| Form 27/27A |  Related  Doc |
| Date Submitted: | 1/3/2024 |
| Date Recv'd: | 1/3/2024 | Assigned by: | Taylor Robinson |
| DocNum: | 403634964 | API number: | 05-123-17930 |
| Document Type: | FORM 27 | Project Number: | 33531 |
| Operator Information: |
| Operator: | KERR MCGEE OIL & GAS ONSHORE LP |
| Oper. No. | 47120 |
| Address: | P O BOX 173779 DENVER CO 80217-3779 |
| Type Of Facility: | SPILL OR RELEASE |
| Fac. Name | William Mayer 5-22A Wellhead |
| County Name: | WELD |
| Operator contact: | Macy Kiel |
| qtrqtr: SWNW | section: 22 | township: 3N | range: 67W | meridian: 6 |
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| Remediation Details: |
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| Reason for Report: OTHER |
| Cause of Condition: OTHER |
| Potential Receptors: Irrigation ditch 340 feet (ft) north and 780 ft east. Water well 210 ft southeast. Occupied building |
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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 ECMC 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 to provide prior notice of the plugging and abandonment of the William Mayer 5-22A wellhead. The flowline will be permanently removed. The off-location flowline system pre-removal notice was submitted under Form 44 Document No. 403632047. In accordance with ECMC Rule 911.a., soil and groundwater (if present) samples will be collected and submitted for laboratory analysis to determine if concentrations and values are in compliance with ECMC Table 915-1. Visual inspection and field screening of soils around the wellhead and associated flowline will be conducted during sampling activities. Soil vapor screening will also be performed around the wellhead. The topographic Site Location Map showing the geographic setting of the site is provided as Figure 1. The Form 44 is attached. |
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| RECLAMATION PLAN: | The site will be reclaimed in accordance with ECMC 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 | | Kari Brown | | | 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 | 250127 | HSR-WILLIAM MAYER
5-22 | 40.213380/-104.884210 |
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| Remediation | 486341 | William Mayer 5-22A Wellhead
| 40.213380/-104.884210 |
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