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HomeMy WebLinkAbout04527150 DED INDIVIDUAL SEWAGE DISPOSAL PERMIT PROPERTY 1: t� Owner's Name g M±±'Li rvASe, 1 (`:i'i Present Address fb�� 325 � , Phone X7-`7 �� J. System Location ,, n I c� ) - flS 112,013 V�f� i 17f�. Legal Description of Assessor's Parcel No. 11-11;i:27--)-E6-2_ -co DU- GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT 108 Eighth Street, Suite 401 4 5 2 7 Glenwood Springs, Colorado 81601 Permit Phone (970) 945-8212 Assessor's Parcel No. 2a." -U32-00 DcLi This does not constitute a building or use permit. SYSTEM DESIGN re \A V Q \ 1 \cF- Septic Tank Capacity (gallon) Other Percolation Rate (minutes/inch) Number of Bedrooms (or other) Required Absorption Area - See Attached Special Setback Requirements: Date Inspector FINAL SYSTEM INSPECTION AND APPROVAL (as installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer Septic Tank Capacity Septic Tank Manufacturer or Trade Name Septic Tank Access within 8" of surface Absorption Area Absorption Area Type and/or Manufacturer or Trade Name Adequate compliance with County and State regulations/requirements Other Date Inspector RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE CONDITIONS: 1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems Chapter 25, Article 10 C.R.S. 1973, Revised 1984. 2. This permit is valid only for connection to structures which have fully complied with County zoning and building requirements, Connection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a violation or a requirement of the permit and cause for both legal action and revocation of the permit. 3. Any person who constructs, alters, or installs an individual sewage disposal system in a manner which involves a knowing and material variation from the terms or specifications contained in the application of permit commits a Class 1, Petty Offense ($500.00 fine - 6 months in jail or both). White -APPLICANT Yellow - DEPARTMENT GARFIELD COUNTY SEPTIC PERMIT APPLICATION 108 8th Street, Suite 401, Glenwood Springs, Co 81601 Phone: 970-945-8212 / Fax: 970-384-3470 / Inspection Line: 970-384-5003 www.gurfield-county.com 1 Perk Fee: _ Parcel No: (this information is available at the assessors office 970945-9134) 2453 052 00004 2 Septic Permit #: Job Address: (if an address has not been assigned, ()tease provide Cr, Hwy or Street Name & City) or and legal description App. 12.25 miles S of Town of Rifle, NWNE, Section 5, T8S, R93W, 6th P.M. 3 Buil Lot Size: Lot No: Block No: Subd./ Exemption: 320 Acres N/A N/A N/A 4 Owner: (properly ower) R.M. and Lindsey A. Johnson Mailing Address 2384 Hwy 325 Rifle, CO 81650 Ph: 970-625-5353 Alt Ph: 5 Contractor: Laramie Energy 11, LLC Mailing Address 601 28-1/4 Road Grand Junction, co 81506 Ph, 970-683-5419 Alt Ph: 970-985-5383 6 Engineer: N/A Mailing Address Ph: Alt Ph: 7 PERMIT REQUEST FOR: (X) New Installation ( ) Alteration ( ) Repair 8 WASTE TYPE: ( )Dwelling ( )Transient Use (X)Commercial or industrial ( )Non- Domestic wastes ( )other - Describe 9 BUILDING OR SERVICE TYPE: Sewage vaults associated with tempo ary employee housing - Pad Johnson Fed 5-152 Number of bedrooms N/A Garbage Grinder ( )Yes (X)No 10 SOURCE &TYPE OF WATER SUPPLY: ( )WELL ( )SPRING ( )STREAM OR CREEK (X)CISTERN If supplied by COMMUNITY WATER, give name of supplier: Water hauled to location by Thirsty water 11 DISTANCE TO NEAREST COMMUNITY SEWER Was an effort made to connect to the Community System? SYSTEM: Town of Rifle - app. 12.25 miles to the North No - dist anCe too great YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITH OUT A SITE PLAN 12 GROUND CONDITIONS: Depth tots, Ground Water Table_app . 80 feet Percent Ground Slope < 10- 0%13 13 TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM (ISDS) PROPOSED: ( }Septic Tank ( )Aeration Plant ()Vault ( )Vault Privy ( )Composting Toilet ( )Recycling, Potable Use ( )Recycling, other use ( )Pit Privy ( )Incineration Toilet ( )Chemical Toilet ( )Other- Describe 14 FINAL DISPOSAL BY: ( )Absorption trench, Bed or Pit ( )Underground ( )Wastewater pond (X)Other- Dispersal ( )Above Ground Dispersal ( )Evapotranspiration ( )Sand filter DescribeSouth Canyon or W. Garfield Landfill or other permitted facility 15 Will effluent be discharged directly into waters of the state? ( )YES (X)NO 16 PERCOLATION TEST RESULT: (to be completed by Registered Professional Engineer, if the Engineer does the Percolation Test( Minutes N/A per inch in hole No.1 Minutes N/A per inch in hole No.3 No._ Minutes N/A per inch in hole No.2 Minutes N/A per inch in hole Name, address & telephone of RPE who made