HomeMy WebLinkAbout3.4.4 STEH PermitGARFIELD COUNTY
Building and Planning Department
108 8 to Street, Suite 401
Glenwood Springs, Colorado 81601
Telephone: (970) 945-8212 Facsimile: (970) 384-3470
www.carfield-county.com
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 5-T7S-R95W Well Pad Number: GV 82-5
Tax Parcel Number for Parcel Containing Housing Site: 2407-081-00-152
GPS and/or Lat-Long Coordinates of Housing Facility
Site (Often included in APD):
Zone District: Planned Unit Development
Maximum Number of Occupants at
Permitted Site (e.g. well pad):
Cumulative Amount of Time (in Days) The Facility Will
be at Location:
State or Federal Permitting Agency Overseeing Reclamation,
Restoration and Revegetation and Relevant Permit Number:
Date of Installation:
Date of Removal:
Name of Landowner: Battlement Mesa Land investments
Street Address:
73 G Sipprelle Dr/ PO Box 6000
Telephone: 970- 285-9740
Fax: 970-285-9721
Email:
eschmela(a�battlem
entmesa.com
City: Parachute
State: CO
Zip Code: 81635
Name of Operator's Compliance Officer: Williams Production RMT CO Sandy Hotard
Street Address: PO Box 370
Telephone: 970-285-9377 ext
2288
Email:
Sandy.Hotard(a�willi
ams.com
City: Parachute
State: CO
Zip Code: 81635
Company 24 -Hour Emergency Contact: Williams Production RMT CO Phone Number: 970-285-9377
This Administrative Checklist must be received by the Garfield County Planning Department
hours following occupancy of the Small Facility.
within 48
be delivered to
within 48 hours
Office and
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 Sheriffsrecelpt)
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 Sheriff's Office.
2. Application to the County
B. Review Process. Prior to submittal of any forms to the Planning Department, the applicant
shall submit all documents to the relevant fire protection district(s) and the Garfield County
Sheriff's Office. All forms shall be accurately completed, signed, dated and submitted to the
Garfield County Planning Department within 48 hours following occupation of the Small
Facility.
C. Submittal Requirements. The application submitted to the County shall contain the following
information:
i. A vicinity map indicating the section, township, and range of the subject lot and the location
of Small Facility within the subject lot and the Permitted Site; general relation to surrounding
public roads, private roads, adjacent utility systems, residential development, other actively
permitted Small, Minor and Major Facilities, natural drainage courses and municipalities within
one (1) mile of the proposed Small Facility; north arrow and scale; GPS coordinates and current
surface ownership of the subject lot. The vicinity map shall be presented on a USGS 7.5
minute series quadrangle at a scale of 1"=2000' or equivalent, with a topography depicted at a
minimum of 40' intervals.
ii. Surveyed layout of the proposed Small Facility within the surveyed boundaries of the
Permitted Site, including at a minimum: sewage and wastewater disposal, trash receptacles,
potable water storage, all other associated infrastructure and all other equipment located within the
Permitted Site. (See Section 4-502 (C )(3) for site plan definition)
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 Sheriffs Office dispatch location and responsible fire district headquarters to each Small
Facility, along each roadway.
iv. Name, address and phone number of surface owner of the subject lot.
v. Name, address and phone number, including a 24-hour emergency response
number of at least two persons responsible for Operator's emergency field operations;
contact numbers for local hospitals, emergency response, fire protection
2
districts, Garfield County Sheriffs Office, Life/Care Flight, and applicable regulatory
agencies; site safety/evacuation plan; and any other written response plan for
potential emergencies at the Permitted Site.
vi. Identification of the anticipated dates of installation and removal of the Small Facility.
The site plan shall include a notation of the total cumulative length of time (number of
days) that the Small Facility will be installed at the Permitted Site.
ELIGIBILITY
Requirement (Section 7-808 (D)(3) — All Requirements
Must be Satisfied to be Eligible as a Small Facility
Applicant
Planning
Department
Complies (Y/N)
Complies (Y/N)
The Small Facility and any associated infrastructure must
be completely contained within a state or federally
permitted parcel (such as a Colorado Oil and Gas
Conservation Commission (COGCC) approved oil/gas
well pad) in which reclamation and revegetation are
secured with the permitting agency (Permitted Site); and,
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
Serial Number or Unit ID Number:
354074502
Manufacture Year: 4/5/2007
Size of Unit (Square Feet): 14X56
Unit 2
Make: ATCO Structures
Serial Number or Unit ID Number:
350463906
Manufacture Year: 4/2/2007
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-8.09-1236
,� 6
1 ,
Signature of Operator's Compliance
Officer:to
1I .
