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, GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
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j INDIVIDUAL SEWAGE DISPOSAL PERMIT
PROPERTY
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f k Owner's Name, li-'til-{ L ? i Q Present Address
1 System Location
nLl� 109 8th Street Suite 303
Glenwood Springs, Colorado 81601
Phone (303) 945-8212
Permit N2 3103
Assessor's Parcel No.
This does not constitute
a building or use permit.
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ALio-A c
Legal Description of Assessor's Parcel No.
SYSTEM DESIGN
t ; Septic Tank Capacity (galion) Other
Percolation Rate (minutes/inch) Number of Bedrooms (or other)
Required Absorption Area - See Attached
Special Setback Requirements:
Date Inspector
0.' FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Cali 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 4--1-.L60)f /��—
Date Inspector 4 L H au–Arc-Ay rt44 , At/ I`4--oc
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 ($500.04 fine — 6
months in jail or both).
White - APPLICANT Yellow - DEPARTMENT
• INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
OWNER ii l fit_
ADDRESS
CONTRACT
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ADDRESS
PHONE
PERMIT REQUEST FOR (1) NEW INSTALLATION (-:p 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 FFACILITY:
Near what City of Town Lairkit 60 c(ttlC _.. Size of Lot P%
Legal Description or Address % s-- g 04t L /U £s41f bo �at,A-CC C -o r C G 2;
WASTES TYPE: DWELLING ( ) TRANSIENT USE
( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES
( ) OTHER - DESCRIBE
BUILDING OR SERVICE TYPE: /4 4'ott' D w
Number of Bedrooms
( ) Garbage Grinder (gAutomatic Washer
SOURCE AND TYPE OF WATER SUPPLY: 0('ELL
If supplied by Community Water, give name of supplier:
Number of Persons
(0 Dishwasher
( ) SPRING ( ) STREAM OR CREEK
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: —'
Was an effort made to connect to the Community System? hof 71-t/.
A site plan is required to be submitted that indicates the following MINIMUM distances:
100 feet
50 feet
50 feet
10 feet
Leach Field to Well:
Septic Tank to Well:
Leach Field to Irrigation Ditches, Stream or Water Course:
Septic System to Property Lines:
YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT Will NOT BE ISSUED WITHOUT
A SITE PLAN.
GROUND CONDITIONS:
Depth to first Ground Water Table
Percent Ground Slope
2
TYPE OF IIsiDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
SEPTIC TANK
( ) VAULT PRIVY
( ) PIT PRIVY
( ) CHEMICAL TOILET
FINAL DISPOSAL BY:
) AERATION PLANT ( ) VAULT
) COMPOSTING TOILET ( ) RECYCLING, POTABLE USE
) INCINERATION TOILET ( ) RECYCLING, OTHER USE
) OTHER - DESCRIBE
ABSORPTION TRENCH, BED OR PIT ( ) EVAPOTRANSPIRATION
UNDERGROUND DISPERSAL ( ) SAND FILTER
ABOVE GROUND DISPERSAL ( ) WASTEWATER POND
OTHER - DESCRIBE
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE?
PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer, if the Engineer does the
Percolation Test)
Minutes 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:
Name, address and telephone of RPE responsible for design of the system:
Applicant acknowledges that the completeness of the application is conditional upon such further mandatory and
additional tests 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. 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.
Signed Date
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!!
Se e
3
GCCPtE'Ch
January 20, 2000
Alain Laval
875 Rose Lane
Carbondale, Colorado 81623
Hepworlh-Pawlak Geotechnical, Inc.
5020 County Road 154
Glenwood Springs, Colorado 81601
Phone: 970-945-7988
Fax: 970-945-8454
hpgeoCc hpgentech.com
Job No. 100 127
Subject: Percolation Testing, Proposed Septic Disposal System, 875 Rose Lane,
East of Carbondale, Garfield County, Colorado
Dear Mr. Laval:
As requested, we have conducted a percolation testing at the subject site to evaluate the
feasibility of a new septic disposal system for the existing residence. The results of our
work are presented in this report. The work was done in accordance with our
agreement for professional services to you dated January 17, 2000.
