NEW CONSTRUCTION GROUND DISTURBANCE PACKAGE REQUEST & DOCUMENTATION PACKAGE CHECKLIST

Transcription

1 REQUEST INFORMATION NEW CONSTRUCTION GROUND DISTURBANCE PACKAGE REQUEST & DOCUMENTATION PACKAGE CHECKLIST Phone #: Project #: EWR #: Dig Location (LSD, TWP, RGE) (Attach sketch as required): Associated facility or system area: W5 R New Construction Existing ORIGINATOR USE ONLY BILLING INFORMATION Originator Name: JOHN DOE Approver JOHN.DOE@ABACUSDATAGRAPHIC S.COM JOHN.DOE@ABACUSDATAGRAPHIC S.COM Approver #: XX-XXXXXX Phone #: Location: Fax #: AFE: XX-XXXXX-XX-XX-XX Package Required Date: Mar 18, 2013 Work Order: Auditor: Account Code: XXXXX PO #: Minimum 2 days notice required for construction of package Cost Centre #: Job Scope / Work Description New Lease Construction XXXXXXXXXXX The following documents in bold text are to be the minimum necessary, and must be in any ground disturbance package prior to the ground disturbance package being forwareded to the site representative. All other items provided will be provided dependent on the specific task being undertaken. Certificates of Title, ERCB information, ABADATA must not be greater than 30 days old when the package is issued to field personnel. Documents greater than 30 days must be updated. All crossing agreements, proximity permits and encroachment notices must be valid and current before the package is issued to field personnel. ABACUS DOCUMENTATION DOCUMENTATION R Ground Disturbance Documentation Check Systems Map List & Request Form "As-builts" / plot plans (if available)) R Ground Disturbance Control Sheet Crossing Agreement R ERCB Baseline Maps (AB only) Encroachment Agreement or Notification R Survey Plan Proximity Permit or Notification R Abadata Map / Systems Map Certificate of Title (Freehold) R Standing Report (Crown) R ERCB PL100 (AB only) R Travel/Direction Map R Aerial Photograph Pipeline List (SK & BC) Certificate of Title Summary COMMENTS: Site representatives must complete/submit One-Call notification a MINIMUM 2 Full Working Days prior to work commencing. The documentation generated by this process must be filled in the ground disturbance package. Alberta British Columbia Saskatchewan JOHN DOE Originator Name Signature Date Allana Wolstenholme Abacus Representative Signature Mar 18, 2013 Date Allana Wolstenholme Abacus Control Sheet Rep Signature Mar 18, 2013 Date RETURN TO ORIGINATOR UPON COMPLETION GD ID: GD Web Request ID: 225

2 GROUND DISTURBANCE CONTROL SHEET The information shown on this sheet is intended to identify concerns relative to the proposed ground disturbance being planned. Every effort has been made to ensure all facilitiesof public record are shown in the immediate area of the planned ground disturbance. Notwithstanding this, under no circumstances is this information to be used to the exclusion of proper due diligence. This would include putting in One Calls, proper blind sweeping procedures and examining the included ground disturbance package to verify that all information is available that relates to the proposed ground disturbance has been considered. Caution: The information shown on this ground disturbance control sheet is only intended to give an overview of what facilitiesare located within the proposed work area. Under no circumstances should this information be used to the exclusion of the detailed information contained in this package. Date: Mar 18, 2013 Requested By: John Doe Location: W5M Details of Ground Disturbance: New Lease Construction Cautions: This ground disturbance package identifies the following high pressure lines of public record that are of concern and must be verified prior to any excavation taking place. Husky Oil has four lines within the work area; -1, -7, -9 & -21. There are no other facilities of public record within the work area. Legend: Alberta One Call # GAS Pipelines are shown thus... OIL Pipelines are shown thus... WATER Pipelines are shown thus... Pipeline Right-of-ways are shown thus... Alberta One Call Respondents: HIGH PRESSURE PIPELINES OWNER HUSKY OIL OPERATIONS 1 HUSKY OIL OPERATIONS 21 LICENCE# LN# LOCATION VERIFIED YES NO N/A HIGH PRESSURE PIPELINES OWNER HUSKY OIL OPERATIONS 7 HUSKY OIL OPERATIONS 9 LICENCE# LN# LOCATION VERIFIED YES NO N/A LOW PRESSURE PIPELINES OWNER LOCATION VERIFIED YES NO N/A U/G ELECTRICAL OWNER LOCATION VERIFIED YES NO N/A FIBRE OPTIC TELUS OWNER LOCATION VERIFIED YES NO N/A OWNER CATHODIC FIELD/ANODE BED, CABLE MISC. LOCATION VERIFIED YES NO N/A Comments:

