HomeMy WebLinkAbout3.4.3 ISDS PermitProject Address
Garfield County
Building & Planning Department
108 8th Street Suite 401
Glenwood Springs, CO 81801 -
Phone: (970)945.8212 Fax: (970)3844470
Parcel No.
Issue Date: 911/2009
Expires: 0910112010
Subdivision
Section
Township
Range
PARACHUTE, CO
240708100152
•
Owner Information
Address
Phone
Cell
Battlement Mesa Land Investments 73 Sipprelle DR
Battlement Mesa CO 81636
970-285.9740
Contractor(s)
Phone
Primary Contractor
Proposed Construction 1 Details
Pad GV 82-5 (Williams)
FEES DUE
Valuation:
Total Sq Feet:
$ 0.00
0
FEES PAiD
Required Inspections:
For Mspectians can: 1(970)384-5003
inspection
IVR
Septic Fee - New
Total:
vi= ,,... _ �:,:.,:,:
F..;,.h1%f�L i3C;�'��7 nrY3f lid_i
$73.00
$73.00
RAT .cr::pa�:_�!.
inY # SEPT -8.09.197p6
$ 73.00 Check # 5410
$73.00
$ 0.00
Final 1125
Pero Test 615
IMPORTANT: APPLICATION 15 HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS
AND RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING;
1, Final inspection of the work authorized by this permit is required. A Certificate of Occupancy must be obtained prior to use and
occupancy of new buildings, structures and remodeling work.
Applicant Copy
This permit/plan review expires by time limitation and become* null and void if the work authorized by the permit is not commenced within 180 days from the date of permit issuance or If the permit
is not obtained within 180 days from the date of plan submittal. This permit expires and becomes null and void if any work authorized by this permit is suspended or abandoned for 180
consecutive days or If no progressive work has bean verified by passing a required County Inspection for a period et 180 consecutive days.
Tuesday, September 1, 2009 1
GARFIELD COUNTY SEPTIC PERMIT APPLICATION
10$8"'Street, Suite401, Glenwood Springs, CO 8160i
Phone: 970-945-8212 / Fax: 970-384-3470 / Inspection Line: 970-384-5003
wwwsarfield-countvcom
1
Perk -7
L�1,'�f
Parcel No:(this information is available at the assessors office 970445--9134)
2401-081-00-152
2
Septic Permit �ry '
,••• e+.�..��� ry
`+�,
Job Address: (Nan address has not been assigned, please provide Cr,liwy or Sheet Name & City) or legal description
GV 82-5 Pad Site See attached Access Description
3
1 Y. b
tle.
Lot Size: Lot No: Block No: Subd/Exemption:
See Attached Survey Plat SECT,TWN,RNG:5-795 DESC: NWSE
4
Owner. (property owner)
Battlement Mesa Partners
Mailing Address
73 G Sipperile, Parachute CO
411638
Ph:
970-285-9740
Alt Ph:
5
Contractor:
Williams Production
DMT r'n
Mailing Address
PO Box 370, Parachute, CO
RIME
Ph:
970-285-9377 ext 2288
Alt Ph:
6
Engineer:
N/A
Malang Address
Ph:
Alt Ph: .
7
permit Rust For: IX 1 Ney/ Installation r 1 Alteration f 1 Reoair
8
Waste Type: (X) Dwelling () Tranient Use ( ) Commercial or Industrial ( ) Non- Domestic Wastes
( ) Other- Desalbe
9
Bugling Or Service Type:
Number of Bedrooms:. 2 Garbage Grinder ( ) Yes (X )No
:10
Source & Type of Water Supply: ( ) Well ( ) Spring () Stream Or Creek ( ) Cistern
If supplied by COMMUNITY WATER, give name of supplier: Down Valley Septic and Waste..
