HomeMy WebLinkAbout20110404.tiff e—_—� :ES Office Use Only Form GWS-45(07/2009)
1203
AUG 2 4 2,)1jj
STE OF CO.WATER RESOURCES
1:113 SHERMAN,8TH FLOOR !tin
DENVER CO 80203
Phone:303866-3581 _ 6. Use Of Well (check applicable boxes) _ —
Fax:303-866-2223 Attach a detailed description of uses applied for.
Industrial O Dewatertng System
Select R•Ca —.. f
O Municipal O Geothemtal(O production or O re )
Transaction#: 3647034 • '_ _ _ O"ga + q 'or-42�ed l<-e ve
Lute: 81141'l41U lime: 12:23:12 PM a Commercialrer-N �DQ5Q S �
Cashier: yfni Register#: 1 Spa_k 7.Well Data(proposed) r
Doscr;pticxt Amount 1 ._ !t ~Maximum pumping i Annual armed w be ww,aawn
dent xcasrx __-a�-smssa 01d0 tilM gpm _---._-.----.
esm.,e.c. 13�'a"�' $100.00 ,des) acre-feet
it EitemptJNonExOut — o
-Total depth _....------ -- _._
ce(aquifer)Total
___ MO 00 h(expired permit) feet j �-a.roam,e- t'o X L I I S
CHECK#1795 Tertticifed $100 00 8.Land On Which Ground Water Will Be Used
Change Due 50.00 — — --
Legal Description(may be provided as an'Sediment):
Thank you `
4)t(O Q i(p0 u-e e i(1`.---. l 6L V►.S �a i 0'-`
rn ,..J_f sL._�.a.— <5W 0 E a.. 1 .0 a (r"L D R)
Designated Basin Determination aI 1 Well name or s
em
4.Location Of Proposed Well(Important! See Instructions) b'''JOANQaurdY
- se --- (If used for crop kripation,attach a scaled map that shows Irrigated area.)
i - E ---
w.� le d i ss w 114 d the NI 1/4 A. *Acres I es B. Owner
Section Township...- .Nor S_ Rarge E a W 1 Prk.d�F Aen ---. __._.... l 3 . ; _ Q let 1C. i' r Y`
1 1 I Is.0
‘ -7
Qy rug
t/ ---- C. List any other walls or oat r r used hn rights on f a d:
Distance of war N a linos
from section ee(sad o iris me typically not properly lines) ( —‘ 1 C]1'1a(''t.e LA)dt'e t wk - r- 10'. e-�
96- Ft NoratiN O SIll
L i o o Ft Nora,�E O w_ 9. Proposed Well-Driller License#(optional): n//pt
Fa<replacarr,emwalsardy—e�tmatddecsonooeidd to new well 10.Signature Of Applicant(s)Or Authorized Agent
feet direction The making of false statements herein constitutes perjury In the second
Well looaron address(nduds City,State,Zip) XI Check a well address IS urns a in item 1. degree,which Is punishable es a class 1 misdemeanor pursuant to C.R.S.
24-4-104(13)(a). I have read the statements herein,know the contents
thereof and state that they are true to my knowledge.
Sips hero(Must be alpnier.) ' bars Optional: GPS GPS well follows:
information h lfTivt format You must check GPS unR for 2Y'VVAa required sateen's as TaYows: 17'-9;1+-a Y/- 0T
Pridraneatl0e
Epinal roue be UTM
❑Zone t2 or❑Zone 13 Easting TQ.1M4E-S ro.yr\'''—lie.e r 1
Letts must be Meter !.
Datum must be,ADU Northing Office Use Only
that must be sett;true north i USGS map name DYrrf map no. surface elev.
