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HomeMy WebLinkAbout20113103.tiff Submit by Email • 7 6 1= . l Weld County Referral September 2, 2011 WELD,-COUNTY u The Weld County Department of Planning Services has received the following item for review: Applicant Jeffery Reck Case Number USR11-0010 Please Reply By September 30, 2011 Planner Kim Ogle Project A Site Specific Development Plan and Special Review Permit for an Oil and Gas Support Facility(Roust-a-bout, Excavating and Port-a-let Service)in the A (Agricultural)Zone District. Legal SE-1015 Part NW4NW4 Section 12, T4N, R66W of the 6th P.M.,Weld County, Colorado. Location South of and adjacent to CR 48, 0.25 East of CR 35. Parcel Number 1057 12 200085 The application is submitted to you for review and recommendation. Any comments or recommendation you consider relevant to this request would be appreciated. Please reply by the above listed date so that • we may give full consideration to your recommendation. Any response not received before or on this date may be deemed to be a positive response to the Department of Planning Services. If you have any further questions regarding the application, please call the Planner associated with the request. Please note that new information may be added to applications under review during the review process. If you desire to examine or obtain this additional information, please call the Department of Planning Services. You will be notified in writing of the Planning Commission date once the date is determined. riWe have reviewed the request and find that it does/does not comply with our Comprehensive Plan because )3_ We have reviewed the request and find no conflicts with our interests. See attached letter. Comments: " .__w\ q - t2 - -4O1 i c[.w-. - a -Ib-II Signature die/ Date r!"-Z- 02,67/ • Agency -P. w EXHIBIT +Weld County Planning Dept. +1555 N 171h Ave,Greeley,CC 2011-3103 't u5R,.11-OO 1O RECEIVED 0CT 0 3 2011 • 1861 - 2011 MEMORANDUM Weld auntyGREELEY `tment TO: Kim Ogle, Planning Services DATE: September 28, 2011 FROM: Donald Carroll, Engineering Administrator ode!/ W E L O N T Y Public Works Department SUBJECT: USR11-0010, Jeffrey Reck The Weld County Public Works Department reviewed the submitted application for critical items, including but not limited to Site Plan, Traffic Study, Preliminary Drainage Report, Geotechnical Soils Report, and Flood Hazard Development Permit. A detailed review of these items was not completed at this step in process. Comments made during this stage of the review process will not be all inclusive; as revised materials are submitted other concerns or issues may arise. All issues of concern and critical issues during further review must be resolved with the Public Works Department. COMMENTS: CR 48 is a local gravel road and requires a 60-foot right-of-way at full build out. There is presently a 60-foot right-of-way. This road is maintained by Weld County. Pursuant to the definition of SETBACK in the Weld County Zoning (23-1-90), the required setback is measured from the future right-of-way line. Access Permit Application Form: The applicant has supplied this form. Pictures at the entrance have been supplied as a part of the application. Our Traffic Engineer will evaluate the Access Permit Application and ivccompanying documents. Show the approved access on the plat and label it with the approved access permit number (AP#). This will be provided when a revised application form is received. Off-street truck and vehicle parking and circulation appear to be adequate. REQUIREMENTS: Pursuant to Chapter 15, Articles I and II of the Weld County Code, if noxious weeds exist on the property or become established as a result of the proposed development, the applicant/landowner shall be responsible for controlling the noxious weeds. All vegetation, other than grasses, needs to be maintained at a maximum height of 12 inches until the area is completely developed. Off-street parking spaces including the access drive shall be surfaced with recycled asphalt gravel and shall be graded to prevent drainage problems. Traffic Study: 'The applicant in a traffic statement is indicating that there will be 10 round trips to the site per day. Based upon the speed of traffic on US 85 travelling southbound and the limited sight distance at the intersection of CR 48 and US 85 exiting truck traffic exiting the facility should travel west to CR 35. Drainage Report: 1. The applicant has not provided the water quality calculations needed to determine the size of the water quality feature. Please contact Clay Kimmi for assistance in determining the size of the water quality • feature that will be needed. 