Garfield County Building & Planning Department

108 8th Street Suite 401

Glenwood Springs, CO 81601-

Phone: (970)945-8212 Fax: (970)384-3470

Project Address

318 CR 300 PARACHUTE, CO 81635-

Owner Information

Parcel No.

240934200108

Address

PO Box 1329

Subdivision

William Patterson Grand Junction CO 81502

PO Box 1329 Grand Junction CO 81502

Contractor(s) Phone Primary Contractor WPX Energy Rocky Mountain, LLC (970)285-9377 Yes

Proposed Construction I DetailS Temporary employee housing for SG 24-27 site.

Valuation:

Total Sq Feet:

FEES DUE FEES PAID

Section Township Range

Phone Cell

970-285-2667

Required Inspections:

Fo•losp<"lloos ""' 1 (888)868-5306

Inspection IVR

$0.00

0 See Permit Record

Fee Amount lnv Total Paytype Amt Paid Amt Due

Septic Fee- New

Total:

Wednesday, March 21, 2012

$73.00

$73.00 lnv # SEPT-3-12-21748 $ 73.00 Check# 30572523 $73.00

$0.00

Building Department Copy

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GARFIELD COUNTY SEPTIC PERMIT APPLICATION

1088'"Street, Suite401 , Glenwood Sprin~s. CO 81601 Phone: 970-945-8212 / Fax: 970-384-3470 /Inspection Line: 970-384-5003

www.garfield-countv.com Parcel No:(this information Is available at the assessors office 970-945-9134)

2409-342-00-1 08

Job Address: (if an address has not been assigned, please provide Cr,Hwy or Street Name & City) or legal description

SG 24-27 See the attached plat for description.

Lot Size: Lot No: Block No:

See Attached Survey Plat

Owner: (property owner)

Patterson, William R.

Contractor:

WPX Energy Rocky

Mountain, LLC Engineer:

N/A

Mailing Address

PO Box 1329 Grand Junction , CO 81502

PO Box 370, Parachute, CO 81635 Mailing Address

Permit Reauest For: IX l New I l Alteration

Subd/Exemption:

Ph: AltPh:

970-242-8613

Ph: Alt Ph:

970-285-9377 ext 2754

Ph: AltPh:

I ) Reoair

f.

JIJN y ...... ~G

I '•a

Waste Type: ( X ) Dwelling ( ) Tranient Use ( ) Commercial or Industrial ( ) Non- Domestic Wastes

( ) Other- Describe

9 Building Or Service Type:

Number of Bedrooms: 2 Garbage Grinder ( ) Yes (X )No

10 Source & Type of Water Supply: ( ) Well ( ) Spring ( ) Stream Or Creek ( )Cistern

If supplied by COMMUNITY WATER, give name of supplier: Down Valley Septic and Waste

11 Distance to Nearest Community Sewer System: _ N/A. ____________________ _

Was there an effort to connect to the community System? N/A

YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITH OUT A SITE PLAN

12 Ground Conditions:

Depth to 1st Ground Water Table N/A Percent Ground Slope N/ A

13 Type of Individual Sewage System (ISDS) Proposed:

14

15

( ) Septic Tank ( )Aeration Plant (X )Vault ( ) Vault Privy

( ) Recycling, Potable Use ( )Recycling, Other use ( ) Pit Privy ( ) Incineration Toilet

It X> Other- Describe: Hauled to Down Vallev Waste for their disposal

Final Disposal By:

( )Composting Toilet

( ) Chemical Toilet

( ) Absorption trench, Bed or Pit ( ) Underground Dispersal ( ) Above Ground Dispersal ( ) Evapotranspiration ( ) Sand Filter

It ) Wastewater pond <X )Other-Describe Hauled to Down Valley Waste for their disposal

Will effluent be discharged into waters of the state? ( )Yes (X )No

16 Percolation Test Result: (to be completed by Registered Professional Engineer, if the Engineer does the Percolation Test) N/A

17

Minutes per inch In hole No.1 Minutes per Inch in hole No.3

Minutes _____ per inch in hole No.2 Minutes _____ per Inch in hole No.4

Name, address & telephone of RPE who made soli absorption test: .:.;N:..:./.:..A.:...... ____________ ___ _

Name, address & telephone of RPE responsible for design of the system:N/A 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 conditions as deemed necessary to insure compliance with the rules and regulations made, information and reports submitted herewith and requi~ed to bi i

1

tted 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 c dep rtment of health In evaluationg the same for purposes of issuing the permit applied for herin. I further understand that any falsification or mis entaio may result In the denial of the application or revocation of any permit granted based upon said application~gal action for p~n~,J<f'ttfaw. - , ()