11
Distance to Nearest community Sewer
Was there an effort to connect to the
System:N/A
community System? - NIA _ _ --_ _
YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUSED WITH OUT A SITE PLAN
12
Ground Conditions:
Depth to 1st Ground Water Table NIA Percent Ground Slope N/A
13
Type of Individual Sewage System (ISDS) Proposed:
( ) Septic Tank ( )Aeration Plant (X) Vault ( ) Vault Privy ( )Composting Toilet
( ) Recycling, Potable Use ( )Recycting, Other use ( ) Pit Privy ( ) Incineration Toilet ( ) Chemical Toilet
(X) Other -Describe: Hauled to Down Valley Waste for their disposal
14
Final Disposal By:
( ) Absottfon trench, Bed or Pit ( ) Underground Dispersal ( ) Above Ground Dispersal ( ) Evapotranspiration ( ) Sand Mer
() Wastewater pond (X )other -Describe Hauled to Down Valley Waste for their disposal
15
Will effluent be discharged into waters of the state? ( )Yes (X )No
16
Percolation Test Result (to be completed
Minutes per
by Registered Professional Engineer, if the
inch In hole No.1
in hole Not
made soil absorption test: N/A
Engineerdoes the Percolation Test)
Minutes per inch in
N/A
hole No.3
No.4
Minutes per inch
Minutes per inch in hole
Name, address & telephone of RPE who
Name, address &telephone of RPE responsible
for design of the system:N/A
17
Applicant scknowidget that
by the local health deparimentto
and the issuance of the
information and reports
knowledge and b;, ,=-, = nd
he - • — It I er un. _ -,r
.• , - ,, and leg
the completeness of the application is conditional upon such further mandatiory and additional test and reports es may be required
be made and furnished by the applicant or by the local health department for purposed of the evaluation ofthe application;
permit is subjectto such terms and conditions as deemed necessary to insure compliance with the rules and regulations made,
submitted herewith and required to be submitted byfhe applicant are awn) be represented to be true and correct to the best of my
are designed to , - ,= ed on by local department of health In evaluationg the same for purposes of Issuing the permit appted for
, ,r, any tatsr , irdsreprensentaton may result in the denial dna application or revocation of any permit granted based upon
, •n s,41,
, ded by taw.
5's naturey
Hotard CPL Date
STAFF USE ONLY
Parmitr7 Qy
Perk -7
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Teta fa .
$itirsEgs,,Pcrm[ttF:
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Septic Permit �ry '
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issnlJe 2�aie
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Building a Planning
1 Y. b
tle.
APPROVAL
j �J[ 5�„ f 11Q
s DATA , .451./..,
GENERAL PERMIT CONDITIONS
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.RS., 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 alibis 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 1236
WELL SITE LOCATIONS (APD#(s)) GV 82-5
OPERATORS NAME Williams
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. Milumum, 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.
1
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. Eachvault unit shall be equipped with an acdess 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 oldie 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 PIumbing 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. An 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.
C. 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 third party upon request. Required records shall include,
but not be limited to, the following:
• Koopy of the permitees'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.
D. 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 48 hours after construction, and shall furnish the
.Garfield County Building Department such plans and specifications to evaluate compliance with the
Garfield County ISDS Regulations.
E. 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 alt 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.
F. 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.
G. ACCESS TO THE S1ii
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
$73.00 I
tfV be
Galls— County
108 8th Street Suite 401
Glenwood Springs, CO 81601 -
Phone: (970)945-8212 Fax: 970)3843470
av 8z-5
Invoice Number: SEPT -8-09-19706
Invoice Date: August 31, 2009
Permit Number: SEPT -8.09-1236
Bond Number:
Battlement Mesa Land investments
73 Sippreile DR G
Battlement Mesa, CO 81636
Williams Exploration & Production POB 21218 Tulsa,
OK 74121
Date Fee Name
08/31/2009 Septic Fee - New
Fee Type
Fixed
Total Fees Due:
Fee Amount
$73.00
$73.00
Payments
Date Pay Type
08/31/2009 Check
Check Number Amount Paid
5410
$73.00
Change
$0.00
Total Paid:
Monday, August 31, 2009
i
Total Due: $0.00
I1
2
3
4
'5
6
7
8
9
GARFIELD COUNTY SEPTIC PERMIT APPLICATION
1088"'Street, Suite401, Glenwood Springs, CO 81601
Phone: 970-945-8212 / Fax: 970-384-3470 / Inspection Line: 970-384-5003
Parcel No:(this information is available at the assessors office 970-945-9134)
2407-081-00-152
Job Address: (if an address has not been assigned, please provide Cr,Hwy or Street Name & City) or legal description
GV 82-5 Pad Site See attached Access Description
Lot Size: Lot No: Block No:
See Attached Survey Plat SECT,TWN,RNG:5-7-95 DESC; NWSE
Owner_ (property owner)
Battlement Mesa Partners
Contractor.
Williams Production
RUT I' e%
Engineer.