2. Please delineate the location of the water quality feature on the plat and construction drawings. Please label the water quality feature as a "No Build/Storage Area" on the plat. 3. Please add the following development standards to the resolution. a. The historical flow patterns and run-off amounts will be maintained on site in such a manner that it will reasonably preserve the natural character of the area and prevent property damage of the M:\PLANNING-DEVELOPMENT REVIEW\-2011 Planning Referrals\USR11\USR11-0010.docx type generally attributed to run-off rate and velocity increases, diversions, concentration and/or • unplanned ponding of storm run-off. b. Weld County will not maintain on-site drainage related areas or medians. This must be addressed by the homeowner's association or land owner. c. The applicant is required to comply with all Colorado Department of Health and Environmental (CDPHE) regulations regarding berming and spill prevention for materials and liquids stored on site. d. The applicant is required to comply with all Colorado Department of Health and Environment, Water Quality Control Division regulations regarding storm water quality permitting and protection and construction storm water discharges. Grading Permit: Please place the following language in the resolution under "Prior to the Release of Building Permits". 1. If more than 1 acre is to be disturbed, a grading permit will be required prior to the start of construction. The grading permit application must contain: an erosion and sediment control plan, a grading plan, installation details of all BMPs to be utilized, typical installation and maintenance notes for all BMPs to be utilized, and a copy of the approved CDPHE stormwater permit. Flood Hazard Development Standards: This area IS NOT in a Special Flood Hazard Area (SFHA) as determined by the Federal Emergency Management Agency (FEMA). • • M:\PLANNING-DEVELOPMENT REVIEW\-2011 Planning Referrals\USR11\USR11-0010.docx • Kit k4a." ,' , MEMORANDUM C TO:FROM: KIM OGLE, PLANNING SERVICES MARY SUBJECT: USR 11-0011 OOIITRECK ENVIRONMENTAL HEALTH COLORADO DATE: SEPTEMBER 30, 2011 Environmental Health Services has reviewed this proposal for an oil and gas support facility to include excavating, roust-a-bout, solid waste hauling and portable toilet services. There will be up to 10 employees who access the facility, with up to 2 on site at any given time. The existing residence and warehouse on the property are served by an individual sewage disposal system (Permit No. SE-0300119). The existing septic system was reviewed by a Colorado Registered Professional Engineer and was found to be inadequate and the septic field was found to be located under the driveway. The applicant is proposing to install a new septic system for the residence and warehouse • and abandon the existing septic system. The applicants are waiting for the percolation test data and engineer design to make application to Weld County Environmental Health Services for a commercial septic system permit. The facility is served by an individual well (Permit No. 192808-A) and is permitted for domestic purposes only. Application has been made to the Colorado Division of Water Resources for approval of the well for commercial use. There is an aboveground diesel fuel tank (4000-6000 gallons in size) on the property. The applicant informed that the fuel tank is not being used by his operation, and he is proposing to have the diesel fuel tank removed. The applicant shall provide documentation to the Weld County Environmental Health Services that the fuel tank has been removed from the property. Environmental Health Conditions No. 5 and 6, regarding registering the fuel tank and providing a Spill Prevention, Control and Countermeasure Plan, will remain until this documentation has been received. The applicant initially proposed to add a solid waste transfer station for the company's solid waste hauling operation to reduce the number of loads being hauled to the landfill. The applicant informed that he is withdrawing the proposed solid waste transfer facility from this USR application. Environmental Health Services is requesting that the applicant provide a written statement of withdrawal of the solid waste transfer station from the USR application. • The applicant provides a portable toilet service and is currently licensed as a septic tank cleaner by Weld County Environmental Health Services (License No. CL-1100005). , According to the applicant, there are 3-4000 gallon and 2-2000 gallon poly storage tanks to store portable toilet waste (sewage). The sewage is then taken to the Greeley Wastewater Treatment Plant (WVVfP). According to the application, the poly storage tanks would be located in a plastic lined containment berm. The applicant also informed that the portable toilets will be washed out on the property and the effluent will be stored in the poly tanks for removal and disposal at the Greeley WWTP. The portable toilet washout area shall be designed to capture all effluent and prevent discharges. The applicant shall submit plans for the operations and associated structures for the portable toilet washout area for review and approval by Weld County Environmental Health Services. The operations plan shall include containment and