~~----- .f .. / ~... 3 - l'1- l 2-~~~O~w~n~e~rs~S~i~QI~rnfi~tu~re;:~B~I~~·an~~~- ~~~~oita~r~d------~~~Tn~?n~D~a~te~--------------------------------~ o 5P 3 -».0 -Ic9, 1 C!l-30S'"12-~2..lOlf . .J=J-3. STAFF USE ONLY r-I ~lldlnr: PcnnJI #: PermltFe.c::

.]1) t3 '- I Issue Date:

3~2-0-12-DATE

High level Alarm lllltlll ar Alar11

II PI'ISI!II

Tank Is full

One aboveground sewage holding tank with 4000-gallon capacity on-site. The Vault System is displayed in both of the pictures. Sewage flows esti­mated to be 300 gallons/day (4 individuals x 75 gpcd). Sewage holding tank needs to be emptied approximately every 13 days (4000 gallons/ 300 gallons per day). Wastewater vault is equipped with overflow alarm device. Williams utilizes the services of a licensed contractor to removed and haul the wasterwater to a state certified treatment/disposal facility.

One potable aboveground water tank of approximately 4000 gallons ca­pacity 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 300 gal­lons/day (4 individuals x 75 gpcd). Required minimum fire suppression demand is 2500 gallons. Total potable and fire suppression demand is estimated to be 4000 gal­lons.

Road access to the site is maintained year round through the services of pri­vate road maintenance and construction contractor.

SEPTIC

SG 24-27 Vault System Description

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.

I I I I I I I I

Existing Fenceline

ut,?ity Li~e J

Sfa. 1+20

/ /

/

I

/~ I

2+35

io I')

1:::1

~ (.) ~

~ e: F-0.4' £/. 5010.9'

"' ·

Sta. 0+00

Approx . ../Toe of

. p Fill Slope

GAS PLANT AREA

I I I I , I '

F-1.2' :. '<·:·:: ::,z·' .;;;:;,::·.~;:::;:~tiG-~f{:;f#:2:~:i::·: <·s~:·>· ··

F-2.2' £/. 5010.1 '

/( I I £/. 5009.5' £/. 5009.1'

___.;.._--Proposed Access Road

I I I I I

E/ev. Ungraded' Ground A f SG 514- 2 7 Loc. Stake = 5012. 0 1

FINISHED GRADE ELEV. A T SG 5 14-27 LOC. S TAKE = 5011. J' UINTAH ENGINEERING & LAND SURVEYING 85 S o. 200 East • Vernal, Utah 84078 • (435) 789- 1017

LEGE ND: ---------------- PROPOSED ACCESS ROAD -------- EXISTINGROAD =======-- EXISTING ROAD NEEDS UPGRADED

Ill Uintah Engineering & Land Smv eying 8 5 South 2 00 Eas t V ern al. Uta11. 8 4078 ( 4 35) 789 - 1017 ~· F.AX ( 4 35) 789 -1 8 1 3

N WIL LI.Alv1S PRODUCTION RMT COMPANY

SG 24-27 SECTION 27, T7S, R96W, 6th P.M.

Mr. Fred Jarman, Director Garfield County Building and Planning Deparbnent 108 8th Street, 4th Floor Glenwood Springs, CO 81601

RE: SG 24-27 Drilling Pad Locations, Garfield County, Colorado

Dear Mr. Jannan:

This letter authorizes WPX Energy Rocky Mountain, LLC 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,

By: {J f /I, 1/h rz Ya,/hvw Name: Will" R. Patterson

. 7/h«-~ L ~~ Name: Marie E. Tipping

IIIII ~~;.I'~IW\,~~~IIHIIWI-II'L"Iw.IIM:flll~.lr\«,m'i 1111111 Recept1gnW; 615004 02/27/2012 12:10:1B PM Jean Alberico 1 or "1 Roo Fae:$16.00 09c Fee:0.00 GARFIELD COUNTY CO

LIMITED POWER OF ATTORNEY

WPX ENERGY ROCKY MOUNTAIN, LLC ("Company") a Delaware limited liability company, having its principal place of business in the City of Tulsa, County of Tulsa, State of Oklahoma, does hereby make, constitute and appoint Bryall S. Hotard with the full authority hereinafter provided, the true and lawful Attorney-in-Fact of the Company, authorized and empowered on behalf of the Company and in the Company's name, and for the sole and exclusive benefit of the Company and not on behalf of any other person, corporation or association, in whole or in part, to enter into, execute, deliver, file and accept all instruments and documents affecting the real property or real estate rights of the Company as more specifically set fmth below: :

