HomeMy WebLinkAboutApplication- PermitGARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
108 Eighth Street, Suite 401 4 6 4
Glenwood Springs, Colorado 81601 Permit
Phone (970) 945-8212 Assessor's Parcel No.
ta-IS stls.
INDIVIDUAL SEWAGE DISPOSAL PERMIT
PROPERTY {�1 q p
Owner's Name F/L "
System Location RNA V �.2)• Il
This does not constitute
a building or use permit.
Present AddressJ,Qg y(Od 16aPhone 6't—]• ?Sal
Legal Description of Assessor's Parcel No. I J. I74. 00 9.69
SYSTEM DESIGN
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
1088 -Street, Suite401, Glenwood Springs, CO 81601
Phone: 970-945-8212 / Fax: 970-384-3470 / Inspection Line: 970-384-5003
1
Parcel No:(this information is available at the assessors office 970-945-9134)
2175-174-00-959
2
Job Address: (if an address has not been assigned, please provide Cr,Hwy or Street Name & City) or legal description
RMV 53-17 Pad site Off of Hwy 6 See attached Access Description
3
Lot Size: Lot No: Block No: Subd/Exemption:
See Attached Survey Plat and Assessors Detail 2ICO6'11
4
Owner. (property owner)
Bureau Of Land
Manaaement
Mailing Address
50629 HWY 6824 Glenwood
SDrinas. CO 81601
Ph:
970-947-2757
Alt Ph:
5
Contractor:
Williams Production
RMT Co
Mailing Address
PO Box 370, Parachute, CO
81635
Ph:
970-285-9377 ex[ 2288
Alt Ph:
6
Engineer:
NIA
Mailing Address
Ph:
Alt Ph:
7
Request For: (X 1 New Installation ( 1 Alteration (1 Repair
8
,Permit
Waste Type: (X ) Dwelling ( ) Tranient Use ( ) Commercial or industrial ( ) Non- Domestic Wastes
( ) Other- Describe
9
Building 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 System: N/A
Was there an effort to connect to the community S stem? N/A
YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITH OUT A SITE PLAN
12
Ground Conditions:
Depth to 1st Ground Water Table N/A Percent Ground Slope N/A
13
Type of individual Sewage System (ISDS) Proposed:
( ) Septic Tank ( )Aeration Plant (dI Vault ( ) Vault Privy ( )Composting Toilet
( ) Recycling, Potable Use ( )Recycling, Other use ( ) it Privy ( ) Incineration Toilet ( ) Chemical Toilet
(X) Other- Describe: Hauled to Down Valley Waste for their disposal
14
Final Disposal By:
( )Absorption trench, Bed or Pit ( ) Underground Dispersal ( ) Above Ground Dispersal ( ) Evapotranspiration ( ) Sand Filter
( ) 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 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
17
Applicant acknowldges that
by the local health department
the issuance of the permit
and reports submitted herewith
belle f - • : - e • esigned to
- •• - • hat any fals
the completeness of the application is
to be made and furnished by the applicant
is subject to such terms and conditions
and required to be submitted by the
.: relied on by •c- department of health
• n or misre re -en fon may resulpn
conditional upon such further mandatiory and additional test and reports as may be required
or by the local health department for purposed of the evaluation of the application; and
as deemed necessary to insure compliance with the rules and regulations made, information
applicant are or will be represented to be true and correct to the best of my knowledge and
In evaluationg the same for purposes of issuing the permit applied for herin. I further
the denial of the application or revocation of any permit granted based upon said application
and legal ar••
r •erju
provide 1
•wners 'ignatu a Date
TAFF USE ONLY
Permit Fe
Perk Fee:
ToW-[ecn"at
`Daat?e-
Building Permit A•:
Septic Permit #.
Issue
Building & Pion
-d
ill
)
APPROVAL
1
DATE S/ ep
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.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
41.Q49)
WELL SITE LOCATIONS (APD#(s)) RMV -53-17
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.
TERMS AND CONDITIONS
I. 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.
1.6. 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.
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:
• A copy 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 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.
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 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 k 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
October 1, 200ft
Garfield ]A4 t Stied
Glenwood Springs, CO 81601
RB: Anther* as Agent
EXIMPlandtPXXXIMION
IOU DSO
0, Rea
rico mtu
Asn
Matirmistec
Dear County es
s fe'ism eaten fee appointment of Sue Wend awl Bak
/Saran atafrarland
Agents toexeeate theountents forth. MS"
c
*
Rya ColokLIC
This astbosity Is panted faildoetenterdsr,., er: i::s,Ur Galan Cowae.