(By signing this form, I verify that all information pro .. -d in
the best of my knowledge)
Print Name: Sandy Hotard CPL
this checklist is correct and accurate to
Title: Manager Field Landmen
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 Tess 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 1 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, 1 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: Sandy Hotard CPL
Title: Manager Field Landmen
Phone Number: 970-285-9377 ext 2288
Email: Sandy.Hotard(c�willlams.com John.morris(c�williams.com
1 hereby attest that I am a Licensed Professional Engineer in the State of
Colorado. I attest that I have conducted a visual inspection of the Small Facility
identified in this Administrative Checklist, as installed, and, based on information
from that inspection I certify that the Small Facility complies with the standards
set forth in Article 7-808 (D) (3) of the Unified Land Use Resolution of 2008.
PE Certification Number
PE Stamp
See
Summary
Date of Inspection See Summary
Print Name and Title: David Fox of Fox
Engineering Solutions
Signature See Form
8
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
GV 82-5 Small Temporary Employee Housing
Williams Production RMT
NW 1/4 SE 1/4 of Section 5, T7S, R95W, 6th P.M. Garfield County
David Fox, P.E.
September 1, 2009
Garfield County
Article 7-808(D)(3) Land Use Resolution 2008
Characteristic or Standard Description
3.a. Small Facilities, in the nature of Factory Built Nonresidential
Structures [as defined under C.R.S. 24-32-3302(a)] but NOT
recreational vehicles [as defined under C.R.S. 42-1-102 (61), including
truck, truck tractor, motor home or camper trailer], may be utilized
for housing of workers on projects related to commercial, industrial,
mineral extraction or highway operations, pursuant to the standards
for Small Facilities contained in subsection (2), below. Such facilities
are not subject to Garfield County building and fire codes (building
code, fire code). However, Small Facilities are subject to all pertinent
state (i.e. electrical permits), federal permits and relevant fire
protection district(s) code requirements.
3.a.(1)
3.a.(2)
The Small Facility and any associated infrastructure must be
completely contained within a state or federally permitted parcel
(such as a Colorado Oil and Gas Conservation Commission (COGCC)
approved oil/gas well pad) in which reclamation and revegetation
are secured with the permitting agency (Permitted Site); and,
The Small Facility is located at the Permitted Site for less than a
cumulative of one (1) year and at the end of the utilization period, all
structures, foundations and associated infrastructure are completely
removed: and.
3.a.(3) 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.
1
Small Facility must comply with all applicable federal, state and local
laws and regulations.
Inspection Comments
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.
2 The Small Facility shall NOT contain recreational vehicles as defined No recreational vehicles observed on site.
in Section 7-808 (D).
Page 1 of 5
GV 82-5 Inspection Fox Engineering Solutions LLC
Williams Production RMT
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.
11
Domestic animals are prohibited at all Small Facilities.
Page 2 of 5
September 1, 2009
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 located in all factory
built non-residential structures.
Fire extinguishers observed in all structures.
No domestic animals observed on-site.
GV 82-5 Inspection Fox Engineering Solutions LLC
Williams Production RMT
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
September 1, 2009
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.
GV 82-5 Inspection Fox Engineering Solutions LLC
Williams Production RMT
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)
19(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.
Individual Sewage Disposal System (ISDS): If an ISDS is Facility (eight
or Tess 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
September 1, 2009
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 clay). 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.
GV 82-5 Inspection
Williams Production RMT September 1, 2009
Fox Engineering Solutions LLC
1 hereby attest that I am a Licensed Professional Engineer in the State of Colorado. I 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:
Print Name and Titl David J. Fox, Prin ' al Engineer
Signature: — ..-14 497(
September 1, 2009
Page 5 of 5
PE Stamp
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 Battlement Mesa Partners LLC
Property Owner (hereinafter OWNER) agree as follows:
1. OWNER has submitted to COUNTY an application for
GV 82-5 pad location STEH (hereinafter, THE PROJECT).
2. OWNER understands and agrees that Garfield County Resolution No. 98-09, as
amended, establishes a fee schedule for each type of subdivision or land use review
applications, and the guidelines for the administration of the fee structure.
3. OWNER and COUNTY agree that because of the size, nature or scope of the
proposed project, it is not possible at this time to ascertain the full extent of the costs
involved in processing the application. OWNER agrees to make payment of the Base Fee,
established for the PROJECT, and to thereafter permit additional costs to be billed to
OWNER. OWNER agrees to make additional payments upon notification by the COUNTY
when they are necessary as costs are incurred.
4. The Base Fee shall be in addition to and exclusive of any cost for publication or
cost of consulting service determined necessary by the Board of County Commissioners for
the consideration of an application or additional COUNTY staff time or expense not covered
by the Base Fee. If actual recorded costs exceed the initial Base Fee, OWNER shall pay
additional billings to COUNTY to reimburse the COUNTY for the processing of the
PROJECT mentioned above. OWNER acknowledges that all billing shall be paid prior to
the final consideration by the COUNTY of any land use permit, zoning amendment, or
subdivision plan.
