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Home My WebLink About20121160.tiff EXHIBIT INVENTORY CONTROL SHEET SHOW CAUSE HEARING, PCSC12-0001 (RE: USR-1431) - MARLIN NESS Exhibit Submitted By Description A. Planning Staff PowerPoint presentation E-mail from Mark Thomas, dated April 30, 2012, and copy of Application for Drinking Water Construction B. Planning Staff Approval C. Planning Staff E-mail from Mark Thomas, dated April 30, 2012, E-mail from Mary Evett, dated May 1, 2012, and site D. Planning Staff photos E. Planning Staff PowerPoint presentation (updated) F. Planning Staff Minor Amendment Application, dated 4/12/2012 E-mail from Health Staff and City of Greeley re: Sewer G. Planning Staff Connection, dated 5/2/12 H. Planning Staff E-mail from Health Staff re: Policy 6, dated 5/2/2012 I. Planning Staff Updated PowerPoint Presentation with M Email from Mary Evett regarding Notes and Pictures J. Planning Staff from 9/17 and 8/29/12 Inspection of Septic System Email from Mark Thomas regarding Drinking Water K. Planning Staff System Approval CDPHE L. Planning Staff Pre-Application Review Request M. Planning Staff Land Use Application Summary Sheet N. Q. P. Q. R. S. T. U. V. W. 2012-1160 I. N O r-I cp pro _c •� Z No a) ca •� 4-) Cr) n3 o 0 fB .E T- .__ co in 0_ co N ^, O .� ^, .c •E N Wul a Q o v 2 L- 06 N O 4 bA ^ ►O O cn O O C fl —s— CD U +-+ O N co be o CU O •'- c -w O •X • N c� a) a) .v lO4-1 O - = L E to tip CV a L N M a - a W V a O �- 06 La CC tri 5 a) a Q O O U v 0 cc _c m co coc a) C C -a CU C co zir- O i co • - cc 4— O p . . n +,, v o C O CC N 4— N C a) ci C a N (� Q O in +' tie ro V) O C CO a 1— _ V) C O U N 0_ p N N O L an < 3 O C O a) .— a) s_ ca co o a U r-I •- L- CO o CO O C N 0m > U N co O [U a) U U L • 0 a o a ri CC _I V) o c i Q 1\ Ito ' 4 Art .41, .I It* iS 711D1fro, ii , # . ‘) II�% *' `� I. ` 4_ j...0 , LI , W' r .,\ • i r IS 16 el iill %Ile " i • a �r sik: 1 i, . ill i I ate 4 ; . * .. 4, . .4 ild i , • ,l .. 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".. . i .. 1 f ilia40 .. .; .' � � a Y .. • _ r r ;.• Iv .0 Y .f 1 A • i W W Z D 0 D W z 0 = w U Z 5 II 2 WHOI Q � Uvn Q D wQ ww 0 oo O Z < C 0 0 2 - a. < w LU v) Joc • = O c o0 O ~ zt7) 0 U QO � V) = Z Z w LU w m DC cnzctW w � N LL w Q OJ U Q w w Z w = 6 I- m Q i Z DC cry � mMaQ I- 0 = w v) cn rl I-- _ • • Esther Gesick om: Chris Gathman nt: Monday, April 30, 2012 2:47 PM o: Esther Gesick Subject: FW: Greeley RV Park South Attachments: Doc.pdf Esther, Here is an exhibit for the Ness Show Cause hearing (PCSC12-0001) for this Wednesday 5/2. Sincerely, Chris Gathman Planner III Weld County Department of Planning Services 1555 N. 17th Avenue, Greeley CO. 80631 Ph: (970)353-6100 ext. 3537 Fax: (970)304-6498 Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you ve received this communication in error, please immediately notify sender by return e-mail nd destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. Original Message From: Mark Thomas Sent: Thursday, April 26, 2012 8:43 AM To: Chris Gathman Cc: Mary Evett; Trevor Jiricek Subject: FW: Greeley RV Park South FYI. . .Greeley RV Park thus far from CDPHE, however, concerning the wastewater no commitments have been made. Mark Mark Thomas Chemist Weld County Department of Public Health and Environment 1555 N. 17th Avenue Greeley, Colorado 80631 Email: mthomas(aco.weld.co.us Office #: 970-304-6415 ax #: 970-304-6427 r¢ e:. � fi v 1..;'t . 1 Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you Ilive received this communication in error, please immediately notify sender by return e-mail d destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. Original Message From: Camrud, Douglas J. [mailto:Douglas.Camrudfdphe.state.co.us] Sent: Thursday, April 26, 2012 8:39 AM To: Mark Thomas Subject: Greeley RV Park South Mark, Attached is the Greeley RV Park South drinking water design submittal. I have been meaning to send this to you (Weld County) for review as I don't think David Ness sent Weld County a copy of the submittal. Hopefully I can get to it in about 2 weeks. Upon first glance, it appears mostly complete. As for wastewater, we have had a couple of phone calls from an engineer in Missouri about the process for constructing a small 10,000 gal/day treatment system. I believe this is what Marlin Ness wants to do, but I know he is concern about the 6 or so months it would take to go through all the steps/submittals. However, I do not know which way they want to go. Doug Camrud Senior Review Engineer �ter Quality Control Division lorado Department of Public Health and Environment 4300 Cherry Creek Drive South Denver, CO 80246-1530 303-692-32711 douglas.camrud(state.co.us 24-hour Environmental Release/Incident Reporting Line: 1-877-518-5608 • 2 Colorado Department of Public Health and Enviro C E IV ado Primary Drinking Water Regulations Water Quality Control Division Application Form 4300 Cherry Creek Drive South,B2 Non-Community, GIN Systems 41303-692-3500 Denver,Colorado 80241-1530 APR 1 .3 2�i Engnering Section Application for Drinking Water Construction Approval Application Form: Non-Community Public Water Systems using Groundwater(GW) sources Pre-Accepted Disinfection Designs Colorado Primary Drinking Water Regulations 1.11 A.Project and System Information System Name CAE E LEY Rd ?Aft. Sour H Project Title PWSID • County WELD Submittal Date Design Company Name (,i\E E Le'( k\J nliK Design Engineer/Designer NINAtiLfI•-) Or S S I CO License Number1 Address SO I e-A S T 2.1 tR ST�e-r ._..__ - (,0.C-€LEY Co gUe31 Email rnacl;nri4S1€k-vtr•.a;1. corn Phone `110- 3vZ- 0412.1 Fax Applicant/Entity C.(LEELP-e Rv ()ARK Representative Name/Title _ co,rw.t O rst"s S5 / opah-vlZ .ddres$ 501 S Jyr 2 t', STMiET ----- — hl10Et.f`1 Co $0631 Email rivaxQvNer.171.0 hotr‘a%l . cQM Phone °1?U • 3S I-- 6 y'r b Fax B.Public Water System(PWS)Type Community N/A Non-Transient. Non- Transient.Non (CWS) Community(NTNC) Community(TNC) ❑ C.Current Primary Source Surface Water/ ®N/A Ground Water(GW) Consecutive/ N/A Classification GWUDI Purchased D.Design Submittal Scope(Check all that apply)and fill out corres ning sections -- I Source Treatment Facility Storage Tank Other New ground water(GW) pl. New Treatment Facility New Distribution State Revolving System Tank(Section O Fund(SRF) N/A source(Section 5: Pa ge 5-6) (Section T. Page 7-9) 057 Page 10) _-.—. P New ground water under the Expansion of existing New Tank(s)used for Technical, ________ _____ direct influence of surface N/A treatment facility disinfection contactri Managerial, WA water(GWUDI)source (Section T: Page 7-9) time(Section T. Page Financial ) Evaluation Modification to existing Distribution New surface water(SW) Modifications to source WA treatment(Section T: n existing tank N/A System(SRF WA Page 7-9) Projects Only) Existing source modification o.__ Other(Please describe) E. Estimated Project Schedule and Cost Estimate F.Project Flows G. Residual PlanQif pplkabie) —, Estimated Construction Start Date _i ) i Minimum Flow O COPS Discharge Permit N/A Estimated Com�ietion Date 1-31 - I I Monthly Avera9e 110,O00 bAL Impoundment N/A Estimated Project Cost E 1 Soo.0 0 Peak Hour Flow 400 4RL Class V injection welt i N/A ill 0a,as•o.+ r.,....,..,'Mal 0.,..0 1 ,s in Colorado Department of Public Health and Environment Colorado Primary Drinking Water Regulations Water Quality Control Division Application Form-Signature Sheet 4300 Cherry Creek Drive South, 82 Non-Community,GW Systems 0 Denver,Colorado 80246-1530 Engineering Section 303-6924500 Application Form: Non-Community using Groundwater (GW) sources Pre-Accepted Disinfection Designs Signature Sheet A.Pro ect and S tern Information System Name Y� l,tkee:t_e-r v.k/ PgRtc SwTH Project Title County WELD PWSID Directions_ Prior to submission to the Water Quality Control Division(Division),the construction application must be signed by the Owner and/or a System Legal Representative. Signatures of System Representatives Rote Date ±rypert Name Signature Owner rA t(1ta/i M rt 3,S `f-to - I1 PAARLIIA.i roe S /1 YyG,,-, Y7 /1/. .,.1.. z_ The owner is an individual, -._._ the oorpwation,partnership,association,state or political subdivision thereof,municipality,or other legal entity. Applicant/System Legal ..__ —._-- I Representative The system legal representative is the legally responsible agent and decision-making authority for a public water system(e.g.mayor, — board,public works director). The president of a Designer or Consulting Engineer is not the legal representative. Local health authorities The Division expects the public water system to send a duplicate copy to the local County health authority or County Commissioner(it no County Health authority)in whose jurisdication(s)the dnnking water facility is to be located. The Division does not require County signature prior to submittal. III) I � i o.s..ioo.l 1-an..on.11111 Dimas')ni 9n Colorado Department of Public Health and Environment Colorado Primary Drinking Water Water Quality Control Division Regulations 4300 Cherry Creek Drive South,B2 Application Form-Pr NC GW Systems ofect s ill Denver, Colorado 80246-1530 Engineering Section 303-692-3500 Project Information: Non-Community Public Water Systems using Groundwater (GW) sources Pre'-Accepted Disinfection Desiins I. Project and Sirstem Information Project Title System Name (,6L4ELEY KV t'n0.K Bovril PWSID County WELD Pro act Information and Viciniyr Maw 01 Description and scope of proposed project. Please attach a potable water system schematic in Appendix D. (Example text The proposed proved includes improvements to an existing potable water system at a campground in La Plata County. The proved will include: one new well (approx. 12 gpm), sodium hypochkxtte treatment, three 100 gallon pressure tanks for disinfection contact time, arid one 500 gallon buried distribution storage tanks A schematic of the water system is available in the appendix.")