Brotakon
Vag President
Denver lesion
DRE SH 1016I10S
SEC. 17
GLO
BRASS
CAP
T. 6 S., R. 94 W. OF THE 6TH P.M.
e, 889'48'37"E 2624,70'
GLO BRASS 10L0
CAP W.C, BRASS
CAP
1 W.C.
1 2228'
6
40
dc
TO
BOTTOM HOLE -LOCATION
1181' FNL, 3D7' FEL
LAT:. 39131'45:2731"'
LONG: 10754'14.3995"
T'1
111
PLAT #1
LOCATION PLAT
11
1
i'3
`fl4
CLO
BRASS
CAP
WIULIAMS PRODUCTION
RMT
RMV ;55-11, .....
GND. ELEY-5820.0'
PAD ELEV:5920.0'
LAT: 39'31'34.9258"
LONG: 107'54'16.3456"
• y0� 16 ' �a4 16
GLO
BRASS
CAP
GLO
BRASS
CAP
-LEGEND-
(g, STANDARD LOCATION OF
GLO SECTION CORNERS
• GLO CORNERS FOUND
® WELL LOCATION STAKED
o BOTTOM HOLE LOCATION
Pffiad
o �'
i(
THIS WELL LOCATION PLAT WAS PREPARED FOR WILLIAMS PRODUCTION RUT TO
LOCATE THE RMV #53-17, 2228 FEET FROM NORTH LINE AND 458 FEET FROM
TILE EAST LINE IN LOT 8 (SE1/4 NE1/4) OF SECTION 17, T. 6 S., R. 94 W. OF
THE 6TH P.M. GARFIELD COUNTY, COLORADO.
REFERENCE DOCUMENTS _ . _ SIIBVEYO '.S „CERTIFICATE
1) T.65., R.94W., 6TH P.M. GLO PLAT
2) U.S.G.S. QUAD: ANVIL POINTS, CO
3 ELEVATIONS BASED ON NAVD 1988
4) LATITUDES AND LONGITUDES ARE BASED
NAD 83, COLORADO CENTRAL ZONE.
5) WELL MEASURED 90' FROM SECTION LINES
ON
i; George R. Bauer: a Professional Land Surveyor in the State of
Colorado do hereby certify that this rvey wog..mpde::p y1 er my
direct supervision, and thot thi
CO
CONSTRUCTION SURVEYS, INC.
0012 SUNRISE BLVD.
SILT, CO S1652
(9'10) S16-5153
represtdep j r ei7,
Ar
`" ' 27925
$J Ctt
°��it i V& SzS '
SURVEYED: 07/30/0
SCALE: 1" = 1000
DRAFTED: 01/22/02
REVISED: 10/14/02
DWG: BARRETT\RMV53-17
SHEET: 1 OF 7
NE C9fi'.
PIT tle, EX9E
tOR ,"
SE' Cori AA
tOR'
.F 0.:0:
1.1 Ei<ISTINC:
I I DRAIOGE:
Is\ s•
E
PLAT 4$2
PIT & PAD LAYOUT
F 0.0'
141 COTii
FILL: tINEI
' I. .tE.
;:"
"
—
a
kLj
.r)
co
Sq,#6
F 0.01
/
40' tW80'
F 0.0 to EXISTING
-FUTURE or RWF 42-17
RWF 341-17 In
-FUTURE 0.
RWF 32-17 0
FUTURE 0 .."-
-RWF 342-17 0
FUTURE 0 --
-RWF 332-17
.;"7•••-•-••-•" •
COR #7A
C o.0'
I
COR #7A
C 0.0'
COR #1A
44;.
10
; 1.1. ' 1 ter :
i i chSTINg
INAINAtE
:7
.:.%,.....,,,,, ...
.,„.
e'00:11.0,..ORIOAGE AttiNG
• i1 •9E1 OF PAQS•V-ptleCH )
•e , '1 .[\ ' *•:?;"
I .q CIT/1 . -3). •, ...,
FtLL PEI ' • Eli
• /
7.
s:t s i... ". • ! ."-• • l"
'""•{,.._.f • SWfl). • • • •.„..e • •
•
' ,:515 •
,
•I. I I. • • f.' • 'V/ •
1' :
•
• , ES ILM:A1E 0 Duf37,.IDU AN TI TI ES
.
:COT. •
.
"FiLL'.
TOPSOIL
EXCESS
. P AO :.
.
'
0 ' •
0
TOTALS
0
0
0
0
CONSTRUCTION SURVEYS, INC.
