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HomeMy WebLinkAboutApplicationGarfield County Community Development Department RECEIVED 108 8t" Street, Suite 401 Glenwood Springs, CO 81601 (970) 945-8212 GARFIELD COUNTYwww.garfield-county.com COMMUNITY DEVELOPMENT TYPE OF CONSTRUCTION X New Installation 0 Alteration ONSITE WASTEWATER TREATMENT SYSTEM (OWTS) PERMIT APPLICATION 0 Repair WASTE TYPE X Dwelling 0 Transient Use 0 Comm/Industrial 0 Other Describe 0 Non -Domestic INVOLVED PARTIES Property Owner: Bureau of Land Management Phone: Mailing Address: 2300 River Frontage Road Silt, CO 81652 Contractor: TEP Rocky Mountain LLC Phone: (970) 285-9377 Mailing Address: PO Box 370, Parachute, CO 81635 Engineer: Fox Engineering Solutions, Inc. Phone:j970) 250-5505 Mailing Address: 670 Canyon Creek Drive, Grand Junction, CO 81507 PROJECT NAME AND LOCATION Job Address: RWF 12-12 Pad Assessor's Parcel Number: 217511100956 Sub. Lot Block Building or Service Type: Small Temporary Employee Housing #Bedrooms: 5 Garbage Grinder : No Distance to Nearest Community Sewer System: NA Was an effort made to connect to the Community Sewer System: NA Type of OWTS Ground Conditions Final Disposal by Water Source & Type O Septic Tank 0 Aeration Plant O Recycling, Potable Use O Chemical Toilet X Vault 0 Vault Privy 0 Recycling l 0 Pit Privy 0 Composting Toilet 0 Incineration Toilet X Other Hauled by Civeo to Garfield and Mesa County Landfills Depth to 1't Ground water table NA O Absorption trench, Bed or Pit Percent Ground Slope NA 0 Underground Dispersal 0 Above Ground Dispersal O Evapotranspiration 0 Wastewater Pond 0 Sand Filter X Other Hauled by Civeo to Garfield and Mesa County Landfills O Well 0 Spring 0 Stream or Creek ❑ Cistern X Community Water System Name Clay of Rifle & Ute Water—Hauled by Civeo Effluent Will Effluent be discharged directly into waters of the State? 0 Yes X No CERTIFICATION Applicant acknowledges that the completeness of the application is conditional upon such further mandatory and additional test and reports as may be required by the local health department to be made and furnished by the applicant or by the local health department for purposed of the evaluation of the application; and the issuance of the permit is subject to such terms and conditions as deemed necessary to insure compliance with rules and regulations made, information and reports submitted herewith and required to be submitted by the applicant are or will be represented to be true and correct to the best of my knowledge and belief and are designed to be relied on by the local department of health in evaluating the same for purposes of issuing the permit applied for herein. I further understand that any falsification or misrepresentation may result in the denial of the application or revocation of any permit granted based upon said application and legal action for perjury as provided by law. I hereby acknowledge that I have read and understand the N have provided the required information w 'ch is correct a Z4,4) /Zif,e6 and Certification above as well as to to the best of my knowledge. Property Owner Print and Sign Date OFFICIAL USE ONLY IAI'd 1051/9 \Mei_ 1°715- °C Special Conditions: Permit Fee: Perk Fee: Total Fees: Fee Paid: Building PermitSeptic n itu Permit: - ir. - ` Issue Date: '1 I1 1 Ii Balance Due:© i4110 BLDG DIV: ~ -'i J ill ■ ~ 2 Cl/9 l APPRO 4&L DATE Reception#: 879861 0717812E16 02:18.46 PCI Jean Rlberloo 1 of 2 Rec Fee:$16.00 Doc Fee:0.00 GARFIELD COUNTY CO POWER OF ATTORNEY KNOW ALL PERSONS BY THESE PRESENTS: CONFORMED COPY THAT TEP ROCKY MOUNTAIN LLC, a Delaware limited liability company, hereby nominates, constitutes, and appoints Bryan S. Hotard, as its true and lawful Attorney -in -Fact to execute and deliver in the name and on behalf of TEP ROCKY MOUNTAIN LLC ("Principal") any of the following designated instruments or documents in connection with the Principal's operations in exploring for and producing oil, gas, or other minerals from lands, or interests in lands, owned, held, or claimed by the United States, any state or political subdivision thereof, any person, corporation, partnership or other legal entity: A. (1) Applications for permits or leases; (2) consents, stipulations, or agreements in connection with the issuance of permits or leases; (3) acceptances of leases, subleases, or permits; (4) acceptances of all instruments transferring leases, offers to lease, permits, applications for permits, or subleases, or an interest in any of these (including assignments of working or royalty interests) to