_ Response: T1+6 PRol:VW) Pb3 EcT INcr_v(E S The Cons StRvc-T ra N o F A ?Or'ALE' 1...011-Eq Sy E M AT T1te (IRSYLEY ttv Al(PA. Sa.TH ANNEi . Ili (1(4.03-E cr it,,ct.vtiE S onirr if w(i.L C Milian. 20 oh") SOoxvM HYPo(Hcus rE 'ME Kt-,,En t oNE 15 00 (A Mao K..1 ° ' C€ TANK wR DISI'NFEct 0,j cowrAc.T tuME p1'it) OLSTA.I,)UTIAr t A Sl-HEMAtL4 of TVG WATER SYST€W 1S AVAzLriie_C .TIV Tlif A?Pen,02,4. IIIIIG2 Description of an existing water facility components utilized(Example text"The existing Well 2,approved in 2007,will continue to be used as part of the potable water system. The existing treatment facility will be decommissioned and will no longer be used after proposed project is complete. The proposed raw water line connecting existing Well 2 to the proposed treatment facility can be seen on e vicinity map in appendix.")the the dix." ! Response. Service Area,Potential Flows G3 Service Area Description of the Public Water System (Example text "The public water system currently serves a population of 40 transient customers. This protect will serve a campground expansion which will increase the transient customers to 80. No further service area expansions are anticipated Response: - — G4 Service Area includes: Campgrotmd Et Restaurant store ❑ I School.daycare ❑ Day use a site(e.g,Park) ❑_ Year round Housing Seasonal Housing Unit ❑ tamer(describe below) ❑ ff) Units(e.g-,subdivision) ❑ e. rental cabin ❑ Business,�� D.,, Inf4n Response.0 GS Future Service Area Does the water system have plans to ever serve year round residents(e.g. a subdivision)or serve realer than 25 people for 6 months Le.g.,daycare,school)? Response: Nj. - RAE Pew CURALElTL'( °rm.Y II 1i&Sioertn1 1)1"51- ttivt tler''► iE mile o Foot rwgF 'TinN C2x Mokm1 S 1►121 r.OLt 54fk JS Not e•ADE(.1-66 pi RinTVATE ov&1)i, zr. I �G6 Potabie/eater Rowan's Describe how the potable water system flowrates were projected and/or estimated. If the flowrates were calculated then please include any calculations in the Appendix. (Example text: "The flowrates were estimated using three methods and the system was designed based on an average flow rate of 5 gpm and a peak flow rate of 40 gpm. Method 1: The campground historic water flow data was projected for the incremental population increase. Method 2: International Plumbing Code fixture units estimation method. Method 3: Manual of campground design by the USFS The calculations are included in the Appendix./Response: i to FWwRAtt wE4E CSTTnMTED usLoc A Pt ow — -- mE7ER, Ate metif\ w/11 RrRfl• — t VE4T VW-0 F-ock 3 0A45 lb be of NE OE AK I"L(IW 'TIMES . {lira AltetPt()E I%Low TIA.E. I� WI 1 0ErEM^INe5 "lU 9 r 2.7 GALt°N S Vol.. r.inAi? w.i7 I1 Pi AK i LtM 2.4.1E aF 6. (• ('PM. Post Construction Disinfection Process G7 Disinfection Process:Please describe how the sources,lines,treatment facilities,and tanks will be disinfected prior to use inducting specific AWWA references(Required Design Criteria Section 3.14, � APPendix t ix 11.0.17, 2.5.6 - Response: _-- �-- Location Information-11N}Year Floodplain Certification must be attached In the Appendix E. G8 Floodplain and Natural Hazardslip a)Is the faality(ies)located in a 100-year floodplain or other natural hazard area? If so,what precautions are being taken? Response: No G9 Land Ownership a)Who owns the land upon which the facility(ies)will be constructed? Please attach copies of the document(s)creating authority for the applicant to construct the proposed facility at this site. • Response.owNc&) wax 1vAf1c_{n1) 5ND SttiAtei NESS, ma ‘,....,(0.44.1110 DEE0 zs ATRIcriet> , ( lip Floodplain certifications are required for all new water system facilities and improvements/expensions that impact building footprint. Oq..:ca1 to.,..a...')flV) Done A..i 1A j Raw Water l Source Information: Reference Section 2 of the Design Criteria Raw Water System Overview 0 S1 Source Description. (Example text 'Well#42 was drilled in June 2010 into the Cliff House Sandstone aquifer. The well is 200 feet deep with a first screen at 167 feet The average well flow rate is 20 gallons per minutes (gpm)and the peak ftowrale is 23 gpm. Water quality samples were taken in June 2010 and all raw water parameters tested were below the drinking water standards . - -.. — ... - --... ___.............. Response: rife 6REeLey Rv PARK Sow t-i WELL w^S...Oat—LED It.) 'my 2009 . NE w E a L -TS -?Z FEET DEEP wShi R Se rt.t-M iyr b FEET. 'ME AtUERA6G JELL FLowitATE T3 2.7 bAuo,vS peQ A,.tyuv7f rN wU ThE PEAK Ft ow RATE rs ‘.6 (FPM. AN ('SA wAi TAKEN _ t.) ocTogER 2ot1 AND REcEtveo A gco4t: OF 6 - Law Al-SK 'S2 Other Sources. Any other wells on site being used(e.g.,existing wells)or that may be used? Response: N10 Raw Water Quality Summary: Laboratory Data on State Forms must be attached in Appendix F. S3 Water Quality Parameter Analysis Results Nitrate•• Nitrite �!^ ._._._(nn9fl) i Bacteriological • Iron(Recommended-No State forms) • • Manganese(Recommended-No State forms) • • Hydrogen sulfide(Recommended-No State forms) Inorganics(Required for NTNC systems-Recommended for INC systems)-please note ar resufs above the MCI. Organics(Required for NTNC systems--Recommended for TNC systems) --- -please note any results above the MCL Corrosivity(Required for NTNC systems-Recommended for TNC III systems-please note any results above the MCL Radionuclides(Recommended for NTNC/TNC systems)-please note any results above the MCL Well Location Information: S4 Nearby Surface Waters Type of nearest surface%valer Response: FBI v 42 R Name of nearest surface water Response: Sour Piq R+r Distance to nearest surface water Response: 2O6O FEET How was distance to surface water measured? Response: LASER SIGH T,I tv — --- I SS Contamination Sources within 100 feet of well? a)Do any potential sources of contamination existing within 100 feet of the well e.( g.,septic field, fueling storage tanks, sewer pipelines)? If so,please list contamination sources,distance to well, if contamination source is up or down gradient, and what precautions are being taken to prevent the contamination source from impaeti�the well? Response: N v 4110—. If only existing sources are used then new raw water chemical are not analyses required However, source water quality information for existing sources should be summarized. o.,.,:.•n.+ Inn,.-s..,7n 1-, r1.1no c ni 10 : , Iiii Well name _T.__.....__..__...._..._.___ (,REEaE`t tZv Pr1yrs ---1 r Max pump rate L 0 9Pm W DR Well Permit No. 6i qo t F Nominal pump rate 9Pm Aquifer Name wq -��- head abovegrade(12 inch minimum) — — ---—___ ----- Well elevation •__ 1 Sanitary Well Seal including but not limited to: ZW inches J gaskets present,bolts,all penetrations sealed Positive_ .. --drainage slope array.._... .-------.1-...."1 (required Design Criteria Section 2.1.5)._______--..-- from well for at least 20 feet -- Yes No❑ ... . Vents screened with 24 Mesh screen(Required `(Rec_ui►ed Design Section 2.1.8 __ - Design Criteria Section 2.1.71 Yes El No❑ Concrete Pad:4 foot by 4 foot %>••.\.•:; sloping pad is recommended '��'; .e,..."\,..:4,' �! for wells with static water less than 100 ft. Design Section - . 2.1.8 _ _ Circular O Rectangular® • . Depth to Piless line — None❑ S` feet 4-7 1—‘ Size: �i Grout Depth I. ..... ___L feet — — Well Summary:Dlvbbn of Water Resources(aka the State Engineers oft'ice) Well Permit and Well DIlliers Lo must be attached in Appendix C. I ti. ,z:::] -Ilill _.„. 0 Deuricnel lore..,.."7rlio D ,.oA ni 1n • Screened Interval Depth, top 50 feet Screened Interval Depth,bottom ?Z feet Total Depth of welt 7 Z feet ooru 7 n 1n Treatment System: Reference Section 3,6,and 7 of the Design Criteriaill _ Tneabnent System Overview: T1 Treatment System Description. Please attach a treatment system process flow diagram in Appendix D. (Example — text: 'Raw water from the source enters the treatment facility. Diluted sodium hypodrionte(manufacturer X's chemical supply)will be added using a peristaltic pump(Manufacturer X's equipment, Model CF42). The chlorine dosing rate will be variable injection rate controlled by a ftowmeter. After chlorination,the chlorinated water will flow through three pressure tanks(Manufacturer X's equipment. Model XX)and then out to the distribution system. Sample taps will be installed for raw water and treated water samples(entry point) The well pump will provide pressure through the treatment facility and into the distribution system. The estimated system pressure is 75-85 psi. A schematic of the water system treatment is available in the appendix.') - Response: MhN vATtR Mom ME Sa►R(E EnrieRi ME TREATMeAf- Fr1crL.XTy, IT PASSES i1+Ruvrr1 A s ,,,rcioanr SAnrp r-1,,TER 1 E1) Th1Rw&ri A I r^ICRUnr AncOLvTc c ern.ft=t)GE Fig_TER . Pi(riTEr) SOgs.,r., HWoc.Pic vs4,rTF ( c corten 6LEAr.rr) vorc.L (3E' FPDEl) v5?►uC. A tJtAerig 1 e? ( ln,t rot.is PILI• 3Sesr), pt c Te(t 041-cikrrr grror1/4/. Il-f E C.HLORLvATEI') w nreR w1LL Ft-Dtv .rwTD A 'Soo ()Pm.-0•V STr,MGC TANf,. ( NortwE5r0 Lr5IS3) A.'0 Th1nJ out Tb lilt DXSTrt1- rov SY s-tEpi,i, SArnPLG PAPS HAue iie•C'„r INSTALLED FoR MIA wAreft AnA TREA'rEt) wr5TeR SAIKPLES. A PrLESSuRt T'ANrL lwb 2 f?oosTER R,v.PS TIA LL PRou.cpi* FREsyt,RE THAovbri 'il,6 D.r1riJTTtu7S.Ar Sy .?EM . rife ESTzvkATFD _ —SYS'TErft t'Reswgte IS 47-6I PSZ . A ScriFMAT1C vF THE kftiorIlit SIOTEM rS AvAtc-AS4E try 1Tt6 fippeNoxx, 12 Ground Water Rule(GWR)Compliance Strategy(Article 13 of the Colorado Printery Drinking Water Regulations) 8 Triggered Source Water Monitoring(Default-Most GW systems: Sample sources if a positive -_ .._. ._ __-•-------__._-- distribution system bacteriological sample) 4 Log Certification(Please contact Compliance Assurance for the GWR 4 Log ceilificalion ❑ application to be submitted along with design review application) Pie Disinfection System BasispH of 7.5 and T ---_. Accepted Design (assuming imp of f0'Celsius) T3 Minimum Required Free Chlorine Residual for 4-log viruses inactivation__._._. • (A minimum of 0.2 m9/L.of free chlorine required at all times) Max Flow Rate 3 tank design( 1 BF 0.35 _—_ 4 tank design(BF 0.5) 10 gpm 0.75 mg/I 0.40 mg/L 15 gpm 1.10 mg/L 0.60 mgA. Illp 20 gpm -_-_1.50 mgll _ Y_ 0.8 Maximum Flowrate(Chose ONE) El10 gallons per minute(gprn) CI15 gallons per minute(9Pm) ® 20 gallons per minute(gpm) Retention tank type(Chose ONE) ❑ Three(3)80 gallon tanks 1 O Equivalent volume- 140 feet of 4 inch pipe ❑ Four(4)80 gallon tanks O Equivalent volume-115 feet of 6 inch pipe Pre-Accepted Treatment Facility Equipment Summary(Chose ONE per Category) --- --- -- if equivalent equipment is proposed then information and ANSI/NSF Certification Documents must be attached in Appendix G.3 T4 Water System Component Used? Manufacturer Model Number Description Flow meter with external output ❑ Endress+Hauser 2"/Promag, magnetic O Endress+Hauser 2-8"/Prosonic 91W —_.