A profile pit and three shallow backhoe pits were excavated in an area to the northwest
of the existing residence and barn and northeast of the existing riding arena on January
18, 2000. Percolation test holes (nominal 12 inch diameter by 12 inch deep) were hand
dug at the bottom of the backhoe pits and soaked with water one day prior to testing.
The holes were covered with rigid foam insulation to protect against freezing overnight.
The soils exposed in the percolation holes and profile pit consist of about 3 feet of
topsoil overlying slightly sandy gravel with cobbles to the maximum profile pit depth of
6 feet. Deeper excavation was not possible because of caving of the pit due to
groundwater encountered at about 41/2 feet.
Percolation tests were performed on January 19, 2000 by a representative of Hepworth
- Pawlak Geotechnical, Inc. The percolation test results are presented on Table I. The
percolation test results indicate an infiltration rate of about 8 to 9 minutes per inch.
Based on the subsurface conditions encountered, primarily the shallow groundwater, we
Alain Laval
January 20, 2000
Page 2
recommend a civil engineer be engaged to design the septic system. A mounded system
will likely be needed.
If you have any questions, please call our office.
Sincerely,
HEPWORTH - PAWLAK GEO
Jordy Z. Adamson
Rev. By: DEH
JZAlksm
attachment
cc: High Country Engineering - Attn: Deric Walter
HEPWORTH-PAWLAK GEOTECHNICAL, INC.
TABLE 1
PERCOLATION TEST RESULTS
JOB NO. 100127
HOLE NO.
HOLE DEPTH
(INCHES)
LENGTH OF
INTERVAL
(MIN)
WATER DEPTH
AT START OF
INTERVAL
(INCHES)
WATER DEPTH
AT END OF
INTERVAL
(INCHES)
DROP IN
WATER
LEVEL
(INCHES)
AVERAGE
PERCOLATION
RATE
(MIN./INCH)
P-1
43
5
9 1/2
8
1 1/2
9
8
6 1/2
1 1/2
6 1/2
5 1/2
1
5 1/2
4 3/4
3/4
4 3/4
4
3/4
4
3 1/2
1/2
3 1/2
3
1/2
P-2
46
5
9
7 1/4
1 3/4
9
7 1/4
6
1 1/4
6
5 1/2
1/2
5 1/2
5
1/2
5
4 1/4
3/4
4 1/4
3 3/4
1/2
3 3/4
3 1/4
1/2
P-3
41
5
9 3/4
8 1/2
1 1/4
8 1/2
6 3/4
1 3/4
6 3/4
5 1/4
1 1/2
5 1/4
4 1/4
1
4 1/4
3 1/2
3/4
3 1/2
2 3/4
3/4
2 3/4
2 1/4
1/2
8
NOTE: Percolation test holes had been hand dug In backhoe pits and soaked on January 18, 2000.
The holes had been covered with rigid foam Insulation to protect against freezing overnight. Percolation tests were
conducted on January 19, 2000. The average percolation rate was based on the last three readings of each test.
�NGYNEER/NC
October 16, 2000
Garfield County Building & Planning
109 Eighth Street, Third Floor
Glenwood Springs, CO 81601
Re: Laval ISDS — HCE No.2000004.01
875 Rose Lane, Carbondale, CO
'RECEIVED OCT 1 8 Mg
To Whom It May Concern:
On October 16, 2000, High Country Engineering (HCE) personnel inspected the construction of the
ISDS located at 875 Rose Lane near Carbondale, Colorado. HCE's original design called for a
1500 -gallon septic tank, a mechanical dosing tank and a 711 sf (gravel area) mounded septic field.
At the time of inspection, the contractor had installed the necessary tanks, sands, gravels and
distribution laterals, but no backfilling had taken place. Field personnel observed that the septic
tank risers had not been installed and advised the owner accordingly. The owner has agreed to
install the necessary components. Otherwise, the installation of the system was in conformance
with the intent of the design.
If you have any questions, or need additional information, please contact us.
Sincerely,
HIGH COUNTRY ENGINEERING, INC.
Roger D. Neal, P.E.
Project Engineer
RDN/djw
Cc: Alain Laval (Owner)
923 Cooper Avenue,
Glenwood Springs, CO 81601
Telephone (970)945-8676 - Fax (970) 945-2555
14 Inverness Drive East Suite B-144
Englewood, CO 80112
Telephone (303) 925-0544 - Fax (303) 925-0547