Name, address & telephone of RPE responsible soil absorption test: N/A For design of the system: N/A 17 Applicant acknowledges that the completeness of the application is conditional upon such further mandatory and additional test and reports as may be required by the local health department to be made and furnished by the applicant or by the local health department for purposed of the evaluation of the application; and the issuance of the permit is subject to such terms and conditions as deemed necessary to insure compliance with rules and regulations made, information and reports submitted herewith and required to be submitted by the applicant are or will be represented to be true and correct to the best of my knowledge and belief and are designed to be relied on by the local department of health in evaluating the same for purposes of issuing the permit applied for herein. 1 further understand that any falsification or misrepresentation may result in the denial of the application or revocation of any permit granted based upon said application and legal action for perjury as provide by laaw. 11/06/08 OWNERS SIGNATURE DATE AFF USE ONLY Permit Fee: 7 Perk Fee: Total fees: g"i'eermit #: (4604 15-028 Septic Permit #: Issue Date: Buil ingD aik 1(— 124—OR— ArPROVAL DATE Lorne Prescott From: Andy Schwaller[aschwaller©garfield-county.comj Sent: Wednesday, October 01, 2008 4:09 PM To: Lorne Prescott Subject: RE: Temp Housing Building Permit(s) Possibly having the option to do both a single permit per pad of several units and also the option of issuing a single permit for each building would be a good way to go. If you guys are doing work for Company A and they move the same units with the rig every time the rig moves, it would make sense to issue one permit for all the units and just amend the permit with a new site plan when the rig moves. Company 6 may mix and match rigs with units and a single permit per building would make sense. Based on that, submit your application based on the practice the company will be following and let's hope they do not mix the two options. If it appears a company may mix the two options, then one complete application per building would be the best way to go. Andy From: Lorne Prescott[mailto:LornePrescott©cordcomp.com] Sent: Wednesday, October 01, 2008 1:19 PM To: Andy Schwaller Subject: Temp Housing Building Permit(s) Andy, Thanks again for answering my questions this morning, I have another one: If I am applying for building permits for a number of housing units on a single COGCC approved drill site, I know I have to submit an application for each unit but , do I have to provide a set of site plans for each unit as well or can I group all the units specific to the pad site and just provide 2 site plans for the entire pad site. The site plan would reflect ail the housing units for the pad site. I'm trying not to double up on the paperwork since the site plan would be the same for all the units on the pad site. Thanks Lorne C. Prescott Project Scientist Cordilleran Compliance Services 826 21 1/2 Road Grand Junction, Colorado 81505 970.263.7800 Office 970.263.7456 Fax 970.210.6889 Cell gv nta A4zf-*#&7.--fac (144)44 GENERAL PERMIT DOMESTIC WASTEWATER VAULT SYSTEMS AUTHORIZATION TO UTILIZE A VAULT SYSTEM UNDER THE GARFIELD COUNTY BOARD OF HEALTH "INDIVIDUAL SEWAGE DISPOSAL SYSTEMS REGULATIONS" The Garfield County Board of Health "Individual Sewage Disposal Systems Regulations" adopted in 1994 pursuant to current guidelines of the state board and adopted in compliance with Section 25-10-104(2), (3), and (4) C.R.S., shall govern all aspects of permits, performance, location, construction, alteration, installation, and use of individual sewage disposal systems of less than 2,000 gallon per day design capacity. This permit specifically authorizes the entity(s) listed on page 1 of this document to install and utilize a vault system, as of the effective dates stated on page 1, in accordance with permit requirements and conditions set forth in part 1 hereof. Any vault system installation authorized herein shall be consistent with the terms and conditions of the permit. SEPTIC PERMIT NUMBER WELL SITE LOCATIONS (APDti(s))7rzi-bc p 14 5-f r , j trEH imC� OPERATORS NAME L �Y �? A. GENERAL: Vaulted wastewater systems are not permitted in Garfield County for any facility that will generate 2000 gallons or more of wastewater per day. A vault system as permitted by Garfield County is allowed only for limited use occupancy with a cumulative usage period of less than one year and for occupancy of 24 or less people, only on property which cannot accommodate