PROPERTY OWNER (OR AUTHORIZED REPRESENTATIVE)
Sandy Hotard CPL
Print Name
Mailing Address:
Date
PO Box 370, Parachute, CO 81635
Page 4
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EXISTING
ACCESS ROAD
7-;
GV 82-5 DRILLING
PAD LOCATION
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ACCESS DESCRIPTION:
FROM THE INTERSECTION OF STATE HIGHWAY 6 AND RULISON ROAD(CNTY. ROAD 323) NORTH OF RULISON, PROCEED
SOUTHERLY ALONG RULISON ROAD(CNTY ROAD 323) ±1.2 MILES TO THE INTERSECTION WITH COUNTY ROAD 309, PROCEED
RIGHT IN A WESTERLY DIRECTION ±3.9 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD, PROCEED RIGHT IN A
NORTHWESTERLY DIRECTION ±1.1 MILES TO THE EXISTING GV 82-5 DRILL PAD LOCATION, AS SHOWN HEREON.
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Construction Pan Prepared for:
SCALE: 1 -2000' Williams Williams Production, RMT
DATE: 17/20(08
SHEET:
PROJECT: Williams
OFT:
s af9 GV 82-5 Drill Pad - Sheet 5
cws ACCESS &- VICINITY MAP
W#3A
C2.3'
W#38
F 2.7'
Exist. Limit
of Disturbance
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o
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W #3A
--
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N --50'R
Edge of Exist. i
Drill Pad
/
Exist. Bldg. �aQ
Proposed PA 13-5
Proposed PA 313-5
Proposed PA 413-5
Proposed PA 14-5
Proposed PA 314-5 0.
Proposed PA 414-5.
Proposed PA 514-5
Proposed PA 324-5
Proposed PA 524-5
SWC #2
C 0�2' 50'
d� / 1'6.5' ' I
20'x50' f
Tank Pad,
(
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F�
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Daylight Line
W#1B
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sF
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eeiv Juawdi!
Proposed PA 23-5
Proposed PA 323-5
Proposed PA 33-5
Proposed PA 333-5
Proposed PA 423-5
ExIsL PA 433-5
Exist, PA 24-5
Proposed PA 34-5
Exist. PA 424.5
Proposed PA 334-5
F0.1' 109'
N48°00'59`E 84'
Exlsl. GV 52-5
ExtsL PA434.5
50' R
Edge of Exist.
Drill Pad
7l,
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83'
N #5B
F 0.2'
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111
NE #6 BB
F 0.5'
94'
C0.8' —X 160'---X
Exist- Limit
of Disturbance
ToPs°I1
stockpile Are
ESTIMATED DIRT QUANTITIES (cy)
ITEM
CUT
FILL
TOPSOIL
EXCESS
PAD
2618
360
0
2258
PIT
1700
1700
TOTALS
4318
360
0
3958
50' 0/S
Ref Pat,
/l! Existing Ditch
STORM WATER LEGEND:
BP BRUSH PILE/ BARRIER
SB STRAW BALE BARRIER
SOIL CONTAINMENT BERM
TOTAL DISTURBED AREA
ED I
2.27 ac
REt71SED.- 11/26/08
Fax 970) 0.25-3773
•
OOKCIJ F
Survey .Services, Inc.
SCALE:
DATE:
SHEET:
PROJECT:
DFT:
1", = 60'
11/20/08
2of9
Williams
CiVS
Construction Plan Prepared for:
Williamss. Williams Production, RMT
GV 82-5 Drill Pad - Sheet 2
GRADING PLAN & PAD LAYOUT
June 2, 2009
Eric Schmela
Authorized Agent for
Battlement Mesa Partners LLC
PO Box 6000
Parachute, CO 81635
Ilk MS 0
EXPLORATION & PRODUCTION
1050 CR :215
P O. Box 370
Parachnie, CO 811 5.0370
970/205.9377
9701285-9573 fsz
RE: Authority for pad GV 82-5 ISDS & Small Temporary Employee Housing Permits
Dear Eric:
Per Garfield County's new regulations instated March I, 2009, Williams is now
required to obtain additional permits pertaining to the trailers on your GV 82-5 pad site.
These permits are for a vault septic unit (ISDS) and the Small Temporary Employee
Housing permit for the Drilling Consultants and the Tool pushers. These new regulations
require authority from Battlement Mesa Partners LLC to Williams Production RIvIT Co
for the processing of said permits.
By signing this document in the presence of a Notary Public, you grant authority
to Williams to process these permits to Garfield County as required by new law.
