE 1/4 of Section 36, TGS. RG4W,
6th P.M. (NAD83 N35.4853e W107.83551
The site will temporarily office and house up to a maximum of four individuals
during natural gas drifting 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 -sue
Sewage flows estimated to be 300 gatIons/day (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 to
remove and haul the wastewater to a State certified treatment/disposal facility.
One potable aboveground water tank of a0Oroximately 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 i5 2500
gallons. Total potable and fire suppreSslOn volume required i5 estimated l0 be
4000 gallons. Water supply appears adequate with 4000 gallons of storage
with refills scheduled at 5 -day intervals. Dry hydrants observed an water tank.
Road access to the site is maintained year-round through the services of
private road maintenance and construction contractors.
Factory -Built Nonresidential Structures (Office/Housing) have a minimum
separation distance of 33 ft.
Base mapping by Bookcliff Surveying Services, Inc.. Site features including
housing trailers, water and wastewater tanks, portable toilets and dumpster
located with Trimble Geo -X1 GPS equipment. Pease note that this is a
construction sae and that the locations of dna equipment and other items are
subject to change.
RWF 32-36 Site Plan
Garfield County, Colorado
Small Temporary Employee Housing and
Septic Permit Application
Applicant: Williams Production RMT
Date. November 7. 7011
Checked DF Verson 00,
Fox Engineering Solutions LLC
670 Canyon Creek Drove, Grand Junction, CO 91507
P5'. (9701250.55051 Fax (620) 764-0667
Errol. eoloradofoxt8abresnen.ner
Bonuales, Gia
From: Bonuales, Gia
Sent: Tuesday, November 08, 2011 9:08 AM
To: 'Kevin Whelan'; 'Julie Taylor'
Cc: Reed, Gary
Subject: RWF 32-36 Rig Move On Notification
Attachments: RWF 32-36 RFPD Letter & Map dated 11-08-11.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 36- T6S-R94W. 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.
Thank you and have a great day!
Cis
rri3onuni��
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@wiiliams.com
1
Whams.
Williams Production RMT Company LLC
1058 CR #215
PO. Box 370
Parachute, CO 81635-0370
970/285-9377
970/285-9573 Fax
November 8th, 2011
Rifle Fire Protection District
Emergency Operations
Attn: Kevin Whelan
1850 Railroad Ave
Rifle, CO 81650
Ph: 970-625-1243
RE: Emergency Response Notification
RWF 32-36 pad
Dear Kevin:
This letter is to inform the Rifle 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 RWF 32-36 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
RWF 32-36 Well Pad
F Sc5 aE sc-wt e
RON rtsE PCSRSECnO.Or STRTE wCMvwv! n Came,. W.0 LT3 NOP,.OF au4ROe. epOCEEY 720* IKy
AL OHC COI.3.3 072 Vj!11EA FS TOTNT enTRSFCTIORMel• c172 RW 2109.P'2*0E01 Frt Ie PHTas•rt- av
OIRECTOtl °74 WRtES TO TME NTER}Eu1Or. W1 N -Occur RAM AD, MOCEED RICH• M IN FASTEM.Y DIRECTION Q.•
.1.7 TO TIE lite 545-ip1WiTh Nin. ROAD }IT 1p�prME RawaI. 7247gDRxx1T N.� 90VMEAT Mgr -CI -ION
.1., 'ALES VO THE INrt2!EC TOY wlrr. ADIRr5DRi5E.RP., PROCEED Amin Ml N. weaTERce aRECnDN •e}wLES
TO THE EXISTING RVR .12.34 EMIL PAO LOCATgN RS SIgwM rEREON
Construe Lien Plan Prepared kir:near ,'i,
!is' wpiams Production, RMT
0
MIT RWP 32.36 D it /bd - Prom 5
PELVP.T WlGr°-raw
ACCF.-SS .COAD MAF
Directions to Site.
_)2
Sheds _
Detling Contractor
OIBc&Housing
(2-Edss
4000-gahon above -
ground Wastewater
Vault
4090-gallsn Above ground ._LI _ ' :33 ft
a.m. Ler+
daeMMM
1
111
Potable Wale Cistern with
Dry Fire Hydrant
Witlams Repeend0ve
OffcerHo.aing (2-bdrm.)