3 ( ) ( ) PIPELINE R/W HUSKY OIL OPER - 21 (P) HUSKY OIL OPER - 9 (O) HUSKY OIL OPER - 1 (O) MSL W5M SW W5 HUSKY OIL OPER - 7 (O)

4 HUSKY OIL OPER - 21 (P) HUSKY OIL OPER - 9 (O) 8 HUSKY OIL OPER - 1 (O) W5M SW W5 HUSKY OIL OPER - 7 (O) 5 4 1

5 ( ) ( ) PIPELINE R/W HUSKY OIL OPER - 21 (P) HUSKY OIL OPER - 9 (O) HUSKY OIL OPER - 1 (O) MSL W5M SW W5 HUSKY OIL OPER - 7 (O)

6 ERCB Pipeline Report Page 1 of 1 18/03/2013 PRINT REPORT VIEW IN EXCEL HIGHLIGHT ALL CLOSE REPORT NOTE: Click on an ERCB Licence/Line # to highlight it on the map. ERCB LIC/LINE # ABACUS # COMPANY NAME SYSTEM NAME FR LSD FR SEC ERCB PIPELINE INFORMATION FOR W5M FR TWP FR RGE FR WOF FR FAC TO LSD TO SEC TO TWP TO RGE TO WOF TO FAC LGTH (kms) STS SUB H2S (mol/ kmol) OD (mm) WT (mm) MAT TYPE GRD MOP (kpa) JNT HUSKY OIL OPERATIONS LIMI WE PL 9.56 O NG S Z W U HUSKY OIL OPERATIONS LIMI B B 2.2 O NG S Z W U HUSKY OIL OPERATIONS LIMI WE PL 0.56 O NG S Z W U HUSKY OIL OPERATIONS LIMI PL B 0.56 P NG S Z W U INTL COAT ERCB PIPELINE INFORMATION CURRENT TO MARCH 4, 2013

7 ERCB Well Report Page 1 of 1 18/03/2013 PRINT REPORT VIEW IN EXCEL CLOSE REPORT WELL ID: 00 / W5 / 0 LICENCE #: LICENCE DATE: FEBRUARY 7, 2003 WELL NAME: HUSKY MINEHEAD WITHIN: W5 H2S (mol/kmol): 0 (NO ANALYSIS ) LICENCEE: HUSKY OIL OPERATIONS LIMITED SPUD DATE: FEBRUARY 21, 2003 FINAL DRILL DATE: MARCH 13, 2003 STATUS: GAS PUMP ABANDONED DATE: SURFACE: DOWNHOLE: OFFSETS: N 90.4 E OFFSETS: N 90.4 E LATITUDE: LATITUDE: LONGITUDE: LONGITUDE: GROUND ELEVATION: 1066 m TOTAL DEPTH: 2615 m WELL TYPE: NOT AVAILABLE SUBSTANCE: NOT AVAILABLE WELL ID: 00 / W5 / 5 LICENCE #: LICENCE DATE: DECEMBER 12, 2011 WELL NAME: HUSKY MINEHEAD WITHIN: W5 H2S (mol/kmol): NOT AVAILABLE LICENCEE: HUSKY OIL OPERATIONS LIMITED SPUD DATE: JANUARY 1, 2012 FINAL DRILL DATE: FEBRUARY 8, 2012 STATUS: COMM ABANDONED DATE: SURFACE: DOWNHOLE: OFFSETS: N 106 E OFFSETS: N E LATITUDE: LATITUDE: LONGITUDE: LONGITUDE: GROUND ELEVATION: 1068 m TOTAL DEPTH: 3329 m WELL TYPE: NOT AVAILABLE SUBSTANCE: NOT AVAILABLE ERCB WELL INFORMATION CURRENT TO FEBRUARY 28, 2013

