| Form 27/27A |  Related  Doc |
| Date Submitted: | 4/30/2021 |
| Date Recv'd: | 4/30/2021 | Assigned by: | Robert Chesson |
| DocNum: | 402676505 | Facility ID: | 336383 |
| Document Type: | FORM 27 | Project Number: | 17960 |
| Operator Information: |
| Operator: | KERR MCGEE OIL & GAS ONSHORE LP |
| Oper. No. | 47120 |
| Address: | P O BOX 173779 DENVER CO 80217-3779 |
| Type Of Facility: | LOCATION |
| Fac. Name | MOSER H-63N65W |
| County Name: | WELD |
| Operator contact: | Gregory Hamilton |
| qtrqtr: NENW | section: 21 | township: 3N | range: 65W | meridian: 6 |
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| Remediation Details: |
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| Reason for Report: OTHER |
| Cause of Condition: MULTIPLE |
| Potential Receptors: The nearest domestic water well is located approximately 380 feet southwest of the facility.
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| HOW REMEDIATE: | Potential impacts that meet the criteria outlined in Rule 912.b.(1) A. through J. will be reported to the Director in accordance with Rule 912.b.(1). A site-specific soil and/or groundwater remediation plan will be developed and submitted to the COGCC through a Form 27-Supplemental in accordance with Rule 912.c.(1). If reportable impacts are not encountered, a Form 27-Supplemental requesting closure will be submitted within 90 days following facility decommissioning activities. Field observations, screening results and applicable laboratory analytical results will be provided in the Form 27-Supplemental. E&P waste records of material transported off-site will be kept on file and available upon request. |
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| INITIAL ACTION: | This form has been prepared in accordance with COGCC Rule 911.a to provide prior notice of closure of one separator, one partially-buried produced water vault (PWV), and one above ground storage tank (AST) at the Moser H 21-29, Moser H 21-30 production facility. Visual inspection and field screening of soils will be conducted following decommissioning of the associated infrastructure. Based on these observations, soil and groundwater (if present) samples will be collected and submitted for laboratory analysis to determine if concentrations and values are in compliance with COGCC Table 915-1. |
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| RECLAMATION PLAN: | Facility infrastructure will remain in place. The site will be reclaimed in accordance with COGCC 1000 Series Reclamation Rules following future facility decommissioning activities. |
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| SOURCE REMOVED: | If a suspected release is identified and confirmed through soil screening and/or laboratory analysis, impacted soils will be removed and transported to a licensed disposal facility in accordance with Rules 905 and 906. Disposal records will be kept on file and available upon request. |
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| Correspondence Log: |
| Final Resolution | | Date | Case Closed? | Letter Sent? | CECMC Person | | N/A | N | | Robert Chesson | | | 10/19/2021 | Y | | Robert Chesson | |
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| Coordinates: |
| Type | Facility ID | Facility Name/Num | Lat/Long |
| Facility | 336383 | MOSER FED
3-21HZ | 40.217899/-104.676789 |
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| Remediation | 480310 | Moser Tank Battery Release
| 40.217911/-104.676859 |
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