a sewage treatment system. Vault systems are allowed on oil and gas well pads due to the limited development time frames and limitation of on site disturbance set by the Colorado Oil and Gas Conservation Commission, the United States Forest Service and the Bureau of Land Management. A vault, as permitted by the local board of health, shall have a minimum 1000 gallon effective capacity. B. TERMS AND CONDITIONS 1. Minimum, horizontal distances from the various components of a system to pertinent terrain features, including streams, lakes, water courses, springs, wells, subsoil drains, cisterns, water lines, suction lines, gulches, dwellings, other occupied buildings and property lines, shall be in accordance with the following "Table of Minimum Horizontal Distances". 2. No vault system shall be installed in a floodway. 3. When a system is installed in a 100 -year floodplain then the system shall meet or exceed the requirements of the National Flood Insurance Program. The system as approved by the Garfield County Building Official or his/her designated agent shall be designed to minimize or eliminate infiltration of floodwaters into the system, and discharge of the system into the floodwaters. 4. Only tanks that have been certified by the Colorado Department of Public Health and Environment shall be used for a vaulted system. 5. All tanks shall be installed in accordance with the manufacturer's specifications. 6. Watertight vaults shall not allow infiltration of groundwater or surface water and shall not permit the accidental or intentional discharge release of wastewater or liquids to the ground surface or to waters of the state. 7. Vaults shall not have an outlet unless designed to flow to another tank in series for the purpose of increasing holding capacity. Such outlets shall be water tight. 8. Tanks shall be so constructed and installed as to withstand earth and hydrostatic pressures when filled and when empty. 9. In locations where groundwater may cause instability problems to the vault due to flotation, the tank shall be anchored in a sufficient manner in order to provide stability when the tank is empty. The method of anchoring must be approved by the Garfield County Building Official or his/her designated agent prior to installation. The local authority may require the design of the anchoring system to be prepared by a Registered Professional Engineer. 10. Each vault unit shall be equipped with an access manhole located to permit periodic physical inspection and maintenance of all the tank and removal of the waste contents. 11. Components shall be so designed and constructed that when installed in accordance with manufacturer's recommendations, they shall be capable of being easily maintained, sampled, drained, pumped, inspected and cleaned. 12. The surface of the ground over the vault system must be restricted to activity or use which will allow the system to function as designed and which will not contribute to compaction of the soil or to structural loading detrimental to the capability of the vault to function as designed. 13. All metal surfaces shall be properly coated to prevent corrosion. 14. Plumbing fixtures, grease traps, building sewers, vents, sewer lines and other appurtenances shall be designed, operated and maintained so as to comply with the minimum requirements of the International Plumbing Code. 15. All wastewater lines used in individual sewage disposal systems shall be constructed of compatible pipe, bonding agent, and fittings. 16. Where plastic pipe and fittings are used, the minimum wall thickness of the pipe shall conform to ASTM Standard D 3034, or equivalent. 17. All electrical work, equipment, and material shall comply with the requirements of the National Electrical Code. 18. A signal device shall be installed to indicate when pumping is necessary. 19. The permittee shall provide for maintenance and cleaning of the vault system through a legal contract with a company experienced in the removal, proper handling, transport and proper disposal of the vault contents. 20. Disposal of waste materials removed from a vault system in the process of maintenance or cleaning shall be accomplished at a site approved by Garfield County in a manner which does not create a hazard to the public health, a nuisance or an undue risk of pollution and which complies with state and local rules and regulations. 