__......_..._transit time ❑ GF Signet 0.5-4"2537 mechanical ❑ SeaMetrics 4yy4MX magnetic fr.--.X.31 O SeaMetrics 2"/MJ-Series mechanical ❑ GLI International mechanical(Mounting I ❑ GLllntemational --, IL mechanical 12100' 3"I8750W mechanical(Brass) O Rosemount magnetic ❑ Elster AMCO _._...._.__._.. 2"IevoO4 magnetic O Dynasonics 2">tTFXA transit time For sodium hypochlorite storage tanks and chemical feed pumps submit either 1)evidence that the storage is constructed of appropriate material as listed in the Chlorine Institute Pamphlet 06 Sodium i•fypochlonte Manual or 2)a manufacturer statement saying the material is compatible with sodium hypochiorite or the proposed chemical rather than of ANSI/NSF 61 certified Oo^e o n{ 1 n ❑ Yokogawa ADMAG AXF/ADMAG SE magnetic -_ ❑ Foxboro MA G2IC/MAG2RT/MAG2RS _— magneb_ ______ fa• _._ Other(equivalent): sat*R mcrER tiu C ,W ^Ifcrf ' XCAL - _ T4 _ hem Pu Cical Feed mps will ❑ Blue White A-100NV peristaltic Cont external input _—..____ _.—�_ — ---- • ❑ Blue White A3V peristaltic ❑ Gnmdfos DME diaphragm ❑ LMI—_. ..... 9 Series with MicroPace diaphragm ❑ LMI 7 Series with MicroPace diaphragm - _Q......... ..... Pulsafeeder MP diaphragm ❑ Pulsafeeder E+ diaphragm ❑ Sterner 45MJH with PCM peristaltic ❑ Sterner 85MJH with PCM peristaltic ❑ Welchem EW-Y diaphragm _ P. Other(equivalent)- l J P O SON I E S DzAPHRXim Chemical Solution Tanks ( 1 Linear Polyethylene/ Chem-Tainer TC1829AA/AB 30 aallon ❑ Linear Polyethylene/ Chem-Taloer TC223tiAA/AB 55 aalhon I .0 _- _____Snyder . _,.._..._.. HDLPE/ 5680000N-L.... ---- 55gallon LMI Polyethylene/27400 Chlorine ❑ 35 gallon with flooded suction Tank U 50 gallon with flooded LMI Potiethylenei 26350 suction ❑ Pulsafeeder Polyethyiene/40365 Top rnount 35gatton __ D Puhsafeeder. Pol�rethytene/J40366 T mount 55 gallon ---rID ❑ Polyethylene/42402 Flooded auditor 30 75 Pulsafeecter (309alktn) gallon 4 ❑ Sterner—.... .. ........Poyethylenet STS15NC _..._ 15 gallon ❑ Sterner Polyethylene/STS30NC 30 gallon -...._._ n HDLPE/ 35 gallon+ Snyder 1000200N97202L containment FA Other(equivalent): PaLIETHYLeouE 15 G pit Con/ Chlorine Solution a Chlorox 5.25%Sodium Hypochlorile �. S sco Reliance 5.2596 Sodium Hypochlotite .00 ❑ Treatment Technology 1096 Sodium Hlr echlorite ____________ --- -- _ _ ❑ Other(equivalent): Chemical Containment I O USA Bluebook PolyethYler?e_—.-..___. 55 galf°n_e°t'drum ! ElUSA Bluebook 62 gallon spill pallet Polyethylene 16 drum) --- ElUSA Bluebook X82 gallon spll pallet Po Secondary Containment Polyethylene S7 drum)E — Other(equivalent): Put-YE7HYLC-n,r Sc firlLLcN 00.vM Retention(Contact)Tanks ❑ Global ases C2UT 300 fiberglass Solutions ❑ Flex-Lite FLU 80 fiberglass ❑ Well Mate UT 80 fiberglass III Pepin.. el lon.1on.7111 7 ann.0 of 1O -Redundant(Back-up)CMmical Feed Pump(required Design Criteria Section 7.4) T5 ' Redundant Feed Pump on-site(same pump as listed above) • Redundant Feed Pump on-site(different pump-list pump information below) . Redundant Feed Pump available within a certain number of hours(request deviation-describe pump available — below) O Other(describe below)--- _ . _ . __- Description: --.. ._ . Other Treatment Facility Equipment Summary Equipment Information and ANSUNSF Certification Documents must be attached in the Appendix G. T6 UN Descri on Manufacturer,Model ANSSF Certified or _ --Equipment number Chorine Institute? Other Equipment(e.g., Roughing Lit\pGE pi I.me, yge-.SCd NuftR,10p,Nt Yes [ — Filter,Re-pressurization Pump) Other Equipment(e.g., Roughing Yes ❑ • Filter,Re-presstuiz.ation Pump • Other Equipment(e.g.,Roughing Yes ❑ I Filter,Re-pressurization Pump• • Other Equipment(e.g.,R • flog Fitter, Re-pressurization Pump ... _...._.. - ------- -----._...._.._..... _.__ .... _,_ Yes ❑ .—.......__. Treatment Facility Appurtenances T7 If not included please include a justification below Raw Water Sample Tap(required-Design Criteria Section 3.9) Finished Water Sample Tap(required-Design Criteria Section 3.9) Chlorine analyzer-handheld or online(required Design Criteria 6.1.17-6.1.18) (required by Primary Drinking Water Regulations) • ❑ Cross connection controls Section 12 of the Colorado Other/Justification: O Other(equivalent): Retention Retention Tank 1 Tank 7 Distribution System Tank : Reference Appix I of the Design Criteria 4i,S Tank Overview: 0ST1 F Distribution Tank Description. Please attach a drawing in Appendix D. (e.g.,The distribution system storage tank. Coyote Tank,is a 2.000 Qaiton buried steel tank located on campgroundcircle B) _ _ . _ THE orswOuTtuN vfsiv" t;iAAG6 w.ni. NOkfleStu tnr iK 1S ^ I,Sao 6te..rON t136 i •DENLuTy I tx.LycrNYLeNF TnNK c.e.ivrYp Ar3WC GflwNo Storage Tank Information —..... _...-----._..... DST2 Storage VolumesIS-0O Total Tank Volume(gallons) Minimum Tank Operating Volume(gallons) Maximum Tank Operating Volume(gallons) DST3 Tank Type ❑ Buried Tank - O Elevated Tank • Oa Ground level • ❑ Other. Describe below Response: DST4 Tank Construction Material ❑ Concrete O I Steel • tig Plastic O Fiberglass • Other,Describe below I Response: Distribution System Tank Summary Equipment Cut Sheets and ANSIMSF Certification Documents must be attached in the rdix G. IllVDSTS Equipment Manufacturer,Model number ANSIJ'NSF Certified? { Storage Tank NORh.Esc° . 45 IS8 Yes Igl Coatings(e.g-,paint) Yes O Other Equipment Yes 0 I Other Equipment Yes O —..l Other Equipment _.._......_-Yes 0 ._..._..__ Tank Appurtenances DST6 If not included please include a justification below O -- Drain(recommended-Design Criteria Appendix I Section 1.0.5)with 24 non corrosive mesh screen ' and energy dissipation(required) O Overflow(recommended-Design Criteria Appendix I Section 1.0.6)with 24 non corrosive mesh screen (required),and energy diss�i ation(required) Access hatch (recommended-Design Criteria Appendix I Section 1.0.7)with water tight overlapping ❑ cover elevated 24-36 inches above grade for ground level tanks or elevated 4-8 inches for above grade tanks Vent(recommended-Design Criteria Appendix I Section 1.0-8)with 24 non corrosive mesh screen ' (required),exclusion of dust(required), and terminate in a U.construction with the openings 12 inches above the average annual snow depth(recommended). VI Roof and Sidewafs must be an impervious watertight material with no openings except vents,access ways,overttovrs, etc- (rewired-.Design Criteria Appends I Section 1.0 9). Other/Justification: Tank t.•ocatlon Information __— DST7 Drain and Overflow discharge location _a)Where does the drain line and overflow line discharge to? Does the drain have a direct connection to any sewer or III storm drain? Does the discharge flow into Stale Waters? _ -r,c c,r .rqo (NTsroe T1keATAner/t' rtdVM. rT toes Not MHvc A uzzec.7 cr,10,AEc7,rvy Tb Ar.,-,01 SF .E4 nil 4TQA.r'• ))M Arty bOSS fuir FI.CAv s1JtO STATF t..iffrkni _-._-------------- 0-....... .11 ...fin • • Appendices Appendix ..--- _-- Description __-- -_--- RequjredT --__. . ._Included __...--- ndix A: Inventory Gecko(i of the Monitoring Plan All Submittals YesD Appends B: Vicinity Map_-- AN Submittals Yes ix C: Ej Water Rights and Well Information Required for new sources Yes ,tirirrl Water System Schematic Required for new treatment facilities or -- ----- Process Flow Diagram(PFD)and improvements modifications Appendix D: Yes W. No❑ Project Drawings(e.g.,well head As applicable for project construction and comprehension(e.g.,treatment urudifxations improvements,treatment facility layouts) require a treatment facility layout) Floodplain Certification and supporting Required for all projects that might be effected by Appendix E documents(e.g., FIRMebe map) flooding (e.g., new sources,facilities,tanks or Yes fig. No❑ ! -----. _ ----- _ — __ __ building expansions) _ ix F Raw Water Quality Results Required for new sources _ Yes , No)_]-- Appendix G: Equipment Manufacturer Information 8 R ANSI/NSF Potable Water Certification squired for all proposed equipment Yes( J, No El Other relevant information(e.g. Appendix supplemental calculations) As applicable Yes❑, No❑ ' i IIII Appendix A: • Inventory Section of the Monitoring Plan All Submittals • Available at http://www.cdphe.state.co.ushvg/drinkingwater/PubticWaterSystemRevortir,Forms.html Appendix B: • Vicinity Map All Submittals • ' /) "-. S16, T5N, R65R651111 ,•• ;/ i � ‘3, , . Lined Storage Pond { L/ T CH fi Pipeline to Existing Leath Field , . rrr .�wwI..rlma�==-+s,,-�v. ,.�� »..,,,,,_,�.,..4.,-a-.•►"""-`-vs.. - � 7v.41-. : .. .. fi `.-,C::'-{•: -.:w1'•i: ..t"s`,, ----• _ ";:i- r-'iii 2. i'' `••••....::..,.:;•.`..,•_;:' --...ef:Jar..;...••:.:et.''f.,!Kx..). .• -:. --..L•ti, ,., • ;.'-' '.'" .-; ." - .:1 46 7,11 r ....-. r �•-r -• .-ti .�r�-..�.... .. vim.-�..-_.� c r.:...� .... a Proposed New Well (Greeley RV Park) ,. _ 1 • t S21, T5N, R65W . 1(.41Sr 41°r I I '' O ,,, --. , i .,, • r' : t y - 1 r t Figure 1: Lined Pond,Leach Fold LegendJR Engineering LLC&Proposed Weil Job No. 19019 "°°°°e°"M Cient Martin Ness . . Pam 2620 East Prospect Rd_, Suite 190 U --_- Q u.a� Font Colires,CO 80525 „ „i ,. e. .., , (970)491-9888 Date Drafted: August 2008 P.waled Una,Palo tf�r .