cleanup of spilled portable toilet waste. According to the applicant, routine maintenance, repairs and washing of vehicles and equipment are performed off-site at commercial facilities. Only minor repairs, such as light bulb changes, are performed on-site. The applicant is proposing to install a used oil space heater in the warehouse and use the waste oil collected from maintenance of the company's vehicles and equipment at an off-site commercial repair shop. Burning used oil generated by the facility for space heating in a company owned oil burner is allowed and is APEN and permit exempt by the state air pollution regulations. However, since the oil changes are performed at an 4111off-site commercial repair shop, and there is the potential for other used oil sources to be mixed with the company's used oil, the company must have this potentially non- exempt practice reviewed for permitting by the Colorado Department of Health and Environment, Air Pollution Control Division before any such used oil is burned. A dust abatement plan and waste handling plan were not included with the application. The applicant shall provide a dust abatement plan detailing on-site dust control measures. If water is proposed to be used to mitigate on-site dust, the source of water shall be provided in the plan. If the well water is proposed to be used for dust control, it must be permitted for this purpose by the Colorado Division of Water Resources. The waste handling plan shall include the types of waste generated on-site and wastes collected from the off-site oil and gas facilities. The name, address, and phone number of the waste facilities where the waste will be disposed shall be included in the waste handling plan. We have no objections to the proposal; however, we do recommend that the following conditions be part of any approval: We recommend that the following requirements be met prior to allowing the plat to be recorded: 2 • 1. The applicant shall provide a written statement to the Weld County Environmental Health Services regarding withdrawal of the solid waste transfer station from the USR application. 2. The applicant shall submit a dust abatement plan, detailing on site dust control measures, for review and approval, to the Environmental Health Services, Weld County Department of Public Health & Environment. 3. An individual sewage disposal system is required for the proposed facility and shall be installed according to the Weld County Individual Sewage Disposal Regulations. The septic system is required to be designed by a Colorado Registered Professional Engineer according to the Weld County Individual Sewage Disposal Regulations. 4. Plans for the operations and associated structures for the portable toilet washout area shall be submitted, for review and approval, to Environmental Health Services Division of the Weld County Department of Public Health & Environment. The portable toilet washout area shall capture all effluent and prevent discharges from the washing of portable toilets. Portable toilet washout area and associated structures should be designated on the plat. 5. The applicant shall submit evidence of an Aboveground Storage Tank permit from the Colorado Department of Labor and Employment (CDL&E), Oil • Inspection Section for any aboveground storage tanks located on the site. Alternately, the applicant can provide evidence from the (CDL&E), Oil Inspection Section that they are not subject to these requirements. 6. A signed copy of the Spill Prevention, Control and Countermeasure Plan shall be provided to Environmental Health Services Division of the Weld County Department of Public Health & Environment. In accordance with Section 3-6-1 of the Colorado Department of Labor and Employment Division of Oil and Public Safety Storage Tank Regulations (7 C.C.R. 1101-14) as well as EPA regulations (40 CFR Part 112). 7. Burning used oil generated by the facility for space heating in a company owned oil burner is allowed and is APEN and permit exempt by the state air pollution regulations. However, since the oil changes are performed at an off-site commercial repair shop, and there is the potential for other used oil sources to be mixed with the company's used oil, the company must have this potentially non-exempt practice reviewed for permitting by the Colorado Department of Health and Environment, Air Pollution Control Division (APCD) before any such used oil is burned. If applicable, the applicant shall submit evidence of an Air Pollution Emission Notice (A.P.E.N.) and Emissions Permit application from the APCD. Alternately, the applicant can provide evidence from the APCD that they are not subject to these requirements. • 3 8. The applicant shall submit written evidence from the Colorado Division of Water . Resources, demonstrating that the well is appropriately permitted for the commercial use. 9. The applicant shall submit a waste handling plan, for approval, to the Environmental Health Services Division of the Weld County Department of Public Health & Environment. The plan shall include at a minimum, the following: 1) A list of wastes which are expected to be generated on site (this should include expected volumes and types of waste generated). 