21. When the use of a vault system is terminated or the vault system is relocated, the contents of a vault shall be properly removed and disposed of and the emptied vault shall be filled with soil or rock, or the Garfield County Building Official may allow the vault to be reused, removed and disposed of properly. E. RECORDS The Permittee shall establish and maintain records. All records shall be maintained a public records and be made available to Garfield County or other thirdparty upon request. Required records shall include, but not be limited to, the following: • A copy of the permi.tees's current legal contract for removal of vault waste. • A copy of this permit. • The dates, location, and time of pumping tank contents; • The individual(s) and company that performed tank pumping; • The volume of waste removed from the tank; • The location of disposal including a receipt from the receiving facility; • Any system repair or maintenance performed including the reason for said repair or maintenance. F. CERTIFICATION OF AN APPROVED VAULT SYSTEM INSTALLATION 2 The Permittee shall inform the Garfield County Building Official in writing of any intent to construct, install, or alter any vault system, no greater than 4S hours after construction, and shall furnish the Garfield County Building Depai talent such plans and specifications to evaluate compliance with the Garfield County ISDS Regulations. G. REMOVED SUBSTANCES Solids, sludge's, or other pollutants removed in the course of vault maintenance shall be removed and disposed of in a manner such as to prevent any of this material from discharging to the ground surface or from entering waters of the State. For all domestic wastewater treatment works, the Permittee shall dispose of sludge in accordance with State (Regulation No. 64) and Federal (Section 405(d) of the Act) regulations. The Permittee shall take all reasonable steps to minimize or prevent any discharge or sludge use or disposal in violation of this permit that has a reasonable likehood of adversely affecting the public health or environment. Permittee shall maintain a copy of a service contract and any pumping and disposal records from the approved contracted systems cleaner and submit such information when requested by the local regulatory authority. H. PERMIT VIOLATIONS Failure to comply with any terms and/or conditions of this permit shall be a violation of this permit. The surface discharge of any pollutant identified in this permit in a manner other than is authorized in this permit shall constitute a violation of the permit. Permit violations will be subject to enforcement provisions as outlined in Section IV.H, IV.I and IV.N of the Garfield County Board of Health "Individual Sewage Disposal Systems Regulations". Violations of the permit are the sole responsibility of the Permittee. ACCESS TO THE SITE For the purpose of inspection and enforcing applicable rules, regulations, terms and conditions of any permit issued, the Garfield County Building Official or his/her designated agent is authorized to enter upon private property at reasonable times and upon reasonable notice for the purpose of determining whether or not operating sewage treatment systems are functioning in compliance with this permit. 3 3-4'DIA HOLES 50 48 INVERT FULL BAFFLE DETAIL 'C' SCALE: 1/24 81 78 INVERT -2 7/8• 9' 1 3/4' 4 42 3/4 �- 9 12 13 NOTE: 4 1 - SEE XERXES' ONE YEAR LIMITED WARRANTY FOR UNDERGROUND SEPTIC TANKS. 2 - [NVERT DIMENSION FROM TANK I.D. 5 4 16 ---62 3/4 83 3/4 18 1/2 6.01A 5CH 40 PVC INLET PIPE WITH INTERNAL SANITARY TEE & PIPES RISER PIPE, FOR 24'(NOMINAL) ACCESS OPENING O FULL PLATE BAFFLE (48' INVERT) WITH 3-4'DIA HOLES LIFTING LUG pQ HOLD DOWN STRAP LOCATION 102 1/4 67 31 6 1/2' 16 3/4(TYP) 0 I.Vss.lw arc 1-- E".. rr- XERXES' RP0RAT ION osu v 8.01A SWT CAP. 10.000 GALLONS . - W,RATHON OIL WASTE oat .1a tat 9,54.9 '0-632-638 DO November 4, 2008 To Whom It May Concern: Laramie Energy II North Mamm Peak Operations Down Valley Septic, LLC P.O. Box 1929 • Rifle, CO 81650 970-625-5556 www.dvseptic.com Please accept this fetter as certification that Down Valley Septic will provide sewage collection, and portable restroom service for Laramie Energy lI Hunter Mesa Operations. I certify that Down Valley Septic will provide the above services for Laramie Energy II for the Drilling, Completion, Construction, Man camps, and Administration units on the North Mamm Peak Operations. Service will be provided every three days, unless needed more frequently. Down Valley Septic is available 24 hours a day, 7 days a week, and 365 days a year. Collection sewage will be disposed of in the Rifle Landfill or other certified disposal facility. (Signature) (Date Please contact me if you need any additional information at 970-625-5556. Thank you, Scott Moyer COO Down Valley Septic, LLC �`.m•. �.tl."^+'.ter, E-: •