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Gar.field County ONSITE WASTEWATER
TREATMENT SYSTEM
(OWTS)
PERMIT APPLICATION
APR 2 5 2017
Community Development Department
108 81h Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-county.com
TYPE OF CONSTRUCTION
x New Installation I D Alteration 1 D Repair
WASTE TYPE
X Dwelling I D Transient Use Jo Comm/Industrial I -D Non-Domestic -D Other Describe
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INVOLVED PARTIES
Property Owner: Chevron USA INC Phone:( )
Mailing Address: PO Box 285 Houston TX 77001
Contractor: TEP Rocky Mountain LLC Phone: (970) 285-9377
Mailing Address: PO Box 370, Parachute, CO 81635
Engineer: David Fox Phone: {970) 250-5505
Mailing Address: PO Box 370, Parachute, CO 81635
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PROJECT NAME AND LOCATION
Job Address: TR 32-23-597 Pad -See the attached Qla t for descriQtion
Assessor's Parcel Number: 213715300009 Sub. Lot Block --
Building or Service Type: TemQora!Y office & house #Bedrooms: 2 Garbage Grinder No
Distance to Nearest Community Sewer System: NA
Was an effort made to connect to the Community Sewer System: NA
Type ofOWTS D Septic Tank l D Aeration Plant I X Vau ~ Vault Privy I D Composting Toilet
D Recycling, Potable Use D Recycling I D Pit Privy ro Incineration Toilet
D Chemical Toilet X Other Hauled bl£ HB Rentals to Garfield Coun~ Landfill
Dis12osal Site
Ground Conditions Depth to 151 Ground water table NA l Percent Ground Slope NA
Final Disposal by D Absorption trench, Bed or Pit I D Underground Dispersal 1 D Above Ground Dispersal
D Evapotransplration D Wastewater Pond l D Sand Filter
XOther Hauled bl£ HB Rentals to Garfield Cou nil£ Landfill Dis12osal Site
Water Source & Type D Well l D Spring j D Stream or Creek l D Cistern
X Community Water System Name Ci~ of Rifle Bulk #2 -Hauled bl£ HB Rentals
Effluent Wiii Effluent be discharged directly Into waters of the State? D Yes XNo
CERTIFICATION
Applicant acknowledges that the completeness of the applicat ion 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
evalu ation of the application; and t he issua nce 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 app licant are or will be re presented to be
tru e and correct to th e best of my knowledge and belief and are designed to be re li ed on by the local
department of health in evaluating the same for purposes of issuing the permit applied for herein . I
further understand that an y falsification or misrepresentation may result in the denial of the
app l ication or revocation of any permit granted based upon said applicat ion and legal action for
perjury as provided by law.
I hereby acknowledge that I have read and understand the Notice and Certification above as well as
have provided the required information which is correct and rate to the best of my knowledge .
Property Owner Print and Sign
0Jif;l€1AL llSE 0Nl:V
Special Conditions:
To.!,ill Fees: OO
~75 .
Fees Paid: CV
$r::j5 .
Building Permit
d·J.S-2017
DATE
1111 11r.1~'\1Ki\ wr.a·~ r~lftl ~'r'·~~i\P~ ~u~~~~ ~.iv~ 11111
·-Receptionlt: 879861
07/1 8 /2016 02 :18 :46 PM Jean Alberico
1 of 2 Rec Fee :$16.00 Doc Feio:0 .00 GARFIELD COUNTY CO
POWER OF AITORNEY
KNOW ALL PERSONS BY THESE PRESENTS:
CONFORM ED
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 assigninents of working or royalty interests) to Principal.
B. Applications for extensions or renewals ofleases 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. ( l) 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 pennits.
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 disaffinn 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 docwnent so executed and delivered .
EXECUTED by Principal on this lJlh day of July, 2016.
Terra Energy Partners LLC as sole member of
TEP Rocky Mountain LLC
AGREED TO AND ACCEPTED
BY:
BY:
ITS:
M ichael S. Land
President and CEO Attorney-in-Fact
ACKNOWLEDGEMENT
State of Texas
County of Harris
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This instrument was acknowledged before me on .Ju~~ /3 , 2016 by Michael S. Land, lmown to
me to be the President and CEO of Terra Energy Partn~ LLC, a Delaware corporation, on behalf of the
coq>oration.