2) A list of the type and volume of chemicals expected to be stored on site. 3) The waste handler and facility where the waste will be disposed (including the facility name, address, and phone number). We recommend that the following requirements be incorporated into the permit as development standards. 1. All liquid and solid wastes (as defined in the Solid Wastes Disposal Sites and Facilities Act, 30-20-100.5, C.R.S., as amended) shall be stored and removed for final disposal in a manner that protects against surface and groundwater contamination. 2. No permanent disposal of wastes shall be permitted at this site. This is not meant to include those wastes specifically excluded from the definition of a solid waste in the Solid Wastes Disposal Sites and Facilities Act, 30-20-100.5, C.R.S., as amended. 3. Waste materials shall be handled, stored, and disposed in a manner that controls fugitive dust, fugitive particulate emissions, blowing debris, and other potential nuisance conditions. 4. The applicant shall operate in accordance with the approved "waste handling plan", at all times. 5. Burning used oil generated by the facility for space heating in a company owned oil burner is allowed and is APEN and permit exempt by the state air pollution regulations; however, in the event the burning of other sources of off- site generated used oils is to be conducted, the company must have this potentially non-exempt practice reviewed for permitting by the Colorado Department of Health and Environment Air Pollution Control Division before any such oil is burned. i 4 • 6. Fugitive dust and fugitive particulate emissions shall be controlled on this site. The facility shall be operated in accordance with the approved "dust abatement plan", at all times. 7. This facility shall adhere to the maximum permissible noise levels allowed in the Commercial Zone as delineated in Section 14-9-30 of the Weld County Code. 8. Adequate drinking, hand washing and toilet facilities shall be provided for employees and patrons of the facility, at all times. 9. Any septic system located on the property must comply with all provisions of the Weld County Code, pertaining to Individual Sewage Disposal Systems 10.A permanent, adequate water supply shall be provided for drinking and sanitary purposes. 11.All other potentially hazardous chemicals must be handled in a safe manner in accordance with product labeling and in a manner that minimizes the release of hazardous air pollutants (HAP's) and volatile organic compounds (VOC's). All chemicals must be stored secure, on an impervious surface, and in accordance with manufacturer's recommendations. • 12.Any portable toilet washout area shall capture all effluent and prevent discharges from the washing of the portable toilets. The effluent shall be captured in a watertight tank and hauled off for proper disposal. Records of installation, maintenance, and proper disposal shall be retained. 13.The applicant shall comply with all provisions of the State Aboveground Storage Tank Regulations. 14.The Spill Prevention, Control and Countermeasure Plan shall be available on site, at all times. 15.If applicable, the applicant shall obtain a stormwater discharge permit from the Colorado Department of Public Health & Environment, Water Quality Control Division. 16.The operation shall comply with all applicable rules and regulations of State and Federal agencies and the Weld County Code. Additionally, please note the following: 1. This application is proposing a well as its source of water. The applicant should be made aware that while they may be able to obtain a well permit from • 5 the Office of the State Engineer, Division of Water Resources, the quantity of 41water available for usage may be limited to specific uses, i.e. domestic use only, etc. Also, the applicant should be made aware that groundwater may not meet all drinking water standards as defined by the Colorado Department of Public Health and Environment. We strongly encourage the applicant to test their drinking water prior to consumption and periodically test it over time. I 411 MEMORANDUM • COLORADO To: Kim Ogle, Planner October 3, 2011 From: Bethany Salzman, Zoning Compliance Officer Subject: USR11-0010 Referral Upon review of my case files and computer, an active Complaint (COMP11-00092) was noted. This complaint was initiated due to the operation of Waste Logistics, LLC and associated commercial storage, without the necessary Weld County Zoning Permits. This case has not yet been presented to the Board of County Commissioners through the Violation Hearing process. Since the applicant has submitted this application while the case is still in the complaint status, no investigation fee is required. This complaint was received through Public Works. This application if approved by the Board of County Commissioners and once a plat is recorded will correct the violation. If this application is denied, all commercial storage and operations shall be removed from the property within 30 (thirty) days. Additionally, if denied by the Board of County Commissioners please request this violation case be referred to the County Attorney's Office with a delay of legal action for the 30 (thirty) days mentioned above. • • SERVICE.TEAMWORK,INTEGRITY,QUALITY Submit by Email 1861 - 2011 • 7 , .