8 TR 540 TR 535 TR 534 RR 2 TR 540 TR 535 TR 534 RR 230 Direction Map To W5M TR 541 TR 540 TR 535 RR 210 Sundance Provincial Park TR 541 TR 540 TR 535 RR 190 TR 541 TR 540 TR W5M RR 254 RR 253 RR W5M RR 251 TR 533 TR 532 TR 531 TR 530 TR 525 TR 524 TR 523 TR 522 TR 521 TR 520 TR 515 TR 514 RR 250 RR 250 RR W5M RR 244 RR 243 RR 242 RR 241 RR 240 RR 235 Athabasca River W5M PEDLEY W5M RR 234 RR 233 RR 232 RR 231 DALEHURST W5M TR 525 TR 524 TR 523 TR 522 TR 521 TR 520 TR 515 TR 514 TR 533 TR 532 TR 531 TR 530 RR 230 RR 230 RR W5M Obed Lake OBED RR 224 RR 223 RR 222 RR W5M RR 220 RR W5M RR 214 RR 213 RR W5M RR 211 TR 534 TR 533 TR 532 TR 531 TR TR 525 TR 524 TR 523 TR 522 TR 521 TR 520 TR 515 RR 210 RR 210 RR W5M W5M RR 204 RR 203 RR 202 RR 201 RR 200 MARLBORO HORNBECK GALLOWAY Annabet Lake W5M W5M Fickle Lake RR 195 RR 194 RR 193 RR 192 RR 191 TR 534 TR 533 Hornbeck Creek Provincial Recreation Area TR 532 TR 531 TR 530 TR 525 TR 524 TR 523 TR 522 TR 521 TR 520 TR 515 RR 190 RR 190 RR 185 RR W5M RR 183 RR 182 BICKERDIKE W5M MCLEOD RIVER ANSELL RR 181 RR 180 RR 175 McLeod River W5M Edson RR 174 RR 173 RR W5M RR 171 TR 534 TR 533 TR 532 TR 531 TR 530 TR 525 TR 524 TR 523 TR 522 TR 521 TR 520 TR 515 RR 170 RR W5M Hinton Thompson Lake Maxwell Lake TR 513 TR 512 TR 511 RR 253 RR 252 RR 251 RR 250 RR 245 TR 510 TR W5M RR 244 RR 243 RR 242 RR 241 RR 240 RR W5M RR 234 RR 233 RR 232 RR 231 TR 513 TR 512 TR 511 TR 510 RR 230 TR 505 RR W5M RR 224 RR 223 RR 222 RR 221 RR 220 RR W5M RR 214 RR 213 RR 212 RR 211 TR 514 TR 513 TR 512 TR 511 TR 510 RR 210 RR W5M RR 204 RR 203 RR 202 RR 201 RR 200 WEALD RR W5M RR 194 RR 193 RR 192 RR 191 TR 514 TR 513 ERITH TR 512 TR 511 TR 510 RR 190 RR W5M RR 184 RR 183 RR 182 RR 181 RR 180 RR W5M RR 174 RR 173 RR 172 RR 171 TR 514 TR 513 TR 512 TR 511 TR 510 RR 170 TR 504 TR 505 TR 505 TR W5M 40 TR 503 TR 502 TR 501 TR 500 TR 495 TR 494 RR W5M W5M TR 503 TR 502 McLeod River Provincial Recreation Area TR 501 TR 500 TR 495 TR 494 RR W5M W5M TR 504 TR 503 TR 502 TR 501 TR 500 TR 495 RR W5M EMBARRAS W5M TR 504 TR 503 TR 502 TR 501 TR 500 TR 495 RR W5M W5M TR 5 TR 5 TR W5M RR 254 RR 253 RR 252 RR 251 TR 493 TR 492 TR 491 TR 490 TR 485 RR 250 RR W5M RR 244 RR 243 RR 242 RR 241 RR 240 RR W5M RR 234 RR 233 RR 232 RR 231 TR 493 TR 492 TR 491 TR 490 TR 485 RR 230 RR W5M RR 224 RR 223 RR 222 RR 221 RR 220 RR W5M ROBB RR 214 RR 213 RR 212 RR 211 TR 494 TR 493 TR 492 TR 491 TR 490 RR 210 RR W5M RR 204 RR 203 RR 202 RR 201 RR 200 RR W5M RR 194 RR 193 RR 192 RR 191 TR 494 TR 493 TR 492 TR 491 TR 490 RR 190 RR 185 RR W5M RR 183 RR 182 RR 181 RR 180 RR W5M RR 174 RR 173 RR 172 RR 171 TR 4 TR 4 TR 4 TR 49 TR W5M TR 484 TR 483 TR 482 TR 481 TR 480 TR 475 RR W5M W5M TR 484 TR 483 TR 482 TR 481 TR 480 TR 475 RR W5M MERCOAL W5M TR 485 TR 484 TR TR 482 TR 481 TR 480 RR 210 DISS W5M W5M TR 485 TR 484 TR 483 TR 482 TR 481 TR 480 RR W5M W5M TR 48 TR 48 TR 48 TR 482 TR 481 TR W5M sper National Park TR 474 TR W5M W5M TR Watson Creek Provincial Recreation Area TR W5M TR 475 TR 474 COAL VALLEY FOOTHILLS Lovett River Provincial Recreation Area TR 475 TR 474 TR 475 Pembina RiR TR 474

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13 116 37'0"W '0"W '0"W Raven Creek Erith River Hanian '48"N 53 14'48"N 53 16'48"N Creek Erit (3) '0"W 0 2,000 4,000 8,000 Metres ALL PIPELINES IN TWP W5 REVISION DATE: 18 December 2012 Coordinate System: 10TM CAUTION - THIS PLOT REPRESENTS THE BEST INFORMATION AVAILABLE TO THE BOARD AT THIS TIME. - SPECIFIC PIPELINE LOCATIONS SHOULD BE OBTAINED FROM SURVEY PLANS, OWNERS AND FIELD OBSERVATION BEFORE DIGGING. - LOW-PRESSURE GAS DISTRIBUTION LINES ARE NOT SHOWN. CONTACT THE GAS DISTRIBUTOR IN THIS AREA FOR LINE LOCATION PERMITTED: LICENSED: DISCONTINUED, ABANDONED, OR ABANDONED AND PARTIALLY REMOVED: LEGEND