«. /eaengineering.com Prepared by: Ryan VP • Appendix C: • Water Rights and Well Information Required for new sources li ii I a • ESCROW NO. : 8056591 DATE August 13 2002 "EXHIBIT A" LEGAL DESCRIPTION PARCEL 1 : Ail chat part ot Lot B ot Recorded Exemption No. 0961-21-1-RE2692, recorded April 5, 2000, as Reception No. 2759836, located within the following described parcel : The W1/2 of the NE1/4 of Section 21 , Township 5 North, Range 65 West of the 6th P.M. , County of Weld, State of Colorado. ALSO that portion of the NE1/4 of the NW1/4 of Section 21, Township 5 North, Range 65 West of the 6th P.M. , County of Weld, State of Colorado, lying East of the right of way of the Chicago, Burlington & • Quincy Railroad Company as now located over and across said land. EXCEPT a tract of land conveyed to Department of Highways, State of Colorado, by Deed recorded January 29, 1974 in Book 707 as Reception No. 1629244 . • 656 • If 4 c.c. . — WARRANTY DEED • THIS oHIS =SSD, Made this 23rd day of August, 2002 between The Robert G. Quick Trust, dated October 25, 1993, a Trust & The Gwendolyn F. Quick Trust, dated October 25, 1993, a Trust of the County of Weld and State of Colorado, grantor, and Marlin Ness and Shirley J. Ness whose legal address is 830 East 28th Street, Greeley, Colorado 80631 of the County of Weld and State of Colorado, grantees: WITNESS that the grantor for and in consideration of the sum of EIGHT HUNDRED SEVENTY EIGHT THOUSAND AND 00/100, ($878,000.00) Dollars, the receipt and sufficiency of which is hereby acknowledged, has granted, bargained, sold and conveyed, and by these presents does grant, bargain, sell, convey and confirm unto the grantees, their heirs and assigns forever, not in tenancy in common but in JONT and being all the realnty eal property, together with improvements, if any, situate, lying of Weld and State of Colorado, described as follows, SEE EXHIBIT "A" ATTACHED HERETO AND MADE A PART HEREOF also known by street and number as 830 East 28th Street, Greeley, Colorado 80631 TOGSTHSR with all and singular the hereditaments and appurtenances thereunto belonging, or in anywise appertaining and the reversion and reversions, remainder and remainders, rents, issues and profits thereof, and all the estate, right, title, interest, claim and demand whatsoever of the grantor, either in law or equity, of, in and to the above bargained premises, with the hereditaments and appurtenances. TO HAVE AND TO HOLD the said premises above bargained and described, with the appurtenances, unto the grantees, their heirs and assigns forever. And the grantor, for himself, his heirs and personal representatives, does covenant, grant, bargain, and agree to and with the grantees, their heirs and assigns, that at the time of the • ensealing and delivery of these presents, he is well seized of the premises above conveyed, has good, sure, perfect, absolute and indefeasible estate of inheritance, in law, in fee simple, and has good right, full power and lawful authority to grant, bargain, sell and convey the same in manner and form aforesaid, and that the same are free and clear from all former and other grants, bargains, sales, liens, taxes, smants, encumbrances and restrictions of whatever kind or nature convey, except general taxes for 2002 and subsequent years; except easements, restrictions, covenants, conditions, reservations and rights of way of record, if any; The grantor shall and will WARRANT AND FOREVER DEFEND the above-bargained premises in the quiet and peaceable po ion of the grantees, their heirs and assigns, against all and every person or persons lawfully claiming the whole or any part thereof. The singular number shall include the plural, the plural the singular, and the use of any gender shall be applicable to all genders. IN WITNESS WHEREOF the grantor has executed this deed on the date set forth above. The Robert G. Quick Trust, dated October 25, 1993, a Trust 6 The Gwendolyn F. By-.;.-i/,, •-hl%/i :f/• (jl_ ",r Quick Trust, dated October 25, 1993, a • Gwendolyn F. Gilick, Trustee Trust BY =)* if.; , 1 ,--N . _ /-k. Robert G. Quick, Trustee • STATE OF COLORADO } } ss. The foregoing instrument was acknowledged before County of Weld } me this 23rd day of August, 2002 . _ , ,. -ti .”,,.-ae „s rtio onMrr (; Ouick Trust. dated October 25, 1993, a TOGETHER with all ana singular ,_.,.., .------ belonging, or in anywise appertaining and the reversion and reversions, renua......a- remainders, rents, issues and profits thereof, and all the estate, right, title, interest, claim and demand whatsoever of the grantor, either in law or equity, of, in and to the above bargained premises, with the hereditaments and appurtenances. he TO HAVE AND TO HOLD the said premises above bargained and fodescribedd,,dw theith thantor, • appurtenances, unto h the grantees, bargain, for himself, his heirs and personal representatives, does covenant, grant, 4 and agree to and with the grantees, their heirs and assigns, that at the time of the annealing and delivery of these presents, he is well seized of the premises above conveyed, has good, aeetright, full and powerindefeasible lawful aauthoritystate of i oegrant,ritance, in law, e in fee lispand has good bargain, sell and convey the same in manner and form aforesaid, and that the same are free and clear from all former and other grants, bargains, sales, liens, taxes, cements, encumbrances and restrictions of whatever kind or nature sieves, except general taxes for 2002 and subsequent years; except easements, restrictions, covenants, conditions, reservations and rights of way of record, if any; The grantor shall and will WARRANT AND FOREVER DEFEND the above-bargained premises in the quiet and peaceable possession of the grantees, their heirs and assigns, against all and every person or persona lawfully claiming the whole or any part thereof. The singular number shall include the plural, the plural the singular, and the use of any gender shall be applicable to all genders. IN WITNESS WHEREOF the grantor has executed thin deed on the date set forth above. The Robert G. Quick Trust, dated October 25, 1993, a Trust & The Gwendolyn F. BY • , , -,r/4"," [ . /c, ,may; Quick Trust, dated October 25, 1993, a Gwendolyn F. Quick, Trustee Trust • BY ) �_c • ' ' ' -, • _ : • Robert G. Quick, Trustee STATE OF COLORADO } } ss. The foregoing instrument was acknowledged before County of Weld } me this 23rd day of August, 2002 by Robert G. Quick, Trustee of the Robert G Quick Trust, dated October 25, 1993, a Trust and Gwendolyn F. Quick, Trustee of The Gwendolyn F. Quick Trust, dated October 25, 1993, a Trust . Witness my hand and official seal. My commission expires 10-17-2002 -k7C ;'., } f_ L / `-- NOTARY PURLIC s `` ti Y. 1113 Tenth Avenue ",.,•-."�.�.:i,, No. 921A. Rev. 3-85 : . c: + Greeley, COLORADO 80631 , ,/.r �,, -Y. `-sz� 1111111 11II now min min , F IIII ill 2981656 08/2712002 09:36A Weld County. CO 1 of 2 R 10.00 0 87.80 J.A. "Selo" Tsukamoto • Form No. OFFICE OF THE STATE ENGINEER GWs-25 COLORADO DIVISION OF WATER RESOURCES ilia CaMemi101ds, 1313 Sharman St,Denver,Corrado 8W03 (303)806-3581 LIC WELL PERMIT NUMBER 87901 -F -- APPLICANT DIV. 1 WD2 DES. BASIN MD APPROVED WELL LOCATION WELD COUNTY NW 1/4 NE 1/4 Section 21 MARLIN NESS Township 5 N Range 65 W Sixth P.M. 501 E 27TH ST DISTANCES FROM SECTION LINES GREELEY,CO 80631- 228 Ft. from North Section Line 2290 Ft. from East Section Line (970)353-6476 UTM COORDINATES(Metars,Zone:13.NAD83) PERMIT TO CONSTRUCT A WELL Easling Northing: ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT CONDITIONS OF APPROVAL 1) Thls well shill be used in such a way as to cause no material kquy to existing water drafts. The issuance of this permit does not ensure that no injury will occur to another vested water right or preclude another owner of a vested water right from seeking relief n e civil court salon. 2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2,unless approval of a variance has been granted by the State Board of Examiners of Water Well Construction and Pump Msfaltebon Contractors in accordance with Rule 18. 3) Approved pursuant to CRS 37-80-137(2)on the condition that ads web(Greeley RV Perk Well)is operated in accordance with the Martin and Shirley Ness(Greeley RV Park and Campground)wended substitute wafer supply plan(2005CW047 • panting)approved by the Stale Engineer on February 17,2009. This well shell not be operated unless it is included in a substitute water supply plan approved by the Slate Engineer(preplan for augmentation approved by the water court. The subject water supply plan is currently valid through May 31,2009,and if not extended or if a court approved plan for augmentation is not in operation,diversion of ground water from this well must cease immediately. 4) The use of ground water from this well is tinted to providing an in-house use water supply for 50 RV lots.The ground water shall not be used for irrigation or other purposes 5) The pumping rate of this well shall not exceed 20 GPM(as requested). 8) The average annual amount of ground water to be appropriated shall not exceed 8.50 ante-loci(as requested)or the quantity covered under a coat approved plan for augmentation Of substitute water supply plan approved by the State Engineer,whichever is lest 7) The owner shall mark the well in a conspicuous place tMh well permit number(s),name of the aquifer,and court case number(s)as appropriate. The owner shell take necessary means and precautions to preserve these markings. 8) A totalizing flow meter mud be installed on this well and maintained in good wakkhg order. Permanent records of all diversions must be maintained by the wen owner(recorded at least annually)and submitted to the Division Engineer upon request 9) This well shat be constructed at least 800 feet from any existing well,completed in the same aqua er,that is not owned by the applicant. 