Shad
O
•
k
n°11 -1n
.3
1
1•
w,ldhle-proof
(Jumpster
Construct en 'tan • repared for:
waianis Williams Production, RMT
RW, .1246 JM7l ped- rice
17R/!.!. RIG U 177(7
Emergency Contact List'
Main Office. 970.2859377 answered 24 Hours
Bob Brown- Wd tarns Dishing 970-309.5479 Cell
Sion Beady. Maras path.] Sop -070-27041187 CNI
Kevin Materna- Willrams Safety -974309-1195 Cell
Mani Mutt), - Stir Contractor 570-2847578 Cell
Williams.
The well pad site is located 4 the SW 1/4 NE 714 of Section 36, TES, R94W,
6th P.M. (NA C183 N30.4853° W107,8355°)
The site will temporarily office and house 40 to a maximum Of four individuals
dunng natural gas drilling activities and is expected to be completed in one
year or less. The dndividuals will occupy two Individual trailer Officeslhpuses
located on the well pad. Office/houses have Colorado Division of Housing
compliance tags.
One aboveground sewage holding lank wan 4000 -gallon capacity on-site
Sewage flows estimated to be 300 gallons/day (4 individuals x 75 gpcd)
Sewage holding tank needs to be emptied approximately every 13.3 days
(4000 gallons / 300 gauons 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 treatmentldiaposal facility.
One potable aboveground water tank of approximately 4000 gallons capacity
on-site. Potable water demand is estimated to be 300 potions/clay (4
indiv144815 x 75 gpcd). Required minimum fire suppression demand is 2500
gabon5. 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 lank.
Road access 10 the site is maintained year-round through the services of
private road maintenance and construction cOntraCtOrs-
Faclory•Built Nonresidential Structures (Office/Housing) have a minimum
separation distance of 33 ft.
Base mapping by BookcIiff Surveying Services, 1nc.. Site features including
housing trailers. water and wastewater tank5, minable toilel5 and dumpster
,located 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.
RWF 32-36 Site Plan
Garfield County, Colorado
Small Temporary Employee Housing and
Septic Permit Application
Applicant: Williams Production RMT
pate_ November 7. 2011 Checked, D3°
Fox Engineering Solutions LLC
870 Canyon Creek ()nye, Grand Junction. CO 81507
726. (979) 750-5505 1 Fax_ (528) 769-0487
Enol, cvl,radolox@bresnan_nel
Version. 001
Section 36
T,6S.,R94W
Exist Limit
of Disturbance
'sa• erS
It"REF. PNr
A - NW #7 _ - _`
1' 0,0T-,_ 139'
I
13
5410
C
Edge of Exrst.
Deft Pad
P oop. RWF 31.36*
Prop. RWF 635.360
P r6p- RWF 42.360
Prop RWF 342-360
W pY, 83'
F 0.0' 132' Prop. RYYF 32-36
1 c 0.0'-)
6420 i
50'
�I
5.3
I
I le
-I �f?,
I // I
•
U t
NEC
N€ M6 143' CAA'
F0.0'� '1
Ew11
�I> +r �
X ft }
Ex. RWF-�31-38 X
Pro P. Rnvir�r 341.96
R RWF 441-36
Prop. RWF 611.38
L .o RWRWFF44542.2-3836X
Pra.
Ex. RWF 343-36
81'
X
�Iw
r East Prolu 6nrr
1 Eou4 neM
SW #51, E411 fie,eo 141'
co.o'��_�--.
50,905
REF, PWT.
Jti
Exist. Limit
of Disturbance
ESTIMATED EARTHWORK QUANTITIES (cy)
ITEM
CUT
FILL
TOPSOIL
EXCESS
PAD
0
0
0
0
PIT
0
0
TOTALS
0
0
0
0
1
�, 14
4 ▪ r 1 }
50 0 100
AA
\EC#2----_BB
97' Cao'
sq
c 0..0.
-6450-
ri.-* s -a•
1*. A7
• Ni0 6+ 623232 V
P.. rom users
J
i
BOOKC/JFF
',Slowly Services, Itic,
SCALE: 1' 100'
DATE: 3/29111
PLAT.: 2 of 7
PROJECT: WPINams Vofle11
DFT. cws
GRAPHIC SCALE IN FEET
1 RICH= 100 FEET
'NOTE:
1.} Total Disturbed Area C 5.79 ac.