I. Applications and documentation associated with Garfield County or Rio Blanco permitting requirements for including, but not limited to, Independent Sewage Disposal Systems, Small Temporary Employee Housing, Major Impact Reviews, Limited Impact Reviews, Oil and Gas well permitting, Driveway Access, C01mty Road Maintenance, Temporary Living QWlrters, Temporary Use Permits, Surface Use Permits, Surface Usc Licenses, Utilities, Snow Removal and Private Construction of County Roads;

2. Agreements and other documentation that grant easements, rights of way, licenses, or permits to Company and also instruments where the Company grants such rights to others;

3. Agreements that assign easements, rights of way, licenses, permits or surface leases in connection with the Company1s operations;

4. Releases and Partial Releases of easements and rights of way; 5. Agreements allowing encroachments onto easements and rights of way owned by

Company and landowner instruments and conveyances on others casements; 6. Agreements subordinating mortgage rights to easement or lease ; 7. Agreements relating to the modification and relocation of Company facilities; 8. Rental or lease agreements for surface use or other surface use agreements and all notices

related to the pipeline agreements; 9. Agreements for the purchase or sale of real property and for the lease of real property for

residential or commercial purposes or otherwise in connection with the Company's operations;

1 0. Agreements to obtain water services, electrical, gas or oil services or the provision of other utility services utilized by Company's facilities;

11. Agreements modif'ying, amending, renewing, extending, ratif'ying forfeiting, canceling and terminating any and all ofthe aforementioned types of instruments and documents.

WPX ENERGY ROCKY MOUNTAIN, LLC hereby declares that each and every act, matter and thing which shall be given, made and done by Bryan S. Hotard in cmmection 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 had been given, made and done by WPX Energy Rocky Mountain, LLC in its limited liability company presence and it hereby ratifies whatsoever Attorney-in-Fact shall lawfully do or cause to be done by virtue hereof. This Limited Power of Attorney shall remain in full force and effect until terminated by Company.

r

IIIII ~'{l'.ol'l!Ms.A',/'11~, N!\1' f\oltllitl'l+ll:lalll:rllll 1-lil.~·i IIIII/ Reeept!on~: 815004 02/27/2012 12' 18:10 PM J•an Alber leo 2 of 2 Rec:: Fee,$16.60 Doc Fee:ltl.00 GARFIElD COUNTY CO

IN WITNESS WHEREOF, WPX Energy Rocky Mountain, LLC has caused tlris 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 1st day of January~ 2012.

TAJN,LLC

ACKNOWLEDGMENT

STATE OF OKLAHOMA ) ) ss.

COUNTY OF TULSA )

BEFORE ME, the undersigned authority, a Notary Public in and for said County and State, on this day personally appeared, Jerry D. Barnes personally known to me to be the Vice President of WPX Energy Rocky Mountain, LLC a Delaware limited liability company, who acknowledged to me that he has executed the above LIMITED POWER OF ATTORNEY authorized by Company's Management Committee.

IN WITNESS WHEREOF, I have hereunto set my hand and affixed my notary seal, theZoi-h day ofJanHary, 2012.

Fci:Yuruy

Notary Public

My Commission Expires: z -l-3-:2()/z_/

After Recordation Please Return To: WPX Energy Rocky Mountian, LLC

Attn: Land Dept. P0Box370

Parachute, CO 81635

2

Account

Account: R460009

L_Q_catil;m

Parcel Number 2409-342-00-108

Situs Address 000318 300 COUNTY RD 000318 BATTLEMENT PKWY

City Parachute Parachute ZipCode 81635 81635

Tax Area 046- 16-BHFZ- 046

Legal Summary Section: 34 Township: 7 Range: 96 TR IN SEC 27,33,34 EXCEPT A TR OF LAND CONT 1.087 AC +I- AS DESC IN BLA AFF REC#765018 AND QCD REC#765019

Transfers

Sale Price

Tax H_isto_r_y

Tax Year

2011

2010

Taxes

$3,888.96 $5,215.96

Page I of2

Own_~r InformMion Ass~ssmJm t _Hist_m

Owner Name PATTERSON, WILLIAM Actual (2011) $380,000

R Primary Taxable $110,200 Owner Address PO BOX 1329 Tax Area: 046 Mill Levy: 35.2900 GRAND JUNCTION, CO 81502

Sale Date

()3/1)/2012

12/02/2011

0711112011

09/08/2009

Images _

• Map • Pho.tQ • GIS

Type Actual Assessed Acres SQFT Units

Land $380,000 $110,200 196.243 0.000 0.000

Doc Type

lli!3 173.

174 ROW

Book Page

Focusing On: 000318 300 COUNTY RD PARACHUTE 81635

Map data ©2012 Google -

https://act.garfield-county.com/assessor/taxweb/account.jsp?accountNum=R460009 3/20/2012