N/A
Mailing Address
73 G Sipperlle, Parachute CO
R1R1,9
Subd/Exemption:
Ph:
970-285-9740
Mailing Address
PO Box 370, Parachute, CO
R1RR.5,
Ph:
970-285-9377 ext 2288
Mailing Address
Ph:
Alt Ph:
Alt Ph:
Alt Ph:
Permit Reaest Fort (X 1 New Installation ( 1 Alteration
Waste Type: (X) Dwelling ( ) Tranient Use
( ) Other- Describe
Building Or Service Type:
! ) Repair
( ) Commercial or industrial ( ) Non- Domestic Wastes
Number of Bedrooms: 2 Garbo • e Grinder ( ) Yes (X No
Source & Type of Water Supply: ( ) Well ( ) Spring ( ) Stream Or Creek ( ) Cistern
If supplied by COMMUNITY WATER, give name of supplier. Down Valley Septic and Waste
Distance to Nearest Community Sewer System: N/A
Was there an effort to connect to the community System? N/A
YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUSED WITH OUT A SITE PLAN
12 Ground Conditions:
10
11
13
14
15
16
17
Depth to lst Ground Water Table N/A Percent Ground Slope N/A
Type of Individual Sewage System (ISDS) Proposed:
( ) Septic Tank ( )Aeration PlantX
( ) Vault ( ) Vault Privy ( )Composting Toilet
( ) Recycling, Potable Use ( )Recycling, Other use ( ) Pit Privy ( ) Incineration Toilet ( ) Chemical Toilet
(X) Other- Describe: Hauled to Down Valley Waste for their disposal
Final Disposal By:
( ) Absortion trench, Bed or Pit ( ) Underground Dispersal ( ) Above Ground Dispersal P ( ) Evapotranspiration ( ) Sand Filter
( ) Wastewater pond (X )Other -Describe Hauled to Down Valley Waste for their disposal
Will effluent be discharged into waters of the state? ( )Yes (X )No
Percolation Test Result: (to be completed by Registered Professional Engineer, if the Engineer does the Percolation Test) N/A
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.4
Name, address & telephone of RPE who made soil absorption test: N/A
Name, address & telephone of RPE responsible for design of the system:N/A
Applicant acknowldges that the completeness of the application is conditional upon such further mandatiory and additional test and reports as may be required
by the local health department to be made and fumished 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 the 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 nd are designed to • - +- ed on by local department of health in evaluationg the same for purposes of issuing the permit applied for
he " ether understan+ + _ any fats" misreprensentaion may result in the denial of the application or revocation of any permit granted based upon
n and leg .n+ .vided by law.
SIlk Ali_ 45
',� nature y Hotard CPL Date
1 Permit Fee:
STAFF USE ONLY
septic Permit #:
Peril Fee:
Total fees: Building i'ermie
Building Re Planning Dept:
APPROVAI,
Issue Date:
DATE
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June 2, 2009
Eric Schmale
Authorized Agent for
Battlement Mesa Partners LLC
PG Box 6000
Parachute, CO 81635
EXPLORATION & PRODUCTION
1058 CR #215
R 0.13ex 370
Parachute, CO 81635-0370
9701285.9377
970/285-9573 fax
RE: Authority for pad GV 82-5 ISMS & Small Temporary Employee Housing Permits
Dear Eric:
Per Garfield County's new regulations instated March 1, 2009, Williams is now
required to obtain additional permits pertaining to the trailers on your GV 82-5 pad site.
These permits are for a vault septic unit (ISDS) and the Srnall Temporary Employee
Housing permit for the Drilling Consultants and the Tool pushers. These new regulations
require authority from Battlement Mesa Partners LLC to Williams Production RMT Co
for the processing of said permits.
By signing this document. in the presence of a Notary Public, you grant authority
to Williams to process these permits to Garfield County as required by new law.
Should you have any furthers questions please feel free to call me at' 970-623-
8909.
Sincerely,
Williams Production T Company
cmen.t Mesa Partners LLC
I3eforr: me, a Notary Public, in and for said Chanty and Stale aforesaid, do hereby rectify that Eric Sample whose name is
subscribed to the foregoing instrument ns AEU rized deme, of Ireltlement 117rso Partner,. LLC., n Colorado Limited
Liability Company, appeared before me this day in person and acknowledged that he executed said instnuncnt ns his free and.
evinntary net gad deed es the free and Volnntiy act and decd of said corporation for the uses and purposes set forth.