Construction Plan Prepared for:
Willi 1us Williams Production, RMT
RWF 32-36 Drill Pad - Plat 2
CONSTRUCTION LAYOUT
Section 36
T 6S,R94W
I ItwYi I I
, 1 J .
I I! • ,,.
i� 1! i .-r.11.%:"-j/
•
flet -� I:'1'I �.
f 3 . Fl a ti'ron
t•, I' • iL` .•
1000
0
,4
2000
GRAPHIC SCALE IN FEET
1 INCH =2000FEET
ACCESS DESCRIPTION:
FROM THE INTERSECTION OF STATE HIGHWAY 6 AND COUNTY ROAD 323 NORTH OF RULISON, PROCEED SOUTHERLY
ALONG COUNTY ROAD 323 ±1.1 MILES TO THE INTERSECTION WITH COUNTY ROAD 309, PROCEED LEFT IN AN EASTERLY
DIRECTION ±2.3 MILES TO THE INTERSECTION WITH COUNTY ROAD 320, PROCEED RIGHT IN AN EASTERLY DIRECTION 2.6.1
MILES TO THE INTERSECTION WITH COUNTY ROAD 317 (Beaver Creek Road), PROCEED RIGHT IN A SOUTHERLY DIRECTION
±1.7 MILES TO THE INTERSECTION WITH A DIRT/GRAVEL ROAD, PROCEED RIGHT IN AN WESTERLY DIRECTION /D.4 MILES
TO THE EXISTING RWF 32-36 DRILL PAD LOCATION, AS SHOWN HEREON.
lip I.M1r1.1+••i
I� r970160M0
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SCALE: 1 = 2000'
DA7E: 3429/11
PM.47 of 7
Matter WiII+pme Valley
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Construction Plan Prepared for:
Wiii1iai Williams Production, RMT
RWF 32-36 Drill Pad -• Plat 5
ACCESS ROAD MAP
STATEMENT OF AUTHORITY
Pursuant to C.R.S. §38--30-172, the undersigned executes this
Statement of Authority on behalf of Susanna M. Hoeppli.
a N/A (corporation, .limited liability Company,
general partnership, registered limited liability partnership,
registered limited liability limited partnership, limited partnership
association, government agency, trust or other), an entity other than
an individual, capable of holding title to real property (the
"Entity"), and states as follows:
The name of the Entity is N/A and
is formed under the laws of
The mailing address for the Entity is PO Box 8531 Aspen, CO
81612
The name and/or position of the person authorized to execute
instruments conveying, encumbering, or otherwise affecting title to
real property on behalf of the Entity is Susanna M. Hoeppli
The limitations upon the authority of the person named above or
holding the position described above to bind the Entity are as
follows: For Signature on Garfield County permits on behalf
of the Landowner that pertain to the Pads located on the landowners
PrOPertY'• (if no limitations, insert "None")
Other matters concerning the manner in which the Entity deals with
any interest in real property are: 3 Pads are GV 15-36, RWF
RWF 32-36
(if no other matter, leave this section blank)
EXECUT • is ,P day of /
Signatur �� '•
Name typed: Susanna" Ho ppli
Title (if any):
STATE OF Colorado
COUNTY OF Garfield
)SS,
}
, 2009.
On the 2day of 1\ \Lif 2009, personally appeared Suaanna M. Hoeppli,
to me known to be the person described in and who executed the foregoing
instrument and acknowledged that they executed same as their free and
voluntary act and deed for the uses and purposes therein set forth.
Witness my hand and official seal the day and year first above written.
My commission expires: 616/202.
JESSICA.
NOTARY FpBLI
STATE OF.001,0
January 5, 2010
Mr. Fred Jannan
Director
Garfield County Building and
Planning Department
108 8°` Street, 4th Floor
Glenwood Springs, CO 81601
RE: GV 15-36; RWF 32-36 and RWF 33-36
drilling pad locations,
Garfield County, Colorado
Dear Mr. Jarman:
This letter authorizes Williams Production RMT Co. to represent me in the submittal and
processing of the required Garfield County Small Temporary Employee Housing (STEH)
and Individual Sewage Disposal System (ISDS) permits on the above drilling pad locations.
