HomeMy WebLinkAbout02138 f
GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N_ 21,3 8
109 8th Street Suite 303 Assessor's Parcel No.
Glenwood Springs, Colorado 81601
Phone (303) 945 -8212
This does not constitute
INDIVIDUAL SEWAGE DISPOSAL PERMIT a building or use permit. 4
PROPERTY ►
5613 DTC Parkway
Owner's Name Meridian 011 Inc. Present Address Englewood, CO 80111 phone 930 -9393
•
System Location 4093 County Road 920, Rifle
Legal Description of Assessor's Parcel No.
SYSTEM DESIGN
i
Septic Tank Capacity (gallon) Other
Percolation Rate (minutes /inch) Number of Bedrooms (or other) 4
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. Con-
. nection 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 I, Petty Offense ($500.00 fine — 6
months in )ail or both).
Applicant: Green Copy Department: Pink Copy
���� rs - ._.�...
EUUL 221993
D t 22, �f.
GARFIELD IND SEWAGE DISPOSAL SYSTEM APPLICATION
In Approval by
County Official
OWNER: Meridian Oil Inc.
ADDRESS:_ 5613 DTC Parkway, Englewood. CO 80111 PHONF:(303) 930 -9393
CONTRACTOR:, Roustabout Specialties. Inc.
ADDRESS:, 2278 1 -1/4 Mile Rd.. Grand Junction. CO (303) 243 -2363
PERMIT REQUEST FOR: [X ] New (Temporary) Installation [ ] Alteration [ ] Repair
Attach separate sheets or report showing entire area with respect to surrounding areas, topography of
area, habitable building, location of potable water wells, soil percolation, test holes, soil profiles in test
holes. (See page 4).
LOCATION OF PROPOSED FACILITY: County:, Garfield
Near what City or Town: Approx. 5 miles from Rifle Lot Size: Drilling Loc. 300' x 400'
Legal Description:_ SWSW Sec. 26 -T6S -R94W
WASTES TYPE: [ ] Dwelling [ ] Transient Use
[ ] Commercial or Institutional [ ] Non - domestic Wastes
[X ] Other - Describe: Temporary disposal facility
BUILDING OR SERVICE TYPE: 3 - contractor trailers
Number of bedrooms: 4 total Number of persons: Approx. 10 -15
[X ] Garbage grinder [X ] Automatic washer [X ] Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: [X ] well[ ] spring [ ] stream or creek
Give depth of all wells within 180 feet of system: Roy Sav -ge well. Sec. 35 -T6S -R94W
If supplied by community water, give name or supplier:
GROUND CONDITIONS:
Depth to bedrock: Approx. 40'
Depth to first Ground Water Table: Approx. 200'
Percent ground slope:, Less than 5 percent
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: Rifle. CO Approx. 5 miles.
Was an effort made to connect to community system? N/A
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
[ ] Septic Tank [ ] Aeration Plant [ ] Vault
[X ] Vault Privy [ ] Composting Toilet [ ] Recycling, potable use
[ ] Pit Privy [ ] Incineration Toilet [ ] Recycling, other use
[X ] Chemical toilet [ ] Other - Describe
FINAL DISPOSAL BY:
[ ] Absorption trench, bed or pit [ ] Evapotranspiration
[ ] Underground Dispersal [ ] Sand Filter
() Above ground dispersal [ ] Wastewater pond
[X ] Other - Describe: Sewage will be removed by certified disposal contractor.
Roustabout Specialties Inc.. Grand Junction CO*
WILL EFFLUENT BE DISCHARGED DIRECT INTO WATERS OF THE STATE? NO
*Sewage will be disposed into an
approved, permitted facility.
SOIL PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer).
Minutes N/A per inch in hole No. 1 Minutes per inch in hole No. 3
Minutes per inch in hole No. 2 Minutes per inch in hole No.
Name, address and telephone of RPE who made soil absorption tests: N/A
Name, address and telephone of RPE responsible for design of system: N/A
Applicant acknowledges that the completeness of the application is condition upon such further mandatory
and additional tests and reports as may be required by the local health department to be made and
furnished by applicant or by the local health department for purposes of the evaluation of the application;
and the issuance of the permit to subject to such terms and conditions as deemed necessary to insure
compliance with rules and regulations adopted under Article 10, Title 25, C.R.S. 1973, as amended. The
undersigned hereby certifies that all statements 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 relief on by the local government of health in evaluating the
same for purposes of issuing the permit applied for herein. I 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 in legal action for perjury as provided by law. /) ,1
Date: July 13. 1993 Signed: 4 �sPS,/ , /v4 4/L
C' Sally L. D an
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY (�
See attached maps.
L•.GGe.'. 13.132420343 F' . FI=
COMPANY: _ MERIDIAN OIL INC.
WELL NAME & N0. 14 -26H JUHAN
FOOTAGE: 1090 FSL 1474 !"WL. .