(Notary Seal)
A.t!.~ TIFFANY CEBELL POLLOCK {~~.,\ Notory Public. State of Texos \{6~!;} Mv Commission Expire&
~;~~,.., April 26, 2019
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Section 23 --~ ./ T. 5 S., R. 97 W. \
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Disturbed & Native Grasslands,
Shrub Land and Plains Raparian
/ Temp. Separa tor \
~~ / ~ · "' Area (30'x30~ y / 4-. ~". . "" \_
·<t>'l."' ~I' ~-1 ~ ---.
r. 't>.,.P // ~" ~=". \
tf , 0 P»tJ'."'" :::--..... ~ \ o so
Exist. Limit · / f of Bef m · ............._ .........._,-i '\ I
of Disturbanpe ~! I I' +~ ~ \ ' . l ' GRAPH IC SCALE IN FEET I I ' . / ' I I ) \ ~ 1 INCH : 80 FEET
A 1 • _ t::; I _/ Exlsl.SeparatJ _ > ~ ~AA
~ ~ 1 !''/1 f<'\' r t ~ -·
;p ;p '!>; , /J I t x " l ' p r
I , !/' I / Jx / /lt1 ~ ~ J/1 ~ ~ ' / 'II
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I I I I Ii I , .ii;'!~ ! x ~ !!'" I l I I I , I I '11 (lj ;.; I I ~-.\.L I I I I ' . ~ G. -/\,-> I I :
I / I ~ Prop. TR 321·29-597 O Prop. TR 12-24-597 I I
Exist. Limit I ii/ / ' J< X I Prop. TR 21·23-597 O Prop . TR 512-24-597 I I
I . 1 l Prop. TR 421 ·23-597 l Prop. TR 13-24-597
R / I l Ex!St. TR 342-23-597 Prop. TR 413-24-597 1 ~ , f , I / _ Piop . TR .322-23·5.9? Prop. TR 521-23-597 >\ I \,,,,;--of Disturbance I / I <;: Extsl. T ~ 542 -23-5~7 rrop. TR 22-23-507 I
1 j Prop. TR 422-23-597 ~rop. TR 522-23-597 ;I
' ! X -!'•Isl. TR 44 3-23-597 t)."Prop. TR 423-23·597 .
, -Prop. TR 323-23-597 OProp. If! !>2:l-23-!>\!I > // I I
I -f( Exist. TR 43-23-597 0 Prop. TR 524-23·597 'B NW ~ #4 " 156' Prop. TR 23-23-597 Prop. TR 24-23-597 SE ~ #8 BB
----Exist TR 334·23-597 Prop. TR 324-23-597 -----
, FO.O' NAz. 128.10 ° '~10 97' FO.O' I
I > I , I
I I <\ !o I I i
I I I I I',;: SE AP #BA ~
; ;-1 1tP·0 ·( r
\
S #1A V I
I L -155' - -60' ~ 1.2~ ' I ~ \
\ I \ '" I ,,{ 1\ \
\
\ \ \ \ ..... \ cuttings Trench ~ I ,; \It-\\ , ~ \
' \ \ ' ' "($_ 215'x 110'x 18.l'd ~ ~ \ 'i \ /11
I \ \ ~ \ (12,000cy) ~ >-\\\\_, .