� Weld County Referral September 2, 2011 WELT EL-C IUNTY The Weld County Department of Planning Services has received the following item for review: Applicant Jeffery Reck Case Number USR11-0010 Please Reply By September 30, 2011 Planner Kim Ogle Project A Site Specific Development Plan and Special Review Permit for an Oil and Gas Support Facility(Roust-a-bout, Excavating and Port-a-let Service)in the A (Agricultural)Zone District. Legal SE-1015 Part NW4NW4 Section 12, T4N, R66W of the 6th P.M., Weld County, Colorado. Location South of and adjacent to CR 48, 0.25 East of CR 35. Parcel Number , 1057 12 200085 The application is submitted to you for review and recommendation. Any comments or recommendation you consider relevant to this request would be appreciated. Please reply by the above listed date so that • we may give full consideration to your recommendation. Any response not received before or on this date may be deemed to be a positive response to the Department of Planning Services. If you have any further questions regarding the application, please call the Planner associated with the request. Please note that new information may be added to applications under review during the review process. If you desire to examine or obtain this additional information, please call the Department of Planning Services. You will be notified in writing of the Planning Commission date once the date is determined. ' I We have reviewed the request and find that it does/does not comply with our Comprehensive Plan because We have reviewed the request and find no conflicts with our interests. ✓ See attached letter. Comments: My concern with this plan is the vagueness of his traffic control plan. He sites that there will be reduced traffic, however if his use is expanded to the public as he mentioned,the impact on the intersection at Highway 85 and WCR 48 could be huge. WCR 48 at the intersection with Hwy 85 only allows for a southbound turn onto Hwy 85, unless you drive north on the frontage road,and then cross Hwy 85 at the base of the Lasalle bridge. The frontage road is a very narrow 2 lane road. Feel free to contact me with any questions. Signature Commander Roger Ainsworth Date 090711 Agency Weld County Sheriffs Office • +Weld County Planning Dept. +1555 N 17"'Ave,Greeley,CO.80631 O(970)353-6100 ext.3540 O(970)304-6498 fax Submit by Email 1861 - 2011 • ._ Weld County Referral September 2, 2011 WEL [_.,000NTY The Weld County Department of Planning Services has received the following item for review: Applicant Jeffery Reck Case Number USR11-0010 Please Reply By September 30, 2011 Planner Kim Ogle Project A Site Specific Development Plan and Special Review Permit for an Oil and Gas Support Facility(Roust-a-bout, Excavating and Port-a-let Service) in the A (Agricultural)Zone District. Legal SE-1015 Part NW4NW4 Section 12,T4N, R66W of the 6th P.M.,Weld County, Colorado. Location South of and adjacent to CR 48, 0.25 East of CR 35. Parcel Number 1057 12 200085 The application is submitted to you for review and recommendation. Any comments or recommendation you consider relevant to this request would be appreciated. Please reply by the above listed date so that • we may give full consideration to your recommendation. Any response not received before or on this date may be deemed to be a positive response to the Department of Planning Services. If you have any further questions regarding the application, please call the Planner associated with the request. Please note that new information may be added to applications under review during the review process. If you desire to examine or obtain this additional information, please call the Department of Planning Services. You will be notified in writing of the Planning Commission date once the date is determined. l We have reviewed the request and find that it does/does not comply with our Comprehensive Plan because HWe have reviewed the request and find no conflicts with our interests. See attached letter. Comments: Based upon the traffic volumes identified in the narrative, it's unlikely that the intersection of CR 48 and US 85 will be significantly impacted. However, I would encourage the County to identify another truck route. The speed of traffic southbound and the sight distance make this intersection less than ideal. Signature Gloria Hice-Idler Date 09/06/11 Agency CD0T • +Weld County Planning Dept. +1555 N 17'"Ave,Greeley,CO.80631 +(970)353-6100 ext.3540 +(970)304-6498 fax Z.