SEC: _ 26 _ TWN: 6 S ._ RNG: 94 W 6TH PRINCIPLE
ELEVATION: 5345 GARFIELD COUNTY, COLORADO
N 88'33'03' E (M) 2685.74' (M) N 88'40'23" E (M) 2663.26' (M)
• • 4
FNO 3 / 4" ALUM. FND MARKED STONE FWD MARKED STONE Z
ON 2' PIPE WITH REFERENCES BY AT FENCE INTERSECT ON
LS 0009 LS /9009 N
b N
oit
‘143 I N
N
_ _ I - v
W
b
E _
g
g FND 3 1/4' ALUM. i FND 6/6' REBAR 0 ON Y PIPE WITH 1 1/7' DAM.
LS 0000 ALUM. CAP LS •11630
2 N 89'35'10' E (C) 288 .40' (C) 26 —•
U t z
4, ^ .,tom
n v ..• i�f:�',1
N N • ' 't, .. . k ., I �, / . � • 1�
vs e ^ c N g OW: 74121 m : N
Z 1 • � .-4
7 J4 mo w. %
/' C 1 I • 1, •
17 � , I s P :- . W
1474' 4^ W :F: , ,�� •,. � ; Q .
ANA( I.ND y r 33
an z 1090' 4 g
FND 1 1/7 ALUM. CAP a SET 2 1/2' PIPE I
LSI11530 WITNESS CORNER' b 0
z WITH FIWSS CAP 1 1962 FILM
I N 6'66' E 53.92' 1 LS #24321 1 ALUMINUM MONUMENT
•
• N 88'07'15' E (M) 2857.82 (M) N 88'07'15' E (M) 2857.82 (M)
C),• LE E END
LAC
•• FD. OR sr
N01C AS NOTED
1. vas OF WM10: A3IR0N3100 OSINPF ON
2. We OF S@LYATION: SPOT 6LYA11p1 MOW 1OP09RAW00 11AP • ROAD RRFRSIMMOM • 118 QWRITR SECTION 27 ELEV. 6303
3. WE OF 0014PLITON Or FIELD SURMVf JULY OS. 1•3.
4. 11100E PREIO4T%Y COSTS A i CIVICS DIMMER PPE (POSSIBLY ABANDONED) OF WW1* 00NRM5 ND)EN SITE NO NO 0111ER
MOLE IMPRp.OPIASe S WITHIN 200 FEU OF T MIL nwv WCAION
4. Pa LISTED AS (M) AM NOM! MEASME AS VISION 19 NOT POSS1SU SEMEN route CORNERS
L
EO N
( LZZ -�c"� 7,77/45 .� 1' • 1000_
D SURVEYOR NO. 24321 DATE
STATE ^r COLORADO o 500 1000
. _ 1 _
o CO Cr) CD L
J n 0 C - NZ
1- co
W
LL
p O p - p 10 (`9 �0
0 O N O V <
+ - - 1- N 01
Z
L1-
0) 111
W O c`7 C C O CD C)
CC
= N R
CC
a
C ..
W
0
O lO M 0
W O O co fD
0 C N M c`7
1 - N
co 1—
x c
2 W o
2 d
0 M O O 1O
co c6 $ o r-: 0 a� C
E. o co
co
C C D
0 0 0 O o
ao c's co co ao
0
° w a 07 0
2
1
0
Z
o m _ c
0 a 1
0 cc c m
E
W R ill R) L Ca ct C3 O J C C C O . 0) 2
O o
0 2 J C o a. O co
a o
= o
W
_) Z
0 = d
CD Q CO C-1 0 W
COMPANY: MERIDIAN OIL INC.
LEASE: 14 -26H JUHAN
FOOTAGE: 1090' FSL 1474 FWL
SEC: 26 TWP: 94W RNG: 94W 6TH PRIN. MERIDIAN
ELEVATION: 5345
F5.1 F1.5 C3.0
A B C2.0 C zw._.
d j 200' : =F. . - Ar EA
/: S'NG :EN ^F_NE
REMA.N F CJ.B
c ,SS . Bc .,R Sc
P °3LIL- O E:iDE R
1' :: c 0E • SLRFACE OF GRCU .C,
•au4D 0 -HIS C:Nf]'
C:13 1
a
'CONTENTS 'UNKSCNNJ
F8.8 , uro0 • _Ere 5345
N 64' N O O RDA C5.2
E b
F4.2 PAD TO END • TCE SLOPE
' iF BERM • PORCUPINE CREDO
*TS DUSTING ROAD
F1.6 20'y — 08 .4
NOTE: -.NO ROAD CCNTINUES ` A C
' JE - B' '
DAb p9 nN• . °J.4 AND N(. • ;c? — - -
RJ J ?: ISTRL' COON .S NECESSARY
EL? ✓. A —A' Cj L
I
C y �! , I ` T r
5360 I I'
1
5350 -4-
5340
5330
5320