10) This well shall be constructed not more than 200 feet from the bonbon spedaed on this permit and not more than 200 feet from the location proposed for the Greeley RV Perk Well in poking rase no.2005CW047(proposed location is at a point 228 feet from the North section line and 2,290 feel horn the East section line of said Section 21). 11) This well Is subject to administration by the Disisfoh Engineer in accordance with applicable decrees,statutes,rules,and regulations. cat/B.a't > r 40.C, APPROVED //_ IDCW ,fAb/7� Sere Engineer , 8j, y(/ •� • Receipt No.3832509 DATE ISSUED 02-18-2009 EXPIRATION DATE 02-18-2010 FORM NO WELL CONSTRUCTION AND TEST REPORT °r Ofike Use Only • 0WS-31 STATE Of COLORADO.OFFICE OF THE STATE ENGINEER 04,/2005 7313 Sherman SI.,Room 818. Denver.CO 80203 III Phone-Info(303)886-3587 Masi(303)866-3581 fax(30)806-3541 (AQ,H1nww.vra tor.slate w.us , 1- WELL PERMIT NUMBER: 67901F 2. WELL OWNER INFORMATION NAME OF WELL OWNERGRELEEY RV PARK MAILING ADDRESS:501 EAST 27TH STREET GREELE STATE CO ZIP CODE. 80631 1------------ CITY. TELEPHONE NUMBER. ( (n?)353'8476 3. WELL LOCATION AS DRILLED: NW 1/4. NE 1/4 Sec 21 Twp 5._. ON or❑S. Range fis ❑E or®W DISTANCES FROM SEC. LINES: . .228 ...._ft.from fl N or❑S section line and _ 2290 ft. from Q E or 0 NA/section line SUBDIVISION _..._ LOT------- BLOCK__ FILING(UNIT)___ Optional GPS Location:GPS Unit must use the following settings. Formal must be UTM Units Owner s Well(kssionation must be motors. Datum must be NAD63.Unit must be set to true N. 0 zone 12 or El Zone 13 Easting. 528266 STREET ADDRESS AT WELL LOCATION. CO Northing 4471206 4. GROUND SURFACE ELEVATION feet DRILLING METHODR°t-mud DATE COMPLETED 5/18/2009 TOTAL DEPTH 72 feet DEPTH COMPLETED 72 feel 5`GEOLOGIC LOG. 6. HOLE D1AM to From(It) T o(ft) Depth Type — —_Grain Size Color Water Loc. 10 0 20 0_20 land Fkw Brown 8 20 72 20-45 .Sand a rirevit 1-h+ia rti"- Brown WL r^..ti 45-65 Sand&Gravel Medihri‘ &Mint WL 7. PLAIN CASING. 'T°Coarse OD(in) Kind Wai Size(in) From(ft) To(ft) b3-72 'LW Him -- —/own -----ID 5 PVC iCH 4{ 10 50 6.625 Steel 0.188 0 22 lIll • PERFORATED CASING. Screen Slot Size(n) — 0.03 S PVC ;CH 4t 50 72 • ,8. FILTER PACK. •9. PACKER PLACEMENT. • — _._..—.. Matena( Sand Type Size 3116 Interval 20-72 _ Depth 10. GROUTING RECORD I Matena( Amount Density Interval Placement Remarks - - Cement_ 4 SA 7 GAL 0-m- - Tremie_ 11. DISINFECTION: Type 12TH rAmL Used 10 Oz 12. WELL TEST DATA: ❑Check box if Test Data is submitted on Form Number GWS 39 Supplemental Wei Test Air TESTING METHOD Static Level 10 ft. Date/Time measured: 5/18/1009 , Production Rate 25 gpm Pumping Level 45 R Date/Time measured 5/18/2009 , Test Length Mrs) 1 Remarks: 13. I have read the statements made herein end bow he contents thereof.and they are true to my know...Joe. This document is signed and certified Ii accordance with Rule 17.4 of the Water Wei Construction Roue.2 CCR 402-2. [The filing of a document Ihet contaris false statements is a valation of 'suction 37-91.109(1x8)-C.ftS..and ispunishable by lutes up to 55000 motor revocation of the contracting licel a-I Company Name. Phone: Licxnsttuber' Orsiling Drilling Co Inc )(970)667-7160 144 Coon Road R Fort Morgan,CO 80701 Malang A : 1/ � Print Name and Title A GAY DroningDate 5/19/2009 Send to: Division of Water Resources Fax: 303-866-3589 1313 Sherman Street, Room 818 Phone: 303-866-3581 • Denver, Colorado 80203 *' OWNER'S NOTICE OF CONSTRUCTED WELL *;' Construction of my well under Permit No. ^ Z.>7 5Q / F was completed on .",5,.-- j% Q(U� (Month) (day) (year) The well was constructed by: Ure 1 ;tick Qr i 1I (d, (drilling ontractor) ji 332 If the pumping equipment has been installed The pumFwas installed in my well by: _ D wkt friar j: ties (pump contractor) on % 2S" 20/C . (month) (day) (year) Signed: i e 5-3-6 476 Date: Vi/.2/.26)6 :r Phone. :� 4 �la a,2 Q9.21' Cell The well must be constructed and pump installed by licensed water well construction and pump installation contractors, OR PLEASE BE ADVISED that, pursuant to section 37-91-106(3), C.R.S. (2006), any person who intends to construct his/her own well or to install pumping equipment in a well as a "private driller" or "private pump installer" shall be required to comply with minimum construction standards adopted by the Board of Examiners of Water Well Construction and Pump Installation Contractors. (See Construction Rules, 2 CCR 402-2.) • FORM NO. PUMP INSTALLATION AND TEST REPORT cws-asENGINEER OF COLORADO, OFFICE OF THE STATE For Mace Use Only • 08/2008 1313 Sherman SL,Room 818, Denver, CO 80203 info(303)866-3587 Main(303)866-3581 Fax(303)866-3589 Main 1. WELL PERMIT NUMBER: ci G f F -- C 2. WELL OWNER INFORMATION NAME OF OWNER I _ Yiak i ti /Less MAILING DR — -- ` _ 50ESS / E 27 ' CP. CITY STATE,- ZI'CJ f G-r . e 1 TELEPHONE I (`)7O)34.E- O'1 2'l _ 3. WELL LOCATION AS DRILLED: 1___ 1/4, (VC 1/4 Sec. Twp. .C &Nor OS. Range.k., "1" 0 E or'W DISTANCES FROM SEC. UNES: an ft, from c 1 Nor❑S section line and ).2 t) ft.from ®'E or❑W section Nr SUBDIVISION: LOT , BLOCK , FILING(UNIT) Optional GPS Location: GPS Unit must use the following settings: Format must be UTOa. Units Fasting: 5 fr?6 must be meters, Datum must be NAD03, Unit must be set to true N, ❑Zone 12 or❑Zone 13 Northing: 11‘1 71.20 'STREET ADDRESS AT WELL LOCATION: L 4. PUMP DATA: Type: "sit.b #.4&/ ,b) Date InstaNed: )1-257-2°A0 Pump Manufacturer iti10 vt Ci r^C 1' Pump Model No. 5 j S ,D )c & Design GPM 11 at RPM_-• --- HP I Volts ,1 3 CU Full Load Amps j 5tir7 7 r(u4ih4 Pump Intake Depth: 95— Feet, Drop/Column Pipe Size 1 Inches, Kind of Drop Pipe 7 k1 C- • ADDITIONAL.INFORMATION FOR PUMPS GREATER THAN 50 GPM Turbine Driver Type: 0 Electric 0 Engine 0 Other Design Head feet Number of Stages Shaft size inches 5. OTHER EQUIPMENT: Airline Installed❑Yes 0 No, Orifice Depth ft. Monitor Tube Installed 0 Yes 0 No, Depth ft_ Flow Meter Mfg. _— Meter Serial No. Meter Readout t(Gallons,Q Thousand Gallons,❑Acre feet Beginning Reading 790 g 5),2 O 6. TEST DATA' 0 check box If Test Data is submitted on Supplemental Form. Date N/3//0 „?1O(3// -7 Total Well Depth' !2 rt. Time: 1. 3`-I V,30 Static Level: 10 ft Rate(gpm): // !'f Dale Measured: J` iDy Pumping Level(ft): f 0 15- 7. DISINFECTION: Type 11T T 1.1 Amt Used 10 0Z, S. Water Quality analysis evadable:0 Yes 0 No If yes,please submit with this report 9. Remarks: 10. I have read the stamments made herein and know the contents thereof, end they are true to my knowledge. This document is signed and certified in accordance with Rule 17.4 of the Water Well Construction Rules,2 CCR 402-2. (The filing of a document that contains false statements is a violation of section 37.81-108(1)(e),C.R.S.,and is punishable by fines up to$5000 and/or revocation of the contracting license.) Company Name: A, �G Phone: License Numberli1 1' i t �• v 3Q� O tr 092? Mailing Address: 501 ; 7 -'. 9. G,"e cl Q.)/ G • (Signature: Print Name and Title ate � ,,€ -/tXA 1./&144-- , Appendix D: Water System Schematic Process Flow Diagram (PFD) Required for new treatment facilities or improvements modifications and Project Drawings (e.g., well head improvements, treatment facility layouts) As applicable for project construction and comprehension (e.g., treatment modifications require a treatment facility layout) E ' a rf-s9 • S 3 I I v I o G N I I I CD I 24. . I N I .l 1 1 y F- 2 • e r ' H 11(D- H • tm-ç 11_ o } I `I ~ C < 0- aol iJ 2 3,C — A at f ~ {- ci _ I,) - p W d W N_ u v. =gl I U of a < m — 23 a€2 g`4 5 V iW • J - J • L) 441- _ .fr—_ _ 0 W . . , ,may 1 " 7 e I t / Y '. / ! 1 C i / ! / / A / / ? • y .n/ • r'.z( / •� ! 1— I / / t 1 t / �`.,.. '- , '.r,.' ✓l / /, S 4 / if_- � �,- CI 2 ..] 'mot L •'J h ..• O e / 1 / r- O / f H N `-- ,y� `. . / --f o I 1-- / % d / r'� Vo 1 CD r! / 4..)______ C4. / C'J /(2/1 41 ( r I ag / l L/- I - to i / N / I C • Appendix E: Floodplain Certification and supporting documents (e.g., FIRMette map) Required for all projects that might be effected by flooding (e.g., new sources, facilities, tanks or building expansions) .......... ----' T fv� N_afn3d . • l• . .. ..... __. s'w�eMrr._ ... . -—. 'fI 1Yf 73dS ca n III roil . • '.'✓ c t.i' r 4;x:'.•714 . . • . . i«iIC.•• t+l III AMU R. --... ._. r t' _f'.-_ V` I S`,• I ICI r' • /Y.i. • • •},• • t 11' r • l / P1v. ►4.' 1. • r .....k a. .5„, 4, or .... •' • • -'DV."3.'. la • I•.-• / .� I rte•',�✓• 111•«1 YI ♦ •:11: 11.1,•••1 ' • • •• I ; MY .111'. ' ri .r I ,t 14“All / ;; I !' i 1':11 i , main CO{ y,'Ir.! 14 ♦C AI IJrtll «I« r•. liht.,at Y:-. . • �:I. ,•• • l ':AY«i1r•II NI 0)1 r)01 /• • • *4'../••ii ' .,-i ,r„,. Arxlrar,l A.1411f. . 9: •J - VtJ,S►1 N3«35 AMl M5 MO j 'j N►' tf Qllr7ll lIl nlll SfM.r III tw •,I' %• •• >/'..7 - t1y 1 . •• •.',; .4/".„.•:• .,`.1f - r I; / I f ;err; li ',/.. i; / -.',.<•-7/,‘-/;,:. I aa. M.x Yla O bravo-0 1Y.-. /.TM,M.?IN til • NXl• /t t Colorado Department of Public Health and Environment Drinking Water Design Review •Water Quality Control Division Floodplain Form 4300 Cherry Creek Drive South, B2 Denver, Colorado 80246-1530 303-692-3500 Application for Drinking Water Construction Approval 100—Year Floodplain Certification -----.-- ------ _ - ___._.---__.—�--- ----..-----------.—.___.. Pro ect and 5 tem information Pro'ed Title_._...__. ...._...- ....- - VRErt.eY l2V P^R em Name Gg-Eet-E4 mku sou-n-1 wELC) PWSlD(Assigned by Derision) ...____ All water facilities must have the potential 100-year flood threat evaluated based on all available floodplain data from one or more of the following sources:the Colorado Water Conservation Board, U.S. Army Corps of Engineers, Housing and Urban Development, County Government, local flood districts,etc. A copy of any background information used in the 100-year flood threat determination process must be included along with a companson of the site vertical elevation datum and floodplain reference elevation datum. The 100-year flood threat was evaluated for. � I {e.g.Well,Water Treatment Facility,Tank) 100-year flood threat determination was based on the information enclosed from: (e.g. FEMA floodplain map, U.S.Army Corp,elevation) . Non-Community Public Water Systems(Transient Non-Community and Mon-transient non-community) For Non-Community Public Water Systems, an authorized representative of the system responsible for operation and compliance must sign the Floodplain Certification I hereby certify that a lodgment has been made after evaluating all available floodplain data and in my opinion,these waterworks. as located and designed. are not subtect to flood damage by a 100-year event Typed Name of Authorized System Representative Date Signed Signature of Authorized System Representative Appendix F: Raw Water Quality Results Required for new sources • I i I Litt-,,...TMENT OF PUBLIC HEALTH AND ENVIRONMENT SC) I ~)5 N. 17:' Avenue - s 1_. $61 y_.