0012 SUNRISE 151..VO. WILLIAMS PRODUCTION RMT
SILT, CO 2,1652 RMV #53-I1
(910) 616-V53 SCALE: 1' = 80' SHEET: 2 OF 7
',:,a: -.:;.,,,j--7----3---/ �) ;AT 3$5
`_`,I, ' TOPO �& ACCESS
11fi: PROPOSED uiLLs At THE
-J EXISTING RMV a53-11 WELL S
. ;{ ;�
HIGHWAY.S "
€1 v
ACCESS:
FROM THE INTERSECTION OF HIGHWAY 6 AND COUNTY ROAD #246 (ANVIL POINTS ROAD) PROCEED IN A GENERAL
NORTHERLY DIRECTION ALONG COUNTY ROAD #246 APPROXIMATELY 0.1 MILES TO A T -INTERSECTION WITH A PAVED
ROAD, PROCEED RIGHT IN A GENERAL NORTHEASTERLY DIRECTION ALONG SAID PAVED ROAD APPROXIMATELY 0.7 MILES
TO A POINT WHERE THE ROAD TURNS TO THE LEFT, PROCEED ALONG DIRT/GRAVEL ROAD IN A GENERAL NORTHERLY
DIRECTION APPROXIMATELY 1.0 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD ON THE LEFT, PROCEED LEFT IN
A GENERAL NORTHWESTERLY DIRECTION APPROXIMATELY 0.1 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD ON
THE RIGHT, PROCEED RIGHT APPROXIMATELY 0.7 MILES TO TO THE EXISTING RMV #53-17 WELL SITE, BEING THE
LOCATION.
CONStRUCtION SURvrtS, INC.
0012 °SUNRISE 5Lv1D.
SILT, CO 81652 WILLIAMS PRODUCTION RMT
(910)516-5153 SCALE: 1" = 2000' SHEET 5 OF 9
- PLAT #i
CURRENT FOOTAGE
1337' TO NEAREST,
PUBLIC ROAD ,:`.
CONSTRUCTION SURVEYS, INC.
0012 SUNRISE BLVD. WILLIAMS PRODUCTION RMT
SILT, CO SISS2 RMV #63-11
(E10)&16. -E153 SCALE: 1" = 500' SHEET: 7 OF 7
Parcel Detail Page 1 of 2
Garfield County Assessor/Treasurer
Parcel Detail Information
Assessor/Treasurer Property Search 1 Assessor Subset Query
Clerk & Recorder Reception Search
Parcel Detail
Assessor Sales Search
Basic _Buildinu_Character stics 1 Tax Information
Value Detail I Sales Detail 1 Residential/Commercial Improvement Detail
Land Detail I Photographs I Mill Levy Revenues Detail
Tax Area
Account Number
Parcel Number
2008 Min Levy
018
R180010
217517400959
41454
Owner Name and Mailing Address
BUREAU OF LAND MANAGEMENT
50629 HIGHWAY 6 & 24
GLENWOOD SPGS, CO 81601
Assessor's Parcel Description
(Not to be used as a legal description)
SECT,TWN,RNG:17-6-94 DESC: LOTS
1(39.52), 7(39.91), 8(39.52),
9(38.71), DESC: 10(39.06),
14(39.20), 15(39.19), 16(38.83).
EXCEPT DESC: 53.50 AC AS DESC IN
1049/941.
Location
2008 Property Tax Valuation Information
http://www.garcoact.com/assessor/parcel.asp?ParcelNumber=217517400959 4/28/2009
Physical Address:
RIFLE
Subdivision:
Land Acres:
260.44
Land Sq Ft:
0
Section
Township
Range
94
17
6
2008 Property Tax Valuation Information
http://www.garcoact.com/assessor/parcel.asp?ParcelNumber=217517400959 4/28/2009
I.�S\ o PLAT 5
1v Cci-1 b - ill%%s° j TOPO Bc ACCESS
PI20Pia D WELTS AT THE \ �. IA
Ex etTIMG RMY p63-17 WELL 617E >a•
1 l ti 11 \Or
�� r`\L
"sszdl .., -7 /
R
l (
L i 4'
tij
d
V-1).-11"aERVE PIT
6�
MAI(
TUB
ma
MB
ACCESS:
FROM THE INTERSECTION OF HIGHWAY 6
NORTHERLY DIRECTION ALONG COUNTY '
ROAD, PROCEED RIGHT IN. A GENERA;
TO A POINT WHERE THE ROAD TUC
DIRECTION APPROXIMATELY 1.0 1'
A GENERAL NORTHWESTERLY
THE RIGHT, PROCEED RIGHTpj
LOCATION. $ r
^0
I
vizi) vNm
'Pt
ro
4-
-7
s_
gia
C700L 7/
PAY TO THE.
ORDERAF;,.L
II' 000000 5 30 300' 40 7 L9 23 2 264 09147813o
,#INCA, WVIM