HomeMy WebLinkAbout20212693.tiffLAMP
RYNEARSON
March 26, 2021
Weld County
Public Works
1555 N. 176 Avenue
Greeley, Colorado 80631
RE: List of Existing Utilities on Property
Mallard Exploration Field Office
4715 Innovation Dr., Ste. 100
Fort Collins, CO 80525
[P] 970.226.0342
[F] 970.226.0879
LampRynearson.com
The project site is located in the southeast quarter of Section 9, Township 8 South, Range 60 West of the 6th P.M., or
about 13 miles west of the Town of Raymer, Weld County, Colorado. More specifically, the site is situated 2 miles
north of Highway 14, and just west of Weld County Road 103. There are open undeveloped fields surrounding the site
to the north, east, and west. The property to the south has multiple oil and gas pads, with an existing gravel access
road. The proposed site has a proposed gravel access road on the southeastern portion of the property.
List the names and addresses of any owner, operator of any oil and gas facilities, irrigation ditches/laterals, pipelines,
overhead lines, railroad, etc. on the property, if applicable.
1. Overhead power lines with 150' wide utility easement (north of project site).
Owner: Tri-State Generation & Transmission Association
Address: 1100 W 1166 Ave, Westminster, CO 80234
2. Gas line with 30' wide right of way (west of project site).
▪ Owner: DCP Midstream
▪ Address: 37017th St unit 2500, Denver, CO 80202
Please feel free to contact me at 970-226-0342 or via email at michael.palizzi@lamprynearson.com.
Sincerely,
Michael Palizzi, PE
Project Manager
Lamp Rynearson
Omaha Fort Collins Lakewood Kansas City
COLORADO DIVISION OF WATER RESOURCES
DEPARTMENT OF NATURAL RESOURCES
1313 SHERMAN ST, RM 821, DENVER, CO 80203
Main: (303) 866-3581 dwrpermitsonline@state.cous
GENERAL PURPOSE
Water Well Permit Application
Review instructions on reverse side prior to completing form.
The form must be computer generated, typed or in black or blue ink.
1. Applicant Information
Name of applicant
Jamison Mcllvain (DPOC, LLC)
Mailing address
1400 16th Street, Suite 300
City
Denver
Telephone# (area code & number)
(720) 543-7955
State Zip code
CO 80202
E-mail (online filing required)
jmcilvain@mallardexploration.com
Office Use Only
Form GWS-45 (01/2020)
6. Use Of Well (check applicable boxes)
Attach a detailed description of uses applied for.
❑ Industrial
❑ Municipal
❑ Irrigation
❑ Commercial
❑ Dewatering System
❑ Geothermal (production or reinjection
❑ Other (describe):
2. Type Of Application (check applicable boxes)
Il Construct new well
❑ Replace existing well
❑ Change source (aquifer)
❑ COGCC Well
❑ Use existing well
❑ Change or increase use
❑ Reapplication (expired permit)
❑ Other:
7. Well Data (proposed)
Maximum pumping rate
15
Total depth
gpm
300 feet
Annual amount to be withdrawn
0.246
Aquifer
All Unamed Aquifers
acre-feet
3. Refer To (if applicable)
Well permit
Designated Basin Determination #
Water Court cased
Well name or#
4. Location Of Proposed Well
County
Weld SE
Section Township N or S Range
9 8 rl rl 60
114ofthe SE
114
E or W Principal Meridian
] El 6th
Distance of well from section lines (section lines are typically not property lines)
467.89 Ft from r N [7 S 1212.14 Ft fromr E EW
For replacement wells only — distance and direction from old well to new well
feet
direction
Well location address (Include City, State, Zip) ❑ Check if well address is same as in Item 1_
0 WCR 103, Briggsdale, CO 80611
Optional: GPS well location information in UTM format You must check GPS unit for
required settings as follows:
Format must be UTM
rl Zone 12 oru Zone 13
Units must be Meters
Datum must be NAD83
Unit must be set to true north
Was GPS unit checked for above? EYES
Easting
Northing
Remember to set Datum to NAD83
8. Land On Which Ground Water Will Be Used
Legal Description of Land (may be provided as an attachment)_
The South 1/2 of Section 9, Township 8 North, Range 60 Wes
of the 6th P.M., County of Weld, State of Colorado
(If used for crop irrigation, attach a scaled map that shows irrigated area.)
A. # Acres B. Owner
C. List any other wells or water rights used on this land:
Existing well - Permit#27866, Receipt 9063363
9. Proposed Well Driller License #(optional):
10. Sign or Entered Name Of Applicant(s) Or Authorized Agent
The making of false statements herein constitutes perjury in the second
degree, which is punishable as a class 1 misdemeanor pursuant to C.R.S.
24-4-104 (13)(a). I have read the statements herein, know the contents
thereof and state that they are true to my knowledge.
Sign or enter name(s) of person(s) submitting application
Date (mmfddlyyyy)
Michael Palizzi 03/26/2021
If signing print name and title
Michael Palizzi, Project Manager, Lamp Rynearson
5. Parcel On Which Well Will Be Located
(PLEASE ATTACH A CURRENT DEED FOR THE SUBJECT PARCEL)
A. Legal Description (may be provided as an attachment)_
The South 1/2 of Section 9, Township 8 North, Range 60 West
of the 6th P.M., County of Weld, State of Colorado
B. # of acres in parcel C. Owner
323.486
DPOC, LLC
D. Will this be the only well on this parcel? ❑ YES ❑ NO (if no list other wells)
Existing well - Permit#27866, Receipt 9063363
E. State Parcel ID# (optional):
Office Use Only
USGS map name
AQUAMAP
WE
WR
CWCB
TOPO
MYLAR
SB5
DWR map no. Surface elev.