I '\\ L -----\\~'\
I I ~-I ~#3A \ !2f: 61'/ / S#~B_ \ -"' CG
\ Ci; t F0.9' --...;_ SW~ #2 C ,266' '\ \
t \ \ \1
Edgoaf ~ / C 9.1' J \\ \
"i Exls l.fad \ I , \ ,
\ ~ 50'0/S -~: ', -.\ \
1 \ REF. PNT. " \ \ \ °' ~ ·L · Daylight \ ~ lb '1l, ~ /8 ~e'l> ~ 'Line ',\ \
I ~"' ~ '&\ "' <(·~0 \ \ \-'\ \
\ \ \ 0\ ~~L\ ~'21\0(.,'!-\ I
\ ' \ \ e:,O ' 'i, \ \
I I ~ '--ro.osoij o . j I ESTl~ATED EA
1
RTHWOR
1
K QUANTl~IES (cy) I ~ \ H.'-P//e~!:Ck ' \
ITEM CUT FILL
PAD 3660 1000
TRENCH 12000
Ex. PIT -5600
TOTALS 15660 1000
136' flast 'lhlrd Sllffl
RTJJe. Colomdo 81650
Pl~ ~7~ 625-2720
Fwc(97 i 625·277,~
TOPSOIL I EXCESS
450 2210
12000
-5600
450 8,610
~ - -~ 1.)TopsollVolumeBasedon12"SollDepth.
\ \ "' 2.) 10% Swell Factor Applied to Earthwork
REVISED: 3/27/17
SCALE:
DATE:
PLAT:
I"~
1/20/17
2of 10
PROJECT: Trail Ridge
DFT: c;;
~ 3.) Total Disturbed Area= ±5.09 ac . ~ Cut Volume.
4 .) Pad Elevation can be Increased by up to
"\_ 12" If needd to ensure material stockpile
does not exceed area shown .
Construction Plan Prepared for:
TE R~ TEP Rocky Mountain LLC
TR 32-23-597 Drill Pad -Plat 2
CONSTRUCTION LAYOUT
ACCESS DESCRIPTION:
FROM THE INTERSECTION OF THE 1-70 FRONTAGE ROAD AND COUNTY ROAD 215 AT PARACHUTE, PROCEED IN A NORTHERLY
DIRECTION ALONG COUNTY ROAD 215 ±7.2 MILES TO THE INTERSECTION WITH GARDEN GULCH ROAD, PROCEED LEFT IN A
WESTERLY DIRECTION ALONG GARDEN GULCH ROAD ±20.2 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD , PROCEED
RIGHT IN A NORTHERLY DIRECTION ±0 .8 MILES TO THE EXISTING TR 32-23-597 DRILL PAD LOCATION, AS SHOWN HEREON.
13 6 &1Bt 'llllrd Street
RIJla, Cqlorado 81650
f>h. (!J70J 625-2720
Fax (970/6'.&5·277.3
Construction Plan Prepared for:
SCALE: r = 2000· TER;:;A'> TEP Rocky Mountain LLC
DAT& ~1~/=19~/~17...._ ___ l-----~-~------------1
;~;;ECT: ""~'-r:~;7""""~:::..~d-q-e ---i TR 32-23-597 Drill Pad -Plat 5
DFT: ~(lS~----1 A CCESS ROAD & TOPO MAP
Two aboveground sewage holding tanks each with 4000-gallon capacity on-site .
T he Vau lt System is displ ayed in the pi ct ure s . Sewage flows estimated to be 600
gallons/day (8 individuals x 75 gpcd). Sewage holding tank needs to be emptied
approximately every 7 days (4000 gallons/ 600 gallons per day). Wastewater
vault is equipped with overflow alarm device . Terra Energy Partners utilizes the
services of a licensed contractor to removed and haul the wastewater to a state
certified treatment/disposal facility .
Two potable aboveground water tanks of appro ximately 4000 gallons each ca-
pacity on-site . Posted on the front of the Tank there is a Sign that states "Potable
Water Only ". Potable water demand is estimated to be 600 gallons /day (8 individ-
uals x 7 5 gpcd). Required minimum fire suppression demand is 2500 gallons.
Total potable and fire suppress ion demand is estimated to be 4000 gallons .
Road access to the site is
maintained year round
through the services of pri-
vate road maintenance and
construction contractor.
TR 32-23-597 Pad
Vault System Description
The site will temporarily office and house up to a maximum of eight individ-
uals during natural gas drilling activities and is expected to be completed in
one year or less . The individuals will occupy four individual trailer offices /
houses located on the well pad . Office /houses have Colorado Div ision of
Housing compliance tags .