Should you have any furthers questions please feel free to call me at 970-623-
8909.
Sincerely,
Williams Production
T Company
dc..
Dasa Bryan
Land Technician
R y
cmcnt lvlesa Partners LLC
More enc, a Notary Public, in and for said County and State aforesaid, do hereby cent!' that Erie Srlrmrin tyhusc name is
subscribed to the foregoing instmmcrrt ns Authorized ,hent, of anulrnrent Mesa Partners. LLC is Colorado l.inlitetl
Liability Company. appeared before me this dny in person and acknowledged that he executed said instrument its his free and
voluntary net and (Iced as the frcc and voluntary net and decd of said corporation fur the uses rind purposes set forth.
Fh T�Ir
Given 3m my hand and Notarial Seal this C, clay ofJun 2009
My Commission l xpiries: Cr — 11— lot 1
(Scat)
5013 Exr�;tics C�ir�i1R011
GS
October 1, 2008
Garfield County
109 8th Street
Glenwood Springs, CO 81601
RE: Authority as Agent
Dear County Representative;
Willi ms,
E'O LORATION & PRODUCTION
1058 CR P215
P. O. Bax 370
Parachutc, CO BIG35-0370
9701285-9377
9701285-9573 fax
This letter is to confirm the appointment of Sandy Hotard and Eric Miller as authorized
Agents to execute documents for the following;
• Williams Production RAH Company
• Bargath Inc.
• Wilgath LLC
• Ryan Gulch LLC
This authority is granted for all documents furnished to Garfield County.
Sincerely,
Alan Harrison
Vice President
Denver Region
DRB15H 10/01/08
Bryan, Dasa
From: Bryan, Dasa
Sent: Friday, August 21, 2009 1:05 PM
To: Donivan Livingston
Subject: GV 82-5 Notification
Attachments: GV 82-5 BMP Sheriff Notification letter .pdf; GV 82-5 BMP Sheriff and Fire Notification
Map. 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 60days. At which time I will notify you
of the removal of the Employee housing.
this notification per the GARCO Regulations for our pad located in Sec 19- 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.
asa K ran
Williams Production RMT CO
Land Data Technician
PO Box 370/1058 County Road 215
Parachute, CO 81635
970-623-8909 Office
970-987-1739 Cell
i
August 17, 2009
Garfield County Sheriff's Office
Emergency Operations
Attn: Donovan Livingston
108 8th Street
Glenwood Springs, CO 81601
Ph: 970-945-0453
RE: Emergency Response Notification Rulison Drilling Pad (GV 82-5)
Dear Donovan:
Williams®
EXPLORATION & PRODUCTION
1058 CR:215
P.O. Box 370
Parachute, CO 81635-0370
970/285-9377
970/285-2047 fax
This letter is to inform The Garfield County Sheriffs Department that Williams Production
RMT Company 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.
In accordance with Garfield County Planning and Zoning Regulations, the attached
documentation provides emergency response information and driving directions for the
Williams GV 82-5 pad.
Should you have any further questions or concerns regarding this notification, feel free to
contact me at (970)623-8909 (0) or (970)987-1739 (M)
Sine ely,
Dasa Bryan
Land Technician
GV 82-5 Pad
Emergency Contact List:
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Bryan, Dasa
From: Bryan, Dasa
Sent: Friday, August 21, 2009 1:04 PM
To: gvfpdops@sopris.net
Subject: GV 82-5 pad Notification
Attachments: GV 82-5 BMP Sheriff and Fire Notification Map.pdf; GV 82-5 BMP Fire Notification Letter.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 200days. At which time I will notify you
of the removal of the Employee housing.
this notification per the GARCO Regulations for our pad located in Sec 5- T7S-R95W. 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.
Dasa K r.,9 an
Williams Production RET C
Land Data Technician
PO Box 370/1058 County Road 215
Parachute, CO 81635
970-623-8909 Office
970-987-1739 Cell
1
Williams.
EXPLORATION & PRODUCTION
1058 CR #215
P.O. Box 370
Parachute, CO 81635-0370
970/285-9377
970/285-2047 fax
August 17, 2009
Grand Valley Fire Protection District
Attn: Rob Ferguson
1777 S. Battlement Parkway
Parachute, CO 81635
Ph: 970-285-9119
RE: Emergency Response Notification Rulison Drilling Pad (GV 82-5)
Dear Rob:
This letter is to inform The Grand Valley Fire Protection District that Williams Production
RMT Company 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.
In accordance with Garfield County Planning and Zoning Regulations, the attached
documentation provides emergency response information and driving directions for the
Williams GV 82-5 pad.
Should you have any further questions or concerns regarding this notification, feel free to
contact me at (970)623-8909 (0) or (970)987-1739 (M)
Sincerely,
Dasa Bryan
Land Technician
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