Receipt area only
DIV WD BA MD
COLORADO
DEPARTMENT
1313
main:
DIVISION OF WATER RESOURCES
OF NATURAL RESOURCES
SHERMAN ST., STE 821, DENVER, CO 80203
(303) 866-3581 dwr.colorado.gov
Form GWS-57 (10/2013)
Application
Applicant's
Receipt No.
Name:
COMMERCIAL DRINKING AND SANITARY WELL WORKSHEET
Review instructions on reverse side prior to completing form. The form must be completed in black or blue ink or typed.
1. Name and Type of Business: Mallard Exploration - Oil and Gas Extraction Company
2.
Is this application for a new well?
for a change
of well (if applicable)
for drinking and
uses may be required.
Statement of
of use for an existing well?
O Yes
• No If no, is this application
• Yes Permit Number
• No For wells used
sanitary purposes
See form
Historical Use for
prior to May 8, 1972, a field inspection of the well to
GWS-12 Registration of Existing Well and
verify historical
form GWS-12A
further information.
3.
Is the parcel the well is located
municipality, water company, etc.)
on (or will be located
or is water
other source is
on) within the boundaries of a water service area (water district,
available from another source (such as a well)?
• Yes If yes, indicate what this
❑ No
(name of water district/supplier, or well permit number)
4.
Proposed type of disposal system to
be used:
tank / absorption leach
System (district name:)
(location sewage hauled
(attach copy of engineering
field
❑ Septic
• Central
❑ Vault
to:)
• Other
design)
5.
Water Demand Calculations (for average factors for water demand see below)
Employees
A
B
C
Number of
Employees
X
Number of Gallons
per Employee per Day
X
Number of Days Employee
Works per Year
=
Gallons per Year
15
X
15
X
365
=
82,125
Customers
Number of
Customers per Day
X
Number of Gallons
per Customer
X
Number of Days Business
is Open per Year
=
Gallons per Year
0
X
0
X
0
=
0
Other Uses (Note: No uses outside of the building would be permitted for this type of well.)
Type of Use
X
Gallons per Use per Day
X
Days per Year
=
Gallons per Year
0
X
0
X
0
=
0
Total amount
of water required:
=
Gallons per Year
(A + B + C)
=
80,125
For wells used for commercial drinking and sanitary purposes
108,600 gallons (1/3 of an acre-foot) per year.
For wells used for commercial drinking and sanitary purposes
gallons (1 acre-foot) per year.
General Guidelines for Water Demand in Gallons per
on or after May
8, 1972, the total water demand cannot exceed
1972, the total water demand cannot exceed 325,900
— 80 gallons/person/day
or from a technical reference on this subject.
prior to May
8,
consultant
Day
Day Workers at Offices — 15 gallons/person/day
Food Service Establishments (with toilet and kitchen wastes) — 10 gallons/patron/day
Churches (does not include food service) — 5 gallons/seat/day
Overnight Lodging —50 gallons/customer/day
On -Site Proprietor of Overnight Lodging (i.e. on -site owner of a Bed & Breakfast)
Additional water demand figures may be obtained from a private water
LAMP
RYNEARSON
March 26, 2021
Water Well Authorization Form
Mallard Exploration Field Office
4715 Innovation Cr., Ste. 100
Fort Collins, CO 80525
[P] 970.226.0342
[F] 970 226.0879
LampRynearson.com
I, Jamison Mcllcain (DPOC, LLC), give permission to Michael Palizzi/Lamp Rynearson to apply for any well
permit or services on our behalf, for the property located at:
0 CR 103, Briggsdale, CO 80611
Legal Description: South Half (S/2) of Section 9, Township 8 N, Range 60 W
Property Owner's Information:
Phone: (214) (471-2718 E-mail: jmeilvain n[)mallardexploration.com
Applicant/Agent Contact Information:
Phone: (303) 319-1385 E-mail: Michael[palizzi@lamprynearson.com
Additional Information:
Owner: DPOC, LLC a Delaware Limited Liability Company
Authorized Agent for DPOC, LLC: Jamison Mcllvain, Executive VP — Land and Business Development
Owner Signature:
Date:
Omaha Fort Collins Lakewood Kansas City
LAMP
RYNEARSON
March 26, 2021
Division of Water Resources
1313 Sherman Street, Suite 821
Denver, CO 80203
RE: Water Well Permit Application Narrative
Mallard Exploration Field Office
4715 Innovation Dr., Ste. 100
Fort Collins, CO 80525
[P] 970.226.0342
[Fl 970.226.0879
LampRynearson.com
A proposed, commercial exempt water well is proposed for the new Mallard Exploration field office location.
The property (a full half section) was recently purchased. There is an existing stock water well on the full half
section property (Permit#27866, Receipt 9063363). The site will be subdivided into two separate properties; a
35 -acre property (which is where the new proposed well will be) and the remaining acreage. The existing stock
well will remain on the larger property (unused) and the proposed commercial exempt well will be located over
800' away within the new 35 -acre property once the property is split via exemption plat.
The exemption plat process has been started and is running concurrently with Weld County's Use by Special
Review process.
Please feel free to contact me at 970-226-0342 or via email at michael.palizzi@lamprynearson.com with any
questions.
Michael Palizzi, PE
Project Manager
Omaha Fort Collins Lakewood Kansas City
Hello