| Form 27/27A |  Related  Doc |
| Date Submitted: | 11/6/2020 |
| Date Recv'd: | 11/6/2020 | Assigned by: | Chris Canfield |
| DocNum: | 402527286 | Facility ID: | 478395 |
| Document Type: | FORM 27 | Project Number: | 16103 |
| Operator Information: |
| Operator: | KP KAUFFMAN COMPANY INC |
| Oper. No. | 46290 |
| Address: | 1675 BROADWAY, STE 2800 DENVER CO 80202 |
| Type Of Facility: | SPILL OR RELEASE |
| Fac. Name | Jillson #5 Flowline |
| County Name: | WELD |
| Operator contact: | Max Knop |
| qtrqtr: NWNW | section: 27 | township: 2N | range: 68W | meridian: 6 |
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| Remediation Details: |
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| Reason for Report: SPILL |
| Cause of Condition: SPILL OR RELEASE |
| Potential Receptors: |
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| HOW REMEDIATE: | Impacted soil will be excavated and disposed of at a certified disposal facility. |
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| INITIAL ACTION: | Flowline release occurred on July 15, 2020. Release was reported to KPK by the surface owner. KPK immediately shut-in associated well operations to resolve the release. During the flowline release event, KPK does not believe any liquids were released. KPK began excavation (potholing) on September 24, 2020 to expose damaged section of flowline responsible for release. Potholing was unsuccessful in uncovering correct flowline associated with the release. |
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| RECLAMATION PLAN: | Upon obtaining compliant confirmation soil samples, the excavation area will be backfilled, recontoured, and seeded to match surrounding area. |
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| SOURCE REMOVED: | Release area is currently being investigated using a hydrovac unit. All removed material from the hydrovacing activites will be disposed of at a certified disposal facility. Impacted soil will be excavated until soil sample results prove no exceedances of Table 910-1 thresholds as described in proposed soil sampling investigation plan. |
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| Correspondence Log: |
| Final Resolution | | Date | Case Closed? | Letter Sent? | CECMC Person | | 12/30/2020 | Y | | Chris Canfield | | | N/A | N | | Chris Canfield | |
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| Coordinates: |
| Type | Facility ID | Facility Name/Num | Lat/Long |
| Facility | 478395 | Jillson #5 Flowline
| 40.116822/-104.993759 |
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