•,., (..reelev. c.:() IJ.(j6:3 Pubhc Health � t• r ' 1 , Web: htD;VAINeIdtieaurn.,,lt Health A4 riunrstratior Publ.c Hea di.. C linr.;al Environments!Healr' -ommunicalion Emerncy Pr paredness it t Vital!Records Straus Sernces Education&Planning 8 Resge C �•� `e :?=4+.3'_ fait ?_?:a t.J :'?04t�Ir Tele 97'.?046e: 7+,e nC�d3_'C 1 I :3r 9'-'_4 -�:'3 F)k ?'C SG:.da0i .- .._.__ -_r,.Ion ;cgi.'.,.TakC-crnour.e;:,hc.-r.t,.a.a.,.. Anon)'ovma;.e:Ve_ ;5m:.•1:rLi•alix,...:a[c.ni aam .,c,,w._ t} Analysis Report Report Number: ENSG120319-004 Customer: GREELEY RV PARK PWSID: 162302 501 E 27th Street NPDES: Greeley, CO 80631 Facility: Comment Lab ID: ENS120319-005 Collected: 3/19/012 11:42:00 AM imple Site Greeley RV Park South Received: 3/19/2012 2:47:00 PM pie Point entry point Collected By: Thomas, Mark PWSID: Purpose: Other le Comment t Name Result Unit Flag MDL MQL MCL Method: Analyst Date Analyzed Limit Comment brine Residual 0 71 mq/L EPA Method 300.0 MT 312012012 6:08 PM rs N 9.96 rng1L 0 01 0.40 10 EPA Method 300.0 MT 3/20/2012.6:08 PM • N <MDL mg/L <MQL 0 (140 1 EPA Method 300.0 MT 3/20/2012 608 PM brine Residual 0.71 mg/L 0.05 0.2 5M 4500-CLG MT 3/19/2012 11:42 AM !Worm Absent 92238 CD 3/20/2012 4:24 PM Absent 9223B CD 3/20/2012 4:24 PM likicable MDL=Mininum Detection Limit MOL=Mhurnan Quanfitation Limit MCL4Aeximurn Contimiruition Level Page 1 o t Detected DLDMection Limit OL=Quantitrton Limit '<'=tees Than ->'R Greater Than nmum Ouantifation Limits of parameters are set forth from the Primary Drinkinn Water ctanrtar.4n frnm Ikea roe n..................,.... ANALYSIS FOR WATERBORNE PARTICULATES • CH Diagnostic and Consulting Service, Inc. Invoice 20110569 512 5th Street, Berthoud, CO 80513 P: (970) 532-2078 F: (970) 532-3358 Laboratory Information Customer 20001198 •Hand Delivery; 10/5/2011: 1135 Hrs;,,15,4'C;Wound Greeley RV Park&Campground Results submitted by: f 501 East 27th Street Greeley. CO 80631 / 7 Sample Identification: 810 East 28th St.Greeley RV Park Sample Information: SOURCE Drilled Well, 72'deep; 1375'from surface water:Unchtonnated Sample Date 8 Time: 10/4/2011 02:00 PM-- c 10/5/2011 Sampler: David Ness Amount: 2598 403 L(686.5 gal) Filter Color:White Filter Type: Polypropylene wound cartridge Datettlme Eluted: 10/5/2011 03:46 PM Centrifugate: 0.00385 mU100 L RESULTS OF MICROSCOPIC PARTICULATE ANALYSIS Amount of sample assayed:310 L Amorphous Debris clay(1-2 pm).silt(2-50 pm),inorganic precipitate,sand(50-2000 pm),aggregates Algae ND Diatoms 1/100 Gal,some Pennales,Plnnulana Plant debns ND Rotifers ND • Nematodes ND Pollen(pine) 5/100 Gal Ameba 137/100 Gal,lest Ciliates ND Colorless Flagellates ND Crustaceans ND Other Arthropods 1/100 Gal,Arthropod pieces Other NO Giaidia and Cocctdia are none detected(ND)by MPA unless reported under'Other" This sample eras aefyrd for ptbaMMes fo louvre ti Enowarrnanal Protection Agency Consensus Method for Deternrrtp Groundwaters 1)151.5 Ina LWuct IvIumxu of Solace Weer Useg Microscopic Pediatric Analysts(MPA) 1992 USEPA,Pon Oranrd,WA EPA 91019.92.029 AA leneaeons stared in the methods apply IS I N mast.* at loam bier was moaned.mottod•m mod/ed by Manna sample though a Pai Enwocter 1e'HV rnpmb Cr IDEXX FOtnbrax"Met l tut sw pte sae it Gordo arm Cryofosoondurn Analysis waS also peAamed perenea s edracem was madded COMMENTS Score 6-Low Risk per EPA Consensus Method referenced above • Appendix G: Equipment Manufacturer Information & ANSI/NSF Potable Water Certification Required for all proposed equipment SER011 20 14 SERIAL NUMBER INVENTORY Sheldon 4/05/12 Master File Inquiry • Serial Number. : 1401 11755 Item Number : 45158 1500 VERT-GREEN-GUSSET-W/F G 1st/2nd/Reject = 1 Material Code. : 10027 Lot Number ' 324056 Mfg Date 5/01/01 F12 Previous • NORWESCO, INC 4365 Steiner Street, PO Box 439 St. Bonrfacius MN 55375-0439 I Y N ivyy c�, e cc() y/V/� • _. .__ . ,.5., ari. va nonwEsYO Nom n aeo Ur I L«alton,! oo.No nt ad aes 1 Contact Us • W 8 FAQ'sforAboveGroundTanks Is Ural itADotnewa _p•I.ac,>, Printer F Ij ndy Version ...r2w•/.�ar• CAN I PURCHASE TANKS DIRECTLY FROM n+.CAC', NORMlSCO? • ,rno,i.. Out lamas ea son through riongesco Radom To IS a oMtrIW>b you.area. `' 6d on the locale a DIatbubr'anon in upper right coma of the screen or ....�.,.,. rid on the navigation Nerd tab. WHAT IS THE WARRANTY ON YOUR TANKS? ~.xn. .1'0!•�•' The uranium Wagft larks and beck or dark green vertical eater storage tanks carry a tree yaw money lore dale of nentdmaa and be Mavy duty treks ...:..., caw a We Yea warranty from dale of mralkrlae.Slimed a defect appear wain .....�,.. the warranty pebd,Navaaco we sappy a new,eptvSect bet b rapboenere Meteor.Nonreecd s fany le S,Sd b the mere of the brit Iasi and Kiraly _, medusas the mat of Inbbblbn andtr removal or coreequantiel drreges HOW CAN I TELL F MY TANK IS UNDER WARRANTY? AN Monism Non are aamoaeed WIT a MIMI runner SW b 117 in height You .•' .' MI usually Ind the serial mime by the Mop.rwg of to bad To gets general .... •. Idea of when your lank was mersded dad dirk en the lotowtg Vic Undemanding mi.�r�n.m .. Nonvesm seral nDIygp.If you road a winlfc mirmtcWa dal.pewee center! your Nonwaco dntaor • `T n l.tva WHAT MATERIAL IS USED TO MAKE YOUR TANKS? Nonvemo saes a tear.high-derelty poVaeMe realm aW pandas awl^dry •F1s�Aitm environmental ent stress add nablnce.The realer is W dMWbut- ad b by keeling the 9tIB5O lank sheltered or Indoors you WI prolong the He of you art,Click on the blowing - erhn b adc intonation regarding the rein used to manufacture Nommen above ground lama Rain Infgmn ton ARE YOUR TANKS FDA APPROVED AND IS IT SAFE TO STORE WATER M AN ABOVE GROUPIE.TANK? Yee I sr sale to store water in be I . The resin and umd o above ground Wks n below gro - castor trim sown on our owbeM.Tae n used to mrMadrae these brie meats FDA specifications lot safe anew of pastier oder.Cot on to Mowing • link Sr wet I nnromn raggedlFDAshag Ile FDA of the meth FDgalnaol br Pl revs ARE YOUR ABOVE GROUND TANKS NSF APPROVED? NSF Intemaeorel.banded ere 1gee as the National Sanitation Foundation.U blown for the devabpr,wn of stamina.prodw Nay and orMaMn M to in to areas of public hank gab"and polaebm of to enraamrel Nona=w s the lira/polyethylene lank producer to receive the NSF term tbn.where applicable. for our potable water tanks. The NSF mraardbn process is dare tram pent by pent basis We currently revs select tanks that ea caeiderad NSF eppoved in our Toone,UT.Washougal.WA and lbnard,CA manufacture'*Ma For further hula plebe mind Nonuse= Customs.Service. The men that we use to nerndenure our afore pout tanks a considered an NSF approved resin Click on the Idbwg lurk for intonation regarding the NSF&talus of the men.NSF scan of resin DOES THE COLOR OF A TANK HAVE ANY SKieFlCA CE? cannily.cows we red to daalpele ors grade era Awn another end is Hoc production eallo0on one except br Water Oral tanks. Our alandrd oar ix premium weight tents e a naked or wart end W heavy duty tanks e l IgTt Nut Do not be naiad Into INrIYg that a Cole Malls the Ia a aMency or W resistance of a tart. HOW MANY POUNDS PER GALLON WILL YOIR TANK HOLD? Noreen proclna to grades of polyethylene tents-women end heavy duty. The Nonagon paean weight tad has been deeged and is marhdeM to meet a appet gaiety of 1.5,way 125 pawls per gear M 73 degrees F.The Nawewo heavy-duty dad Iva been deigned and l mr hated to neat a specific grayly alit equaling 15.75 panda per gala d 75 degrees F.(An thaws,in ken W(pardua we rbMmaly demote the specie grayly rilgg WHAT IS THE WALL MK:MESS OF YOUR TANKS? We refer you to the prmpapn above Vet realm to spent ppMylpwFee per gallon.Because the well Uddteesvans ton bpbbeern one Wit,Ale not the beat kg deeming ewe�Pla Wt The very bottom W l bottom el t the thinnest pert of the twit and med. way to Mx when Its tank Is amply or KR. Garet Ile wee became porter as you go Iron the kyle the totem of a vedkel Sic TNe Is done to masse mdmrYa to Sad perm oaeled by the • hSQM tad the td In t the tat. The ban of he bet S rider to hawse strength WATER/WASTEWATER TREATMENT Filtration I1armscov Cartridge L:ltrster Filters -,:z-iii--„..._!i..., 1. by�, , J • 1r resorts and mobile home• — o ' I r ililmaiilliefor wed water or surface4�- water applicabons I • Removes turbidity, i Galled b re3FrNtL er r fik l nisi,ferric iron,Sill and • : Glardla cysts l i i .«� •NSF approved fitters are 1� err , i I i. 0 • • 1 deanabte and reusable I I / Harrnsco'S up-flow tarttidye • . V, - -I .i cluster filters provide more precise filtration than sand ! filters,and at a lower cost. _ I Hearings areY to distal : � ,' i. ;.+. 