Sincerely,
Susanna M. Hoeppli
KI K&IMAM Kt 1114014WIN WA1W X11
Racr�pplionq; 805426
071Ig1201t 04.28_'23 PJ Jun A Ids
t ui 2 Rso fay fta f0 Dae F�.S X160 0o•ITT OA
LIMITED POWER OF ATTORNEY
WILLIAMS PRODUCTION RMT COMPANY LLC ('"Company") a Delaware
limited liability company, having its principal place of business in the City of Tulsa, County of
Tulsa, State of Oklahoma, deed hereby make, constitute and appoint Bryan S. Retard with the
frill authority hereinafter provided, the true and lawful A erney-in-Foot of the Company,
authorized end empowered on behalf of the Company and in the Company's name, and far the
sole end exclusive berrett of the Company and not on behalf of any otter perm, corporation or
association, in whole or in put, to anter into, execute, deliver, file and accept all instruments and
documents affecting the real property or real estate rights of the Company including but not
limited to, the following described instnttnenta and doetatmnls:
1. Applications and documentation associated with Garfield County or Rio Blanco
permitting requirements, including, but not limited to, Independent Sewage Disposal
Systeme, Small Temporary Employee Sousing, Major Impact Reviews, Limited Impact
Reviews, Oil and Gas well permitting, Driveway Access, County Road Maintenance,
Temporary Living Quartan, Temporary Use Permute, Surface Use Permita, Surfece Use
Licenses, Utilitiea, Snow Removal and Private Construction of County Roads;
2, Agreements and other doeuanentaion that grant casements, rights of way, licensee, or
permits to Company and also instruments where the Company giants such rights to
others;
3. Agreements that assign easements, rights of way, licenses, permits or surface leas in
connection with the Company's operations;
4. Releases and Partial Releases of easements and rights of way;
S. Agreements allowing encroachments ones easements and rights of way owned by
Company and landowner iutetiu rata and conveyance' on others eaaernenta;
6. Agreements subordinating tee,ernent at leasee to mortgage rights;
7. Agreements Mating to the modification and relocation of Company facilities;
S. Rental or lease agreements for surface use or other blacken use agreements end all notices
related to the pipeline agreements;
9. Agreements for the purchase ar sale of real property and for the lease cereal property for
residential purposes or otherwise in connection with the Company's operations;
10, Agreements to obtain water strviccs, electrical, gas or oil service' or the provision of
other utility services utilized by Company's facilities;
11. Agreements modifying, amending, renewing, extending, ratifying forfeiting, canceling
and terminating any and all of the aforementioned types of instruments and documents.
The Company hereby declares that each and every act, master and thing which
shall be given, made and done by Bryan S. Hotard in connection with the exercise of any or all
of the aforesaid powers shall be as good, valid and effectual to all intents and purposes as if the
same bad been given, made and done by the Company in its limited liebrlity company presence
and it hereby ratifies whatsoever Attorney -in -Fact shall lawfully do ar cause to be done by virtue
hereof; nig Limited Power of Attorney shall ramaim in Atli force and effect until terminated by
Comptay.
IIIIIRICWO/H141110M1011Nikil III II
rra�aisai�,rN:`e�alzpa� J� Arb.rsw
t oI * aw F..:141.0* oao Fur::.B1 Cf flCLA Oda�i: 00
IN WITNESS WI EABOB, the Company has caused this Limited Power of Attorney to
be signed by one of its Vice presidents, duly authorized by its Management Committee to grant
powers of attorney this j j lay of Icily, 2011.
WIL r h1S ' • (30U wtttf,►.L . COMPANY LLC
By:
es
Its:,,Pace Pres'.ent
ACKNOWLEDGMENT
STAT OF OKLAHOMA )'
8!.
coug a of TULSA
BEFORE MR, the undersigned authority, a Notary Public In and for said County and State,
on his day personally appeared, lorry D. Barnes personally known to me to be the Vioc Prevideat of
WILLIAMS PRODUCTION AMT COMPANY LLC a Delaware limited liability company, who
acknowledged to me the he has executed the above LIMITED POWER OF ATTORNEY authorized
by Company's Management Committee.
IN WITNESS WHEREOF, I have hereunto set my /and and a tiixad my notary mal, the 1,
day of July, 2011.
My Comrntsa1an Eix.pira : 2, _ 2.3 - 2 Q I r--}
AEIEBAECORQUOLELEasEamiliaLIQ
WLLiAMS PRODUCTION CO RMT LLC
ATTN: LAND DEPT.