Given un my hand and Notarial Seal this Cl ay ofduile 2009
My Commission E piries: (t IP( i
(Seal)
ACCESS DESCRIPTION:
FROM THE INTERSECTION OF STATE HIGHWAY 6 AND RULISON ROAD(CNTY. ROAD 323) NORTH OF RULISON, PROCEED
SOUTHERLY ALONG RULISON ROAD(CNTY ROAD 323) #1.2 MILES TO THE INTERSECTION WITH COUNTY ROAD 309, PROCEED
RIGHT IN A WESTERLY DIRECTION ±3.9 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD, PROCEED RIGHT IN A
NORTHWESTERLY DIRECTION ±1.1 MILES TO THE EXISTING GV 82-5 DRILL PAD LOCATION, AS SHOWN HEREON.
•
Svre
abnacte EU&
Ph. (P70)6254.1PG
Fe. (9701625-277.9
SCALE: 1" w 200p'
DATE: 11/20/08
11"SHEET:
-ri PROJECT: Williams
- • DFT: CWS
1
Construction Plan Prepared for:
Wil1 Williams Production, RMT
OV 82-5 Drill Pad - Sheet 5
ACCESS & VICINITY MAP
W#3B
Fc 7'
.5100
W #3A
C
0
Exist. Limit
of Disturbance
Q
50'%
P
C65.' I
,11t; i i. 1 II.
\ 1 I; 161
\'��111: t0
20'x50'
Tank Pad
oyl
\ \1
ti \'\
ti
0
Daylight Line
50'
T H-
WW #1B
C5.2'
Vi
100'
Exist. Bldg.
Proposed PA 13-5
Proposed PA 313-5
Proposed PA 413-5
Proposed PA 14-5
Proposed PA 314-5
, Proposed PA 414-5.4.
Proposed PA 514-5
Proposed PA 324-5
Proposed PA 524-5
•
6,NW #1
F 0.9'.
fi
1,
it
cu
Q V #5A
-0F1.4
o
0 ^A
Edge of Exist.
Drill Pbd
71
1 '
Proposed PA 23-5 1
Proposed PA 323-5 1 nte
Proposed PA 33-5 0o
Proposed PA 333-5 QQd I i
Proposed PA 423-5 y X
Exist. PA433.5
Exist. PA 24-5
Proposed PA 34-5
exist PA424-5
proposed PA 334-5
1
IV48°00'591E 84'
Exist. GV 52-5
Exist. PA 434,5
;$fl'R
•
/
Edge of Exist.
Drill Pad
a-~ •'- SOK Vie. rea
Exist. Limit
of Disturbance
r
F0.1' 109'
83'
.-'i j,
SE #8111
C 0.8' 11;2.7-7-X-1601— X.
51'
44'
51'
96'
�^- . , -rye
'Excdsss
Pad Material
4
1 v
ESTIMATED DIRT QUANTITIES (cy)
ITEM
CUT
FILL
TOPSOIL
EXCESS
PAD
2618
360
0
2258
PIT
1700
1700
TOTALS
4318
360
0
3958
ie. Cowh eo 6i6:
Ph. 1970)62S-1330
Pah (970) 625,2773
X
STORM WATER LEGEND:
BP BRUSH PILE/ BARRIER
SB STRAW BALE BARRIER
SOIL CONTAINMENT BERM
2.27 ac TOTAL DISTURBED AREA
REVISED: 11/26/08
1" 60'
11/20102
2 of 9
Williams
CWS
IVES #6 BB
F05'
#7' CC
1.3'
Existing Ditch
Construction Plan Prepared for:
Williams Production, RMT
GV 82-5 Drill Pad - Sheet 2
GRADING PLAN & PAD LAYOUT
October 1, 2008
Garfield County
109 g`h Street
Glenwood Springs, CO 81601
RE: Authority as Agent
EXPLORATION & PRODUCTION
1058 CR#215
R 0. Box 370
Parachute, CO BIG35-0370
970/20-9377
970/285-9575 fax
Dear County Representative;
This letter is to confirm, the appointment of Sandy Hotard and Eric Miller as authorized
Agents to execute documents for the following;
• Williams Production RMT Company
• Bargath Inc.
• Wilgath LLC
• Ryan Gulch LLC
This authority is granted for all documents furnished to Garfield County.
Sincerely,
Alan Harrison
Vice President
Denver Region
DRB\S1d 10/01/08
