HomeMy WebLinkAboutApplication- PermitGARFIELD COL 'Y BUILDING AND SANITATION DEP
108 Eighth Street, Suite 401
Glenwood Springs, Colorado 81601
Phone (970) 945-8212
INDIVIDUAL SEWAGE DISPOSAL PERMIT
TMENT
4610
Permit
Assessor's Parc-I
LAt rag
This does not constitute
[building or use permit. i
PROPERTY
><()t, W*S/A q
Owner's Name�(g-D'(u LEVEEK H Present Address PS1'PE I CO b Cy (( 1 I Phonegz5-853/
System Location SUi.'n-{' i lGn f b� I J
Legal Description of Assessor's Parcel No.
SYSTEM DESIGN
2-to3"}$1-4-Co-DH
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)
CaII 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.garfreld-county.com
RICEIyED
JAN 3 0 2009
1
Parcel No: (this information is available at the assessors office 970-945-9134) 2 4 0 3 1 8 4 0 0 014 BUILDING & PLANNING
2
Total lees:
`7 �. °°
Job Address: (if an address has not been assigned, please provide Cr, Hwy or Street Name & City) or and legal description
App. 9 miles SW of Town of Rifle, SWSW, Section 18, T7S, R93W, 6th P.M.
3
LeiO
Lot Size: Lot No: Block No: Subd./ Exemption:
678 Acres N/A N/A N/A
4
13u' ling & PI. n
J 47.--- 2
Owner: (property owner)
Gordman Leverich, LLC
Mailing Address 1005 Waters Ave
Aspen, Co 81611
Ph:
970-925-6559
Alt Ph:
5
Contractor:
Laramie Energy II, 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: 1
All 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 temporary employee housing - Pad South Leverich 18-13
Number of bedrooms N/A Garbage Grinder ( )Yes (X)No q
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 SYSTEM:
Was an effort made to connect to the Community System?
Town of Rifle - app . 9 miles to the North East
No - di stance too great
YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITH OUT A SITE PLAN
12
GROUND CONDITIONS:
Depth to 1s1 Ground Water Table app 80 feet Percent Ground Slope < 10W
13
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM (ISDS) PROPOSED:
( )Septic Tank ( )Aeration Plant (x)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-Describe
Dispersal ( )Above Ground Dispersal ( }Evapotranspiration ( )Sand filter
South 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.i 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 soil
Name, address & telephone of RPE responsible
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 en 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 legal action for perjury as provided by law. Wayne P. oM e w P1 u%wi.MP.V mqy,.
I ll......0-xbwk,rtylsw4.,.97.,., 01/21/09
Bafflteft
_au.
OWNERS SIGNATURE '°°'°""'2"2-070 DATE
STAFF USE ONLY
Permit Fee:
173 .CD
Perk Fee:
Total lees:
`7 �. °°
Building Permit #:
SMcU ITER 1'5o(71
Septic Permit #:
LeiO
Issue Date:
2.4,09
13u' ling & PI. n
J 47.--- 2
ilri
1
4? -1)4.0f-& Cirte/77b1A / 2 -1-0
APPN OVAL(
DATE
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., shalt 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
wo
WELL SITE LOCATIONS (APD##(s)) South Leverrich 18-13
OPERATORS NAME Laramie Energy II, LLC
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.
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. 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.
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.1: 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 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.
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FULL BAFFLE DETAIL 'C'
SCALE: 1/24
81
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0 =r
18
78 INVERT
{
11 2 7/8'
9. 1 3/4
3
5
6
42 3/4--
9
10
11
12
—62 3/4
83 3/4
18 1/7
6'DIA SCH 40 PVC INLET PIPE WITH INTERNAL SANITARY TEE & PIPES
RISER PIPE. FOR 24'(NOMINAL) ACCESS OPENING
FULL PLATE BAFFLE (48' INVERT) WITH 3-4'D/A HOLES
LIFTING LUG
HOLD DOWN STRAP LOCATION
102 1/4
31 6 1/2
NOTE:
1 - SEE XERXES' ONE YEAR LIMITED WARRANTY
FOR UNDERGROUNO SEPTIC TANKS.
2 - INVERT DIMENSION FROM TANK I.D.
73 14 15
J V
67
16
16 3/4(TYP)
0 ( .v,sia. omoriaia
7- ra' r- ��..
XERXES`
oS1
vvoe
`1.3000
0 RPORATION
8•DIA SWT
CAP. 10,000 GALLONS
MARATIilN OIL WASTE
aesnas
D
-632-638
00
11.1, tn.-, •w•
1 on ch•
November 4, 2008
To Whom It May Concern:
Laramie Energy 11
North Mamm Peak Operations
Down Valley Septic, LLC
P.O. Box 1929 • Rifle, CO 81650
970-625-5556
www.dvseptic.com
Please accept this letter as certification that Down Valley Septic will provide sewage
collection, and portable restroom service for Laramie Energy II Hunter Mesa Operations.
1 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.
4210 --T-f3LI
(Signature)
(Date
0P
Please contact me if you need any additional information at 970-625-5556.
Thank you,
Scott Moyer
COO
Down Valley Septic, LLC
SITE PLAT
SOUTH LEVERICI-I 1!
OPERATOR: LARAMIE
GOVT LOT 4 SECTION 18 T'
GARFIELD COUNTY, C
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