P.O. BOX 370
PARACHUTE, CO 81635
2
Project Address
Garfield County
Building & Planning Department
108 8th Street Suite 401
Glenwood Springs, CO 81601 -
Phone: (970)945-8212 Fax: (970)384-3470
2309 RWF 32-36 CR 317
RIFLE, CO
Owner Information
Susanna Hoeppli
Parcel No.
Permit NO. SEPT -11-11-2275
Permit Type: Septic Permit
Work Classification:: New
Permit Status: Active
Issue Date: 11/3/2011
Expires: 11102/2012
217536300062
Address
Subdivision
Phone
Section Township Range
Cell
PO Box 8531
Aspen CO 81612
Contractor(s)
Phone
Primary Contractor
Proposed Construction ! Details
Temporary employee housing for RWF 32-36
FEES DUE
Fee
Septic Fee - New
Total:
Amount
$73.00
$73.00
Valuation:
Total Sq Feet:
FEES PAID
$ 0.00
0
Inv Total Paytype Amt Paid Amt Due
Inv # SEPT -11-11-2150S
$ 73.00 Check # 7179
$73.00
$ 0.00
Required Inspections:
For Inspections call : 1(888)868-5306
Inspection
IVR
See Permit Record
Building Department
Copy
Thursday, November 3, 2011 2
Permit Fee:
Perk Fee:
Total fees:
Building Permit #:
Septic Permit #:
Issue Date;
Buildtn ng Dep t"-+
4, .,--., Awes) Yi.- dt/j/A6. PAZ(
_f_S, ,y
APPR+
I DATE if
GARFIELD COUNTY SEPTIC PERMIT APPLICATION
1088 -Street, Suite401, Glenwood Springs, CO 81601
Phone: 970-945-82121 Fax: 970-384-34701 Inspection Line: 970-384-5003
www.garfield-countv.com
NOV 1 2011
1
Parcel No:(this information is available at the assessors office 970-945-9134)LI1Nt`r, I fav �lji.J l
2't81=244.00' O88- o 1.1-3- 36-5-- 00-OC92, 3UILDING & PLANNI
2
Job Address: (if an address has not been assigned, please provide Cr,Hwy or Street Name & City) or legal description
RWF 32-36 See the attached plat for description.
3
Lot Size: Lot No: Block No: Subd/Exemption:
See Attached Survey Plat
4
Owner: (property owner)
Susanna M. Hoeppli
Mailing Address
PO Box 8531
Aspen, CO 81612
Ph:
970-379-0681
Alt Ph:
5
Contractor
Williams Production
RMT Company LLC
PO Box 370, Parachute, CO
81635
Ph:
970-285-9377 ext 2754
Alt Ph:
6
Engineer:
NIA
Mailing Address
Ph:
Alt Ph:
7
Permit Request For: (X ) New Installation ( 1 Alteration f 1 Repair
8
Waste Type: (X ) Dwelling ( ) Tranient Use ( ) Commercial or Industrial ( ) Non- Domestic Wastes
( ) Other- Describe
9
Building Or Service Type:
Number of Bedrooms: 2 Garbage Grinder ( ) Yes (X )No
10
Source & Type of Water Supply: ( } Well ( ) Spring ( ) Stream Or Creek ( } Cistern
if supplied by COMMUNITY WATER, give name of supplier: Down Valley Septic and Waste
1 1
Distance to Nearest Community Sewer
Was there an effort to connect to the
System:
_NIA
community System? N/A
YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITH OUT A SITE PLAN
12
Ground Conditions:
Depth to ist Ground Water Table N/A Percent Ground Slope N/A
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:NIIA
17
Applicant acknowldges that the completeness of the application is conditional upon such further mandatiory and additional test and reports as may be required
by the local health department to be made and furnished by the applicant or by the local health department for purposed of the evaluation of the application;
and the issuance of the permit is subject to such terms and conditi.ns as deemed necessary to insure compliance with the rules and regulations made,
information and reports submitted herewith and required to b +m ted 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 b a . ep- ment of health in evatuationg the same for purposes of issuing the permit applied for
herin. I further understa d that any falsification or rills Ale n ntaio may result in the denial of the application r revocation of any permit granted based upon
said application a gal action for per .,.y�.�% . . +
Owners Sig ure: Bryan S. .tard Date