Application For Treating Plant - Form 1tp

Application for Treating Plant - Form 1.T.P Department of Mineral Resources Oil and Gas Division 600 East Boulevard Dept 474 Bismarck, N.D 58505 to 0614 (01 to 2018)

Please Read Instructions Before Filling Out Form.

Field: Reset

Field: Print

Please Submit the Original and One Copy.

Field: Type of Work.

Field: Approximate Date Construction Will Start

Field: Operator

Field: Telephone Number

Field: Address

Field: City

Field: State

Field: Zip Code

Field: Name of Surface Owner

Field: Address

Field: City

Field: State

Field: Zip Code

Checkbox option: Notice has been provided to the owner of any permanently occupied dwelling within 1,320 feet of the site perimeter. Also see instructions.

Checkbox option: The treating plant site perimeter is not located within 500 feet of an occupied dwelling. Also see instructions.

Plant Information

Field: Plant Name

Field: Plant Number

Field: Surface Location

Field: Qtr-Qtr

Field: Section

Field: Township

Field: Range

Field: County

Field: Latitude of Center

Field: Longitude of Center

Field: N.A.D Reference

Field: Ground Elevation Feet Above S.L.

Field: Identify the Primary Waste Streams to be Accepted

Field: Process Type(s) (Shale Shaker, Centrifuge, Filter Press, Filtering, Chemical or Gravity Separation, Thermal, etcetera)

Field: Total Number of Tanks to be on Site

Field: Total Enclosed Tank Volume to be on Site Barrels

Field: Total Open-Topped Tank or Container Volume to be on Site Barrels

Field: Total Volume of Solids Stockpiled on Approved Medium or Substrate to be on Site Barrels

Note: Multiply Cubic Feet by 0.1781 to Obtain Barrels.

Is There a Leak Detection System? Also See Instructions.

Checkbox option: Yes

Checkbox option: No

Will Oil be Recovered and Sold?

Checkbox option: Yes

Checkbox option: No

Field: Identify Any Other Permits Required from State Agencies

Field: Comments

I hereby swear or affirm that the information provided is true, complete and correct as determined from all available records.

Field: Date

Field: Signature

Field: Printed Name

Field: Title

Field: Email Address(es)

for State Use Only

for State Use Only

Field: Permit and Facility Number

Field: Industrial Commission Order No.

Field: Date Approved

Field: Field

Field: By

Field: Title

Application for Treating Plant - Form 1.T.P S.F.N 1.T.P

1. Please refer to Section 43-02-03-51 through 51.4 of the North Dakota Administrative Code (N.D.A.C) regarding treating plant permit requirements.

2. No treating plant may be constructed without obtaining a permit from the Commission after notice and hearing.

3. Before construction of a treating plant begins, the operator shall file with the Commission a surety bond or cash bond in the amount specified by the Commission.

4. The application for treating plant shall be accompanied by an accurate plat certified by a registered surveyor showing the location of the proposed treating plant and the center of the site with reference to true north and the nearest lines of a governmental section. The plat shall also include the latitude and longitude of the center of the proposed treating plant location to the nearest tenth of a second, and the ground elevation. The plat shall also depict the outside perimeter of the treating plant site and verification that the entire site is at least five hundred feet exempt from an occupied dwelling.

5. The application for treating plant shall be accompanied by an affidavit of mailing identifying each owner of any permanently owned dwelling within one-quarter mile of the proposed treating plant site and certifying that such owner has been notified of the proposed treating plant.

6. The application for treating plant shall be accompanied by schematic drawing(s) of the proposed treating plant site, drawn to scale, detailing all facilities and equipment, including the size, location, and purpose of all tanks, the height and location of all dikes as well as the calculated containment volume, all areas underlain by a synthetic liner, any leak detection system installed, the location of all flowlines, and the location of the topsoil stockpile. Also included shall be the proposed road access to the nearest existing public road and the authority to build such access.

7. The application for treating plant shall be accompanied by the proposed pad layout, including cut and fill diagrams.

8. The application for treating plant shall be accompanied by appropriate geological data on the surface geology indicating its suitability for fluid containment.

9. The application for treating plant shall be accompanied by any proposed monitoring plans and leak detection system for all buried or partially buried structures, or any other structure deemed necessary.

10. The capacity and operational capacity of the treating plant shall be included.

11. The type of process shall be included, such as shale shaker, centrifuge, filter press, filtering, chemical or gravity separation, thermal, etcetera

12. The application for treating plant shall be accompanied by a narrative description of the process and how the waste and recovered product streams travel through the treating plant.

13. The destination of the recovered wastes and products shall be included.

14. Identify other permits required from other state agencies (including air quality, stormwater, pollutant discharge elimination system, etcetera).

15. Attach a map identifying any surficial aquifers and/or well head protection areas with the proposed treating plant location plotted on print.. Two websites where these features can be found are: nd dot gov U.R.L (surficial aquifers found under hydrography and well head protection areas found under locations), and http/mapservice.swc dot nd dot gov (surficial aquifers and well head protection areas found under water resources).

16. The approved application for treating plant shall automatically expire one year after the date it was issued unless corrective operations have commenced to construct the site.

17. All rules in Chapter 43-02-03 governing oil well sites shall also apply to any treating plant site if applicable.

18. The original and one copy of the entire application shall be filed with the Industrial Commission of North Dakota, Oil and Gas Division, 600 East Boulevard, Dept. 405, Bismarck, N.D 58505 to 0840 before a hearing will be scheduled.