Principal. B. Applications for extensions or renewals of leases and permits. C. (1) Prospecting, seismic, or exploration permits; (2) instruments in connection with the acquisition or maintenance of prospecting, seismic, or exploration permits. D. Instruments withdrawing applications for leases or permits. E. (1) Requests for rights-of-way and surface use permits; (2) acceptance of grants of rights-of-way and surface use permits, including any stipulation or condition in the grants; (3) any statements that may be required in connection with applications for rights-of-way and surface use permits. F. Requests for extension of time in which to drill wells. Principal agrees to be bound by all representations the Attorney -in -Fact may make in any instrument or document he or she is authorized to execute and deliver under this Power of Attorney. Principal hereby waives any defenses available to it to contest, negate, or disaffirm the actions of its Attorney -in -Fact under this Power of Attorney. This Power of Attorney is effective July 1, 2016, and shall continue in full force and effect until revoked in writing, and has the same force and effect as if the Principal granted separate special authority to the named Attorney -in -Fact to execute and deliver each such instrument or document separately for each and every such instrument or document so executed and delivered. EXECUTED by Principal on this 13°' day of July, 2016. Terra Energy Partners LLC as sole member of TEP Rocky Mountain LLC AGREED TO AND ACCEPTED BY: BY: Michael S. Land ITS: President and CEO n S. otard Attorney -in -Fact ACKNOWLEDGEMENT State of Texas County of Harris This instrument was acknowledged before me on � 3 , 2016 by Michael S. Land, known to me to be the President and CEO of Terra Energy Partners LLC, a Delaware corporation, on behalf of the corporation. (Notary Seal) • i.d, TIFFANY CEBELL POLLOCK Notary Public, Stote of Texos ;9: My Commission Expires April 26, 2019 RWF 12-12 Pad Vault System Description The site will temporarily office and house up to a maximum of eight individuals during natural gas drilling activities and is expected to be completed in one year or Tess. The individuals will occupy up to four individual units located on the well pad. Office/houses have Colorado Division of Housing compliance tags. Six above ground sewage holding tanks with 1500 -gallon (9000 -gallon total) capacity on-site. The Vault System is displayed in the pictures. Sewage flow is estimated to be 600 gallons per day (8 individuals x 75 gpcd). Sewage holding tanks need to be emptied approximately every 15 days (9000 gallons/ 600 gallons per day). Wastewater vault is equipped with overflow alarm device. Terra Energy Partners utilizes the services of a licensed contractor to remove and haul the wastewater to a state certified treatment/disposal facility. Two aboveground potable water tanks of approximately 3360 gallon capacity each on-site. "Potable Water Only" signs will be posted on tanks. Potable water demand is estimated to be 600 gallons per day (8 individuals x 75 gpcd). Required minimum fire suppression demand is 2500 gallons. Road access to the site is maintained year round through the services of a private road maintenance and construction contractor. Section 12 T. 6S, R. 94 W Daylight Line 1 (:\ To Ps°11 Ba stocKplie Ar Separators Area (75'x.302 } preaulpmen product Fret. a/nage I 2' High Soil Berm Boulder Armoring on Stream Bank 0 40 GRAPHIC SCA 1 INCH = 6 Install 48" CMP w/ Boulder Armoring on Stream Bank Daylight Line See Construction Layout Sheet for Well Designations Flare Unit 1 (10'x10) "0 NN m J Section 12 T. 6 S., R. 94 W. 6200 RWF \12 :12‘DRILL\ PAD JLQCA TION 1RAVfRT RESEWdorR' sog 11 T6S R94W L Webster Mesa 14 Rest. Acces lgoic Existing Road ACCESS DESCRIPTION: FROM THE 1-70 EXIT No. 87 (WEST RIFLE), PROCEED NOR INTERSECTION WITH A DIRT/GRAVEL ROAD, PROCEED LE THREE-WAY INTERSECTION WITH A DIRT/GRAVEL ROAD, MILES AN INTERSECTION WITH A DIRTY/GRAVEL ROAD, F THE EXISTING RWF 12-12 DRILL PAD LOCATION, AS SHO\ 0 1000 2000 GRAPHIC SCALE IN FEET 1 INCH = 2000 FEET TH ALONG STATE HIGHWAY 6 ±0.2 MILES TO AN FT IN A NORTHWESTERLY DIRECTION ±0.2 MILES TO A PROCEED RIGHT IN A NORTHEASTERLY DIRECTION ±0.7 ROCEED LEFT IN A NORTHERLY DIRECTION ±1 1 MILES TO N HEREON. 1.36 Cast Third Street .Ni,Rc, Culorwtlo 81604 P11. 070)525-2720 Pax 19701 625.27„Am73' SCALE: DATE: PLAT:: PROJECT OFT: 1" - 2000• 4/30/79 Construction Plan Prepared for: TERTEP Rocky Mountain LLC 5 of 7 TEP Vallerl CS RWF 124 2 Drill Pad - Plat 5 ACCESS ROAD 4a ?OPO MAP