-012_L-C1:9.-f;6\ DEPARTMENT OF NATURAL. RESOURCES • • • -- --- `�Q• {~ '.P DIVISION OF WATER RESOURCES *\� �� ' J,'hn`ti'.I}ick•nl •+}'cr .' Uc'vcnwr \likr King ti' September 14, 2011 Dick 14•.,111,, Director for Kim Ogle Weld County Planning Services Transmission via email: kogle@co.weld.co.us RE. Jeffery Reck USR11-0010 Part NW '/ of the NW '/4, Section 12, T4N. R66W of the 6th P.M Water Division 1. Water District 2 Dear Mr. Ogle: This referral does not appear to qualify as a "subdivision" as defined in Section 30-28- 101(10)(a). C.R.S. Therefore, pursuant to the State Engineer's March 4, 2005 and March 11, 2011 memorandums to county planning directors, this office will only perform a cursory review of the referral information and provide informal comments. The comments do not address the adequacy of the water supply plan for this project or the ability of the water supply plan to satisfy any County regulations or requirements. In addition, the comments provided herein cannot be used to guarantee a viable water supply plan or infrastructure, the issuance of a well permit, or physical availability of water. • The proposal is to use the subject 2.8-acre parcel for storage of oilfield equipment and as a waste transfer station. The proposed water supply is an existing well, identified by the applicant as permit no 192808. A review of our records shows that this well was re-permitted in August of 2011 as permit no. 286507. The new permit allows water from the well to be used for drinking and sanitary facilities for a commercial business Water from the well cannot be used for lawn or landscape irrigation or for any other purpose outside the business building structure. This would prohibit the use of water for equipment washing (including portable toilets) or dust suppression. In item H. the applicant discusses using Colorado-Big Thompson project water to augment commercial uses. The applicant can apply to re-permit the well for additional uses, such as outdoor use, if an augmentation plan is approved in Water Court. A new permit application would be evaluated at the time it is received. This office has no objection to the proposal so long as the terms and conditions of well permit no 286507 are complied with. Should you have any questions, please contact Tracy Kosloff of this office Sincerely, ioan a William , P.E. -- �IlVate Resource Engineer cc Dave Nettles, Division Engineer Scott Edgar, Water Commissioner- District 2 Well permit file no. 286507 JMW'[TLK Weld USR11-0010 Reck Oil Field Support.Docx Office of the State Engineer €.;Shr;•rn;ut Strt''t, -alts "IS•i)t•nvo:..(1)80203•Phone:303-%U.3'SI • Pa.,:31)3-S66-3,t<;t w,s,s.t, WATER SUPPLY INFORMATION SUMMARY • Section 30.29.133.Id1. C.R.S. requires that the applicant submit to the County,-Adequate evidence that a water supply that is sufficient in terms of quantity, quality and dependability will be available to ensure an adequate supply of water. 1. NAME OF DEVELOPMENT AS PROPOSED J.-.e:{- k_. k— 2. LAND USE ACTION Geer S-tc_._ ti_-h.lit S`1-r---r >4CC /---;()/7 3, NAME CF EXISTING PARCEL AS RECORDED J C-f f-C.r L/ .Je•( l-rely. / ('/C. I r 15UBDIVISION FILING BLOCK LOT i 1. TOTAL ACREAGE --1 . g ( i 5. NUMBEi 01 LOOTS PlOPDSE' -� i PLAT MAP ENCLOSED 1ES 6. PARCEL HISTORY• P:oasa attach copies of deeds. plats or ether evidence or documentation. A.Was parcel recorded with county prior to June 1. 1972? 7 YES ^ NO 3. Has the parcel ever been part of a division of land action since June I, 1972? E.: YES Li NO 11 Yes, describe the previous action , 7. LOCATION OF PARCEL • Include a map de:inietinp the pro;e_t area and tie to a section corner. �_ » _ 1;3 CF /1.)0)1!.1 SECTION /-2" IO%' SHIP q_ ,,. f7 iI S RANGE 6,26, D E air •I PRINCIPAL MERIDIAN: O 6TH C✓h.M. O UTE :.J COSTILLA I • I 8. PEAT • location of ait wells en property must be plotted and permit numbers prorated, }' Ser:arors plat 0 Yes u No :f not. scaled hand drawn sketch Z Yes 0 No If :I 9. ESTIMATED WATER REQUIREMENTS - Gr•oI pot Day :• s:tr Fs.:err Yea: ID.WATER SUPPLY SOURCE 11 t::'iX1STNG O DEVELOPED 0 WILLS SPRING NEW WELLS • II 1 rson=MATS• •q:t OM: HOUSEHOLD USE + of units . GPO AF WELL PERMIT�^I NUMBERS C7 Elm: C r.-ttt::�rart li / CI,�.3 02 tIns aawscer L tome r.t' r it roeur ore :at !:►1Y,r rlr af,S COMMERCIAL LMS_ 0.560 of S.F. SP!) AF r-porn • C.r.irara .-u, ;RRIGATICN : of acre; GPO _ AF STOCK WATERING # of head GPO AF f M1;NICIPAL ! _ `: A5SUL'fATIL'N WATER COURT DECREE CASE NO.'S OTHER GPO - AF O COMPANY O DISTRICT TOTAL -.5-OO GPO AF NAME • LETTER OF COMMITMENT FOR SERVICE 0 YES 0 ND I1. ENGINEER'S WATER SUrPLY REPORT r....] YES Yri0 ;F YES, PLEASE FORWARD WITH THIS FORM. aFe t+ew:r omit::Oro:t.r renew a:o-::tlr!i 12, TYPE OF SEWAGE DISPOSAL SYSTEM 3 ASEPTIC TANK:LEACH FIELD _ CENTRAL SYSTEM • DISTRICT NAME • . LAGOON i..2 VAULT • LOCATION SEWAGE HAULED TU i 11 ENGINEERED SYSTEM '4r.s:,t I :city e j1,7-.rrlif:4,1)-i --' C 7 iiEil - _ Hello