HomeMy WebLinkAboutApplication- PermitGARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
108 Eighth Street, Suite 401 4 6 5 7
Glenwood Springs, Colorado 81601 Permit
Phone (970) 945-8212 Assessor's Parcel No.
LISVS 1.300
INDIVIDUAL SEWAGE DISPO AL PERMIT
PROPERTY
This does not constitute
a building or use permit.
Owner's NameW t LL-))� PUS MOO Present)�- Addresan 30 t Paik `-il .Phone? , — I3 !/
System Location CO, I' l 2_ (
- 1 I"fro
Legal Description of Assessor's Parcel No. ZJ4 D° • of 4. m, b I I
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)
2409-014-00-011
2
Job Address: (if an address has not been assigned, please provide Cr,Hwy or Street Name & City) or legal description
GM 245-1 Pad site See attached Map and Access Description
3
Lot Size: Lot No: Block No: Subd/Exemption:
See Attached Survey Pla package and Assessors Detail 432.13
4
Owner: (property owner)
Williams Production
RMT Co
Mailing Address
PO Box 370, Parachute, CO
81635
Ph:
970-285-9377 ext 2288
Alt Ph:
5
Contractor:
Williams Production
RMT Co
Mailing Address
PO Box 370, Parachute, CO
81635
Ph:
970-285-9377 ext 2288
Alt Ph:
6
Engineer:
NIA
Mailing Address
Ph:
Alt Ph:
7
permit Reaest For: (X 1 New Installation ( )Alteration ( ) Repair
Waste Type: (X ) Dwelling ( )Tranient Use ( ) Commercial or Industrial ( ) Non- Domestic Wastes
( ) Other- Describe
8
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 communi S tem? N/A
YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUSED 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 (X) 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
14
Final Disposal By:
( ) Absortion 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 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 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 the rules and regulations made, Information
and reports submitted herewith and required to •e 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 be relied on by local • epartment of health in evaluationg the same for purposes of issuing the permit applied for herrn. I further
understane. ny fats' cation• • isrepro s J 4 may result In the denial of the application or revocation of any permit granted based upon said application
ii
legal -•�''
and action
y�rya� ,��:'�.�
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Owners Signa re: San•• otard Date: 6/1/2009
STAFF USE ONLY
Permit Fee: v
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Perk Fec:
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Total fees: C:,,.. -Building
Permit #:
Septic Permit #: r
sue
Is . to , o9
Building & Pin g D
APPROVAL pR-x o7 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., 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 4 u'51
WELL SITE LOCATIONS (APD#(s)) GM 245-1
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. 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.
1
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
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
2
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 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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GM 245-1`'`";.
DRILL PAD
LOCATION
A l
Lt,t J 11 ii
WILLIAMS y\=�
t)iJ, PRODUCTION
RMT COMPANY
ACCESS DESCRIPTION:
FROM THE INTERSECTION OF STATE HIGHWAY 6 AND COUNTY ROAD 215 (PARACHUTE CREEK RD) NORTH OF PARACHUTE,
PROCEED NORTHEASTERLY ALONG STATE HIGHWAY 6 t0.4 MILES TO THE INTERSECTION WITH COUNTY ROAD 149 FRONTAGE
RD, PROCEED LEFT IN AN NORTHWESTERLY DIRECTION ±0.7 MILES TO THE GM 245-1 DRILL PAD LOCATION, AS SHOWN HEREON.
SCALE:
DATE:
SHEET:
PROJECT.
DFT:
1"=2000'
3/12/09
S of9
W;n;ams
DPM
Construction Plan Prepared for:
jj ms. Williams Production, RMT
GM245-1 - Sheet 5
ACCESS & VICINITYMAP
5
Excess Mend
Pad Stockpile Area ._5320-/
Exist. Ditch
fie Are 50 0/8 Daylight
stod(13 REF. PNT. Line
100' N#1
0
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150' NW € #8 4
c93'
N. C 66'
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ProposedccessRd
2
ESTIMATED DIRT QUANTITIES (cy)
ITEM
PAD
CUT
8842
FILL
4098
TOPSOIL
1000
EXCESS
3744
PIT
2845
2845
TOTALS
11687
4098
1000
6589
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14
BOOKCLIff
Sury Services, Inc.
SCALE: 1" sit 80'
DATE: 3/11/09
SHEET: .2 of 9
PROJECT: Williams
0
STORM WATER LEGEND:
BP BRUSH PILE/ BARRIER
SB STRAW BALE BARRIER
i ct 1 SOIL CONTAINMENT BERM
2.86 ac TOTAL DISTURBED AREA
Construction Plan Prepared for:
wit
*7ftams. Williams Production, RMT
5-
DPT: CWS
GI 1 245-1 - Sheet 2
GRADING PLAN & PAD L4YOUT