1l and there is no backwash + .f Piping required. i These filters use cleanable, OM%I - I reusable fitter cartridges •, available in 7 sizes from 0.35 Co - — 100 microns.Easily remove tire Hofrrnsco' Hurri en cane" Filter Housings set of cartridges at one time for - cleaning or replacement.Your .4 • Uses centrifugal torte to remove(tense particles suill as sand,rust and grtt ability to reuse Harrnsco in the hoStq's radar climber cartridges will depend on the • Optinibes solids removal and provides ex cartridge selected c>�iarlatty tong ticker runs Note:Order filter cartridges The Hurricane combines a centrifugal separator with cartridge filtration in separately on facing page. one compact housing to optimize solids removal and provide exceptionally I long filter ruts.Centrifugal force rertgves dense particles into the housing's outer chamber.These solids may then be discharged through the 1'NPT drain valve. Lighter solids spill over into the inner chamber where they are removed by a single large cartridge filer Cartridges are clearlabte and reusable in most applications likousing After evaluating twenty-two filtration systems,the New York State Bureau mate►iet 304 stainless steel Public Water Supply Protection determined Hwmsco hurricane fitters(with Flan (deceo-polished five micron cartridges),following pre-treatment and preceded by Hamisce Gasket material Boca-N upfbw cartridge fitters(with one micron cartridge}ere recommended Pressure 150 psi equipment options for water supplies up to 15,000 gallons per day.rneetrr- all parameters of efficiency,cast and simplicity.TenlperelTxtu: 140'F Note:Order filter cartridge separately below and on page 1638. FLOW PINE I OF Housing rrratwia1 304 stemless steel RATE SIZE STANDARD ALTERNATIVE WEIGHT F- electro-polished (GPM) II,ImT CART KXIES CARTRIDGE (L135) STOP(( EACH 30 Ili; 7 Nam 29 66830 S 1,019.95 Gasket material: Buna-N FO 1'1,' 14 7 Doubles 39 65832 1,419.96 Pressure: 150 psi 15 2 16 8 Orxtds 39 66834 1,609.96 Temperature: 140'F 90 !'/,' 27 /ropier 50 858333 1648.96 Floor space required: IS-x 15' 105 2' 24 -_ II Triples..._-._.» 50 ....- 659313 2.2-09-96 175 2' 42 I4 Triples him 65840 4,315..96 300 3' 75 25 Triples 129 65642 8,208.00 FLOW FILTER PIPE SIZE FILTER WEIGHT 400 3' 100 50 Boobies 180 88844 7,544.00 ) AREA (leT) HEIGHT 11.88) STOCt(I EACH 50 40 T ?1 40 661!10 s 1,919.66 100 ;;'0 2' .1I' `,! 65752 2,279.95 150 I/O 2' 41' 64 65784 3,449.95 Filter Cartridges for Single-Cartridge Housings •7-'/r'pleated cartridges are carrlpeYbte with Hammy*&aricane"'and US*Bteefiook jumbo filler housings Choose from seven different sizes to meet your bNemy requirements_You can wash and reuse all of the cartridges,except the 0.35, 1,and 1-absolute. Fib claming,with 50 GPM Max Flew Fi s Newsier sir 101 WM Max Flom Rh Nwskrys wale 151)GPM Max Firm 3JIATRIDOE NO6SNAL CARTRIDGE NOMINAL C.ARTRIOC¢ NOMINAL )013E MICRON STOOP(• EACH 0TY 2+ COO€ MICRON STOCI(I EACH QTY 2+ CODE MICRON STOCK r EACH QTY 2+ IC-40,035 035 66718 5 12416 $118.70 1-4C-90-0.35 035 66776 $207x96 s 190-86 HC-170-0.35 0.35 66766 $329.96 $313.46 4C-40-I 1 66768 9424 89_.53 HC-90-1 1 66771 14795 14055 NC-I n-I I 66789 224.96 21171) 4.48,10-1 1 Aim iele 65767 194.95 147.10" PP-He-90-f I Ahi+&44 (6789 75166 241.26 l'-HC 170 I 1 Abso&ilr 66771 394.96 375.20 41 65770 81.96 7796 HC-90-5 S 65780 131.96 125.36 NC-170-5 5 66790 19196 182.36 20 20 66772 94.96 90.20 NC-90-70 20 657W 12296 118.80 NC-176-20 20 65792 18696 177.80 50 50 65774 61_65 7795 HC-90-50 50 65784 107.95 102256 11C-17050 to 66794 169.65 161.43 C-40-100 100 95775 86.95 8260 NC-SO-100 100 65785 10796 10255 HC-170-100 100 66793 168`95 160.50 ,..•.. In-Q R DluoDn rib i I Appendix H: Other relevant information (e.g. supplemental calculations) As applicable I ' Esther Gesick om: Chris Gathman nt: Monday, April 30, 2012 2:48 PM o: Esther Gesick Subject: FW: Greeley RV Park South viaa W y k Another item for Ness (PC5C12-0001). Chris Gathman Planner III Weld County Department of Planning Services 1555 N. 17th Avenue, Greeley CO. 80631 Ph: (970)353-6100 ext. 3537 Fax: (970)304-6498 Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. 4Ill---Original Message rom: Mark Thomas Sent: Monday, April 30, 2012 8:17 AM To: Camrud, Douglas J. Cc: Chris Gathman Subject: RE: Greeley RV Park South Doug, thanks for the info. So, is CDPHE approving the Drinking Water system as submitted. I/WCDPHE would really like to know since we have that hearing on May 2nd. Thanks Mark Mark Thomas Chemist Weld County Department of Public Health and Environment 1555 N. 17th Avenue Greeley, Colorado 80631 Email: mthomasMco.weld.co.us Office #: 970-304-6415 Fax #: 970-304-6427 confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you 1 have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than tie named recipient is strictly prohibited. Original Message From: Camrud, Douglas J. [mailto:Douglas.Camrud(Sdphe.state.co.us] Sent: Thursday, April 26, 2012 8:39 AM To: Mark Thomas Subject: Greeley RV Park South Mark, Attached is the Greeley RV Park South drinking water design submittal. I have been meaning to send this to you (Weld County) for review as I don't think David Ness sent Weld County a copy of the submittal. Hopefully I can get to it in about 2 weeks. Upon first glance, it appears mostly complete. As for wastewater, we have had a couple of phone calls from an engineer in Missouri about the process for constructing a small 10,000 gal/day treatment system. I believe this is what Marlin Ness wants to do, but I know he is concern about the 6 or so months it would take to go through all the steps/submittals. However, I do not know which way they want to go. Doug Camrud Senior Review Engineer Water Quality Control Division Colorado Department of Public Health and Environment 4300 Cherry Creek Drive South Denver, CO 80246-1530 3-692-32711 douglas.camrud(astate.co.us ilill-hour Environmental Release/Incident Reporting Line: 1-877-518-5608 • 2 Esther Gesick om: Chris Gathman nt: Tuesday, May 01, 2012 11:39 AM o: Esther Gesick Subject: FW: Greeley RV Park South 4/30/12 photos Attachments: Greeley RV Park South photos 4-30-12.docx Additional exhibit for the Ness Show Cause Probable Cause (PCSC12-0001). I plan to send some more photos that I took this and a staff memo later on today(at the latest I will have at the hearing). Sincerely, Chris Gathman Planner Ill Weld County Department of Planning Services 1555 N. 17th Avenue, Greeley CO.80631 Ph: (970)353-6100 ext.3537 Fax: (970)304-6498 1� A(IrAr f r ' - ,' r • - CJ �Tv Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication.Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: Mary Evett Sent: Tuesday, May 01, 2012 10:53 AM To: Chris Gathman; Heidi Hansen Subject: Greeley RV Park South 4/30/12 photos Chris and Heidi, Attached are the photos I took at the Greeley RV Park South yesterday. A description of the photos is as follows: 1. The first 3 photos are of the asphalt stockpile, asphalt screen for recycling and of asphalt spread on the ground, possibly in the floodplain. 2. The 4th and 5th photos are of fill placed to the east of the RVs,appears that additional fill has been placed in the area since our previous site visits, and possibly encroaching the floodplain. 3. The 6`h and 7th photos are of the sewage holding tanks. No evidence of any overflow or spillage.Tanks are continued to be pumped by Front Range Septic on a daily basis. • 4. The 8th, 9th and 10`h photos are junk vehicles, RVs and other misc. items storage area—in the floodplain. ; of Mary Evett 1 WO z' " Environmental Health Specialist Weld County Department of Public Health and Environment 1555 N 17th Ave areeley, CO 80631 l: 970-304-6415, Extension 2216 ��1pCli� r , its N Confidentiality Notice:This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. 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' .. t 1 t a i i • • • i e. f 1 a CO U L- a s--+ as •, z p O M 'v OC OO cn ca N `� Q CC en D•N H 'E r l a . _c co .L_ D g Q L cn a s o_ aj1/4" a Q 4-1 O C Z D = O a) +_' P a) -o a co E W +-' u 71 0 a) aro -O a > a) a = a) _c a L a c 2 -a >w t, a in +-' -- a G -a -O + aI— aU t v E • 2 ca ) a a a ca -0L -0 CO C O cn r' COO c . 4 '' U p 22 w ' ' +, �t � c000 v) E •— V ' W E N E O ri E inin c U _o = a) (o .O D N a) ' V) E -a v, L N O .0 as o "- LLC +, C O +-1 O � > V) a CO Q U W to b.0 L criocEcrow L g � Co > I- co to- w co co a � L- • • • MINOR AMENDMENT TO SITE SPECIFIC DEVELOPMENT PLAN AND USE BY SPECIAL REVIEW(USR) APPLICATION FOR PLANNING DEPARTMENT USE DATE RECEIVED: RECEIPT#/AMOUNT# 1$ CASE#ASSIGNED: APPLICATION RECEIVED BY PLANNER ASSIGNED: Parcel Number O _9__(2_J_- 2 I -_Q_-OQ- 0 _1 0 (12 digit number-found on Tax I.D.intonation,obtainable at the Weld County Assessor's Office,orwww.co.wetd.co.us) Legal Description Ri- 1I 4 be NEg , Section 21,Township S North, Range ArWest Zone District , Total Acreage: 6 7 , Flood Plain: Geological Hazard: , Airport Overlay District: FEE OWNER(S)OF THE PROPERTY: Name: Ma../(n Neff Work Phone# 97o 353 4 Y7(. Home Phone# Email Address: So/ Is 1'7 c-f- Address: City/State/Zip Code ri ne%7 Co g043 Name: Work Phone# Home Phone# Email • Address: Address: City/State/Zip Code APPLICANT OR AUTHORIZED AGENT(See Below:Authorization must accompany applications signed by Authorized Agent) Name: Work Phone# Home Phone# Email Address: Address: City/State/Zip Code PROPOSED AMENDMENT: I (We)hereby depose and state under penalties of perjury that all statements, proposals, and/or plans submitted with or contained within the application are true and correct to the best of my(our)knowledge. Signatures of all fee owners of property must sign this application. If an Authorized Agent signs, a letter of authorization from all fee owners must be in uded with the application. If a corporation is the fee owner, notarized evidence must be included' dicati t the si story has to legal authority to sign for the corporation. t/-/2—/Z Signature: Owner or Authorized Agent Date Signature: Owner or Authorized Agent Date • e 7 F • Greeley RV Park 501 East 27 Street Greeley, CO 80631 April 16,2012 Department of Planning Services RE: amendment to USR#1431 To Whom It May Concern: 1. The Greeley RV Park would like to request changes to USR#1431 for property located on south side of highway 34, to accommodate water and sewer service for RV's and portable commercial buildings used for living and/or offices. This would remove the "self-contained in regard to water and sewer" standard #14 and allow disposal of sewage at this facility #15. Furthermore make changes to plot plan to include a section for portable buildings, • which is required in standard#27. 