| Form 27/27A |  Related  Doc | | Date Submitted: | 1/27/2022 | | Date Recv'd: | 1/27/2022 | Assigned by: | Rob Young | | DocNum: | 402938601 | API number: | 05-123-05952 | | Document Type: | FORM 27 | Project Number: | 22166 | | Operator Information: | | Operator: | 8 NORTH LLC | | Oper. No. | 10575 | | Address: | 555 17TH STREET SUITE 3700 DENVER CO 80202 | | Type Of Facility: | SPILL OR RELEASE | | Fac. Name | PETERS-612N61W | | County Name: | WELD | | Operator contact: | Jacob Evans | | qtrqtr: SESE | section: 33 | township: 12N | range: 61W | meridian: 6 |
| | Remediation Details: | | | Reason for Report: OTHER | | Cause of Condition: OTHER | | Potential Receptors: Plains sharp-tailed grouse production area and pronghorn winter concentration. | | | | HOW REMEDIATE: | As needed, site specific soil and/or groundwater remediation plans will be developed and submitted to COGCC via supplemental Form 27. | | | | INITIAL ACTION: | This form has been prepared to support removal of a wellhead and off-location flowline. Soil samples will be field screened utilizing a photoionization detector, as well as olfactory and visual senses, at approximately the locations indicated on the attached proposed soil sample locations diagram. Soil samples collected beneath the off-location flowline will be field-screened and submitted only if impacts are suspected. Additionally, soil samples from the flowline will be collected and submitted for laboratory analysis from specific areas of concern: where subsurface piping connects to surface equipment,
where Above Ground Storage Tanks (AST), valves, pumps, compressors, or other process equipment were used on a location, and/or at joints, hammer unions, or previous repairs in above ground or subsurface pipe, if present. Grab samples will be collected and field-screened from the base and each sidewall of the excavation to cut and cap the wellhead. At least one sample, either the highest PID result or the base, will be submitted for laboratory analysis. Initial laboratory soil analysis will include BTEX, 1,2,4 and 1,3,5 Trimethylbenzene, naphthalene, TPH, pH, EC, SAR and boron. Samples will be
submitted to a NELAP accredited laboratory using COGCC approved analysis methods. Any identified impacts will be reported as required for each discovery via Form 19 submittal.
| | | | RECLAMATION PLAN: | Reclamation activities will be completed in accordance with 1000 Series Rules, in collaboration with the landowner, and reported in a Form 4 (Sundry Notice) with proper documentation to demonstrate compliance with requirements for final reclamation. After all road base or other material is removed for reclamation, Operator may submit samples for laboratory analysis for soil suitability in compliance with 915.b if impacts from inorganic constituents are indicated. | | | | SOURCE REMOVED: | If a suspected release is identified and confirmed through soil screening and/or laboratory analysis during decommissioning of this facility, soils may be removed and transported to a licensed disposal facility. Transport and disposal records will be kept on file under usual and customary practice and are available upon request. If all source material cannot be removed during excavation activities, additional methodologies will be proposed in subsequent Form 27 supplementals. | | | | Correspondence Log: | | Final Resolution | | Date | Case Closed? | Letter Sent? | CECMC Person | | N/A | N | | Krystal Heibel | | | N/A | N | | Rob Young | | | N/A | N | | Krystal Heibel | | | N/A | N | | Krystal Heibel | | | N/A | N | | Krystal Heibel | | | N/A | N | | Rob Young | | | N/A | N | | Laurel Anderson | | | N/A | N | | Krystal Heibel | | | N/A | N | | Krystal Heibel | |
| | | | Coordinates: | | Type | Facility ID | Facility Name/Num | Lat/Long | | Remediation | -99999 | No Facility
1 | 40.971150/-104.212910 |
| | Remediation | 481792 | PETERS-612N61W
| 40.958322/-104.203712 |
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