| Form 27/27A |  Related  Doc |
| Date Submitted: | 7/10/2023 |
| Date Recv'd: | 7/10/2023 | Assigned by: | Taylor Robinson |
| DocNum: | 403453113 | Facility ID: | 457921 |
| Document Type: | FORM 27 | Project Number: | 30632 |
| 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 | PSC-63N67W |
| County Name: | WELD |
| Operator contact: | Erik Mickelson |
| qtrqtr: NWSE | section: 10 | township: 3N | range: 67W | meridian: 6 |
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| Remediation Details: |
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| Reason for Report: OTHER |
| Cause of Condition: SITE/FACILITY CLOSURE |
| Potential Receptors: County Road 70 feet (ft) west. Water well 980 ft northeast. Surface water 930 ft northeast. |
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| HOW REMEDIATE: | Potential impacts that meet the criteria in Rule 912.b. will be reported to the Director in accordance with that Rule and a site-specific soil and/or groundwater remediation plan will be developed and submitted to the COGCC via a supplemental Form 27 in accordance with Rule 913. If reportable impacts are not encountered, a supplemental Form 27 requesting closure will be submitted within 90 days following completion of sampling activities. Field screening and applicable laboratory analytical results will be reported in all submittals. E&P waste records of material transported off-site are 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 the PSC 15-10, FSV24A&4 O SA 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. The topographic Site Location Map showing the geographic setting of the site is provided as Figure 1. |
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| RECLAMATION PLAN: | The site will be reclaimed in accordance with COGCC 1000 Series Reclamation Rules. |
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| SOURCE REMOVED: | If a suspected release is identified and confirmed through soil screening and/or laboratory analysis, soils will be removed and transported to a licensed disposal facility. 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 | | Taylor Robinson | | | N/A | N | | Collin Metz | | | N/A | N | | Taylor Robinson | | | N/A | N | | Taylor Robinson | | | N/A | N | | Taylor Robinson | |
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| Coordinates: |
| Type | Facility ID | Facility Name/Num | Lat/Long |
| Facility | 457921 | PSC-63N67W
10NWSE | 40.238599/-104.876651 |
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| Remediation | 485465 | PSC 15-10FSV, 24A&4 O SA Facility
| 40.238921/-104.876676 |
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