14 Land Status Report Page 1 of 1 18/03/2013 PRINT REPORT VIEW IN EXCEL CLOSE REPORT SORT BY ACTIVITY General Land Data Location Surface Administrative Titled Surveyed Water Freehold Land Freehold Title Existance Ownership Crown Agency Status Status Coverage Area (ha) Area (ha) Township W5M CROWN FLW MIXED SURVEYED ALL EXISTENT PARTLY COVERED 0 0 Section W5M CROWN FLW UNTITLED SURVEYED ALL EXISTENT N SW W5M CROWN FLW UNTITLED SURVEYED ALL EXISTENT N LSD W5M CROWN FLW UNTITLED SURVEYED ALL EXISTENT N 0 0 Surface Disposition Data Location Activity Client Activity Effective Expiry Plan Plan Plan Num. Option to Near Area (ha) Activity Purpose ID Name Status Date Date No. Type Type Purchase Water Dimensions Comments O.C. 463/88 ; O.C. Township W5M FMA WEST FRASER MILLS LTD. Active/Disposed 6/15/1988 4/30/ UNKNOWN 214/89 ; O.C.610/95 ; O.C. 565/2007 Section W5M TPA 1266 ARLIN HILLA Active/Disposed 8/17/1987 6/30/ UNKNOWN SW W5M LOC HUSKY OIL OPERATIONS LIMITED Letter of Authority for Amendment 1/1/1900 1/28/ IHS Import MINERAL SURFACE 3.89 N ACCESS ROAD 20M X 1.96KM LOC HUSKY OIL OPERATIONS LIMITED Letter of Authority for Amendment 1/1/1900 5/13/ IHS Import MINERAL SURFACE 2.58 N ACCESS ROAD 20 M X 1.22 KM,18M X 0.5KM,15M X 0.48KM MSL HUSKY OIL OPERATIONS LIMITED Letter of Authority 1/1/1900 1/28/ IHS Import MINERAL SURFACE 1.44 N WELLSITE 120M X 120M MSL HUSKY OIL OPERATIONS LIMITED Active/Disposed 12/6/ /5/ Conventional Survey MINERAL SURFACE WELLSITE irregular PLA HUSKY OIL OPERATIONS LIMITED Letter of Authority 1/1/ /31/ IHS Import PIPELINE 13 Y PIPELINE 5M, 15M PLA HUSKY OIL OPERATIONS LIMITED Letter of Authority for Amendment 1/1/ /31/ Conventional Survey PIPELINE N PIPELINE 10 M & 15 M PLA HUSKY OIL OPERATIONS LIMITED Letter of Authority for Amendment 1/1/ /31/ IHS Import PIPELINE N PIPELINE 10 M & 15 M PLA HUSKY OIL OPERATIONS LIMITED Letter of Authority 1/1/ /31/ Sketch PIPELINE PIPELINE 10M,13M PLA HUSKY OIL OPERATIONS LIMITED Letter of Authority 1/1/ /31/ Sketch PIPELINE PIPELINE 15M PLA HUSKY OIL OPERATIONS LIMITED Active/Disposed 6/18/2012 6/17/ Conventional Survey PIPELINE PIPELINE 10 m TFA SYNTERRA TECHNOLOGIES LTD. Active/Disposed 11/22/2010 1/1/ UNKNOWN TFA SYNTERRA TECHNOLOGIES LTD. Active/Disposed 12/6/2010 1/1/ UNKNOWN TFA SYNTERRA TECHNOLOGIES LTD. Active/Disposed 12/8/2010 1/1/ UNKNOWN Company Contact Information Name Address City Province/State Country Postal Code Attention Client # ARLIN HILLA AVE EDSON AB CANADA T7E 1E HUSKY OIL OPERATIONS LIMITED AVE SW PO BOX 6525 STN D CALGARY Alberta CANADA T2P 3G7 LAND DEPARTMENT 573 SYNTERRA TECHNOLOGIES LTD AVE SE SUITE 304 CALGARY AB CANADA T2G 0V WEST FRASER MILLS LTD. WOODLANDS 756 SWITZER DR HINTON Alberta CANADA T7V 0A2 HINTON WOOD PRODUCTS

15 PLA SRD Plan: P, , kma PLA SRD Plan: P, , kma PLA SRD Plan: P, , kma PLA SRD Plan: P, , kma