2. This proposal would not change the intent to follow Comprehensive Plan pursuant to chapter 22-2-50 of non-prime farmland. 4. The surrounding land is still agriculture except for the Riverview housing to the west, which was not there when this USR was granted. This amendment would not impact surrounding land uses as long as sewer discharge standards are maintained. 5a. Currently there are 36 RV sites approx 2 per coach and 11 portable living buildings with maximum 10 ea. 12 more RV sites are planed this year and would like to add 6 more portables for approximately 266 people at maximum capacity. 5b. No employees live on site. Grounds keepers from main park maintain this site. • Sc. Hours of operation are 24 hours a day as peoples needs are not controlled. 12 noon is the normal check in/out time. • 5d. No structures are proposed at this time. Future structures may include restrooms and club meeting area at which time plans will be submitted to weld county planning dept. 5e. No animals other than domestic pets and wildlife in the area. 5f. RV's and customer's vehicles, which may include semi trucks and RV toters, weight ratings ranging from cars to 26,000 lbs rating. On a daily basis mostly cars and light trucks. 5g. This will not change from current protection. 5h. Water will be supplied by well and water treatment will follow guidelines per Colorado state health, which is currently in process of reviewing plans submitted. 5i. Sewage disposal permit is currently in the design and application stage with plans for a treatment system that discharges clean • disinfected water, to augment the water used from water well. It will be ran by state licensed operator and meet state regulations. Currently all sewage is retained in a collection tank for off site disposal. 5j. Only RV and vehicle storage is currently used on site. 5k. Storm water will be detained onsite and delivered to the South Platte River. Adjacent properties do not shed storm water to this property. 51. stockpile of waste currently on the property is clean asphalt, which is being screened to roto-mill to make roadways on site; an emulsifier is sprayed and material packed to make all weather roadway. A dirt barrier surrounds stockpile to contain run-off water. At current this stock pile is just inside the 100 year flood plain to the south of park. With this season of low snow pack in mountains, flood dangers this summer is low and asphalt piles should be processed by this fall. Esther Gesick Chris Gathman nt: Wednesday, May 02, 2012 8:06 AM .om: : Esther Gesick Subject: FW: 830 E. 28th Street-SS Capacity Ness Show Cause e-mail. I have one more on the way. Chris Gathman Planner Ill Weld County Department of Planning Services 1555 N. 17th Avenue,Greeley CO.80631 Ph:(970)353-6100 ext.3537 Fax:(970)304-6498 i 1 ~,, lii _ i - A -' r , 1_ c , NT T 1 Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise iirotected from disclosure. If you have received this communication in error, please immediately notify sender by return mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: Mary Evett Sent: Wednesday, May 02, 2012 7:58 AM To: Chris Gathman; Trevor Jiricek Cc: Mark Thomas; Heidi Hansen; Lauren Light Subject: RE: 830 E. 28th Street- SS Capacity At least one thing is resolved. If Mr. Ness is proposing to install multiple septic systems(and as long as the septics meet the requirements of the Water Quality Site Application Policy 6) a variance will not be required to make application for a septic permit. Mary Evett Environmental Health Specialist Weld County Department of Public Health and Environment 1555 N 17th Ave Greeley, CO 80631 tel: 970-304-6415, Extension 2216 1 I , k 0 " rr R 1 U N 1 Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return alimail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the ntents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: Chris Gathman Sent: Wednesday, May 02, 2012 7:18 AM To: Esther Gesick; Mary Evett Cc: Trevor Jiricek Subject: FW: 830 E. 28th Street - SS Capacity Another item for the Ness Show Cause. Chris Gathman Planner III Weld County Department of Planning Services 1555 N. 17th Avenue, Greeley CO.80631 Ph:(970)353-6100 ext.3537 Fax:(970)304-6498 •) rl !, -a L' r , :ajN*v • Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication.Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: Derek L. Glosson [mailto:Derek.Glosson@Greelevoov.com] Sent: Tuesday, May 01, 2012 6:22 PM To: Chris Gathman Cc: Brad Mueller Subject: 830 E. 28th Street - SS Capacity Chris, Brad and I met with Matt Ness a couple of weeks ago regarding the feasibility of the City providing sanitary sewer service to his RV/"Man Camp" development at 830 E. 28th Street. The existing lift station located to the northeast, just south of E. 24th Street is the limiting factor. The City is currently using 66% of this lift station's capacity, but we'll be at 97% capacity once the single family residential development (Riverview Farms) to the west of the Ness property fully builds out. We need to maintain capacity in our lift station to accommodate the remaining lots within Riverview Farms, therefore we cannot accept additional sanitary sewer allows from the Ness property at this time. Please let me know if you have any questions. 2 Thanks Derek trek Glosson, P.E., CFM Engineering Development Manager City of Greeley 1100 10th Street, Suite 402 Phone: 970-350-9798 Fax: 970-336-4170 Derek.Glossonc oreelevoov.corn It's free! Subscribe now so you won't miss the next edition of City Scoop, the City's monthly E-newsletter. • • 3 Esther Gesick om: Chris Gathman nt: Wednesday, May 02, 2012 8:06 AM o: Esther Gesick Subject: FW: Policy 6 Ness Show Cause e-mail. Chris Gathman Planner Ill Weld County Department of Planning Services 1555 N. 17th Avenue,Greeley CO.80631 Ph:(970)353-6100 ext. 3537 Fax:(970)304-6498 } ter ' - !, Sri' bJN.. Confidentiality Notice:This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise rotected from disclosure. If you have received this communication in error, please immediately notify sender by return mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: Mary Evett Sent: Wednesday, May 02, 2012 8:04 AM To: Trevor Jiricek; Lauren Light Cc: Chris Gathman; Heidi Hansen; Mark Thomas Subject: FW: Policy 6 Policy 6 interpretation from the state regarding exceeding 6000 gallons. See below. Mary Evett Environmental Health Specialist Weld County Department of Public Health and Environment 1555 N 17th Ave Greeley, CO 80631 tel: 970-304-6415, Extension 2216 a ia6 •nfidentiality Notice:This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return 1 e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. 'tom: Camrud, Douglas J. [mailto:Douglas.Camrud(aldohe.state.co.us] nt: Wednesday, May 02, 2012 8:01 AM To: Mary Evett Subject: RE: Policy 6 Mary, Based on the April pumping/flow records,the design capacity for all the systems (or one system if that is the option chosen)would be based on greater than 6000 gpd since there were a few days when 6000 gallons was exceeded (3 days). The Division's ISDS guidelines state that"In no event may the system be designed for a lesser capacity than the anticipated maximum daily sewage flow or Weld County's ISDS regulations probably have a similar statement. Ideally,they would have current matched population and flow records,which could be used determine why they had 4 high flow days in April and also size the system for their future growth plans. As you noted, according to Policy 6 if the combined design capacity of all systems is greater than 6000 gpd, a site location application and plans and specifications may need to be submitted. We (both the State and Weld County) would need to review a site analysis(as referred to in Policy 6)to determine if that is necessary. I will call you to discuss further. Thanks. Doug Camrud Senior Review Engineer ater Quality Control Division lorado Department of Public Health and Environment 300 Cherry Creek Drive South Denver, CO 80246-1530 303-692-32711 douglas.camrud@state.co.us 24-hour Environmental Release/Incident Reporting Line: 1-877-518-5608 From: Mary Evett jmailto:mevettCdco.weld.co.usl Sent: Tuesday, May 01, 2012 4:05 PM To: Camrud, Douglas J. Subject: Policy 6 Importance: High Doug, Please provide the state's interpretation of the following reference from WQSA-Policy 6: According to Reg. 22, the design capacity for ISDS is the average daily flow at full occupancy. This is in regards to the "mancamp" at the Greeley RV park.We have received daily pump receipts for the month of April indicating a few days with waste loads of over 6000 gallons, but the majority of the days the waste load averaged and 3000-3500 gallons. Based on these pumping records, it appears that the occupancy at the "mancamp" is consistent. 2 The applicant is proposing to install multiple septic systems. According to Policy 6, if the combined design capacity of all systems is greater than 6000 gpd, a site location application and plans and specifications would need to be submitted to the state. Ike are trying to determine if the design capacity to use would be based on greater than 6000 gpd since there were a few days when 6000 gallons was exceeded, or would it be based on the average over a period of time—week or month. We have a show cause hearing tomorrow morning (loam) before the County Commissioners for Park's land use violations. It would be greatly appreciated if you could respond before the hearing. Thanks for your help. Mary Evett Environmental Health Specialist Weld County Department of Public Health and Environment 1555 N 17th Ave Greeley, CO 80631 tel: 970-304-6415, Extension 2216 -.into--I. i 1 j r ' li r ' &Gust Y. Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for ,e person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise otected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication.Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. • 3 Hello