Was GPS Loll checked far abow4 O YES Remember to sat Datum to NAM
5. Parcel On Which Well Will Be Located ------- —Receipt area only
jYOU MUST ATTACH A CURRENT DEED FOR THE SUBJECT P CEL)
A. Legal Description(maybe provided as an anad,mem):
Trans Number:3647034
8/24/2010 12:23:12 PM
Yolanda Johnson(14)
Total Trans Amt:$100.00
B. :a acres In parcel IL c. Doter .ou.t AP Check Number: 1795 — — —
Check Amount: $100.00
D. viii this be the only well on this weal? YES ONO Of no—cat other weds) WR
CMS
E. Stare Prod ID.(opiorti): TOPO
0 MYLAR
se5 DIV ND BA MD
2011-0404
COLORADO DIVISION OF WATER RESOURCES Office Use Only Form GWS-45(07/2009)
DEPARTMENT OF NATURAL RESOURCES
1313 SHERMAN ST,RM 818,DENVER,CO 80203
phone—info:(303)866-3587 main:(303)866-3581
fax:(303)866-3589 http://www.waterstate.co.us
GENERAL PURPOSE
ater Well Permit Application
Review instmetions on reverse side prior to completing form.
The form must be completed in black or blue ink or typed.
1.Applicant Information 6.Use Of Well(check applicable boxes) _
Name of applicant Attach a detailed description of uses applied for.
1 ' , t rl ❑Industrial ❑Dewatedng System
� J (r ,, C '. �../V 0 e r ,.
Mailing address - I 0 Municipal 0 Geothermal(❑production or 0 reinjection)
7 / I �
City ! -! �.nJ / , �{ E.tlt t ,./.: � - ❑Irrigation Other(describe): Do q Orr e .. .'.0 q I<-ehhv'
State (no code ❑Commercial t)
I i ." .
1 " ' r., I /'" 1 7.Well Data (proposed)
Tdephare% ( E not l(Optional)
Madmum pumping rate Annual amount to be withdrawn
( -) ,/j.,., 'i I-.`1. - �, .T- i (lr'.,. ; `I n_).'OC/„h, 1
2.Type Of Application (check applicable boxes) % 0. .) •. • .1/ oc. `iI.
acre-feet
total depth Aquifer
❑ Construct new well 0 Change source(aquifer) '
1 lc
❑Replace existing well ❑Reapplication(expired permit) `S O feet La.r(le�i f -. '�!:'X. ��,
R Use existing well 0 coecc well 8.Land On Which Ground Water Will Be Used
f(Change or increase use 0 Other. Legal Description(may be provided as an attachment):
3. Refer To (If applicable) (>t , ()Ito ' _.. R'' ,1 , 1 J
Well permit St Water Court case it
i
/ 1 I c I % r"Iv u W N t `,L I •O N • i Ott 1
Designated Basin Determirwtlon% Well name or%
(M
4.Location Of Proposed Well(Important!See instructions) 6'xiv\r,
County r 1 - - Of used for crop irrigation.attach a scaled map that shows fidgeted area.) -_
.A 1/4 of 1/4 A. %Acres 1 B. °miff
1 C: v Vi N ET a
Section Township N or S Range E or W Principal Mehden ( v ' '" J E i l i' •-."'
Sv I C I ,
/ F1 ❑ / -7 ❑R C.Ask fiat any other wells or water tights used on tie�sJland: `� \ �
Catanoe of wellborn bon section lines(section Ines arePtyViury not property lines) �L '��-.f'Q.,. L�P-/�P r eland.
,-' Y�Q r- mss Ae y�
Plea ❑N❑s
WorrepaceFL tram❑E❑w 9. Proposed Well Driller License#(optional): f)// Pc
For regarenree wells l only—3ata Nx and woman from old eel to new well 10.Signature Of Applicant(s)Or Authorized Agent
feet direction The making of false statements herein constitutes perjury in the second
Well Iocaem address(Include Gry,Slate,Zrp) f1i(Chad if well address is same as 1n Item 1. degree,which is punishable as a class 1 misdemeanor pursuant to C.R.S.
24-4-104(I3)(a). I have read the statements herein,know the contents
thereof and state that they are true to my knowledge.
Sign here(Must be signspre) l7 7 J Dale
Optional: GPS wail location information in IJTM forms You must check GPS unit for {\\_ 1 � �
required settings as follows: \.1(J/�.)t / � -: J -.2Y-.20/6
Fauna)tousles VIM PAM name&tile 1 -Tl
❑Zone 12 or O Zone 13 Easting 1` '4 rI ,I
Urals mart be Meters V�..1'1\e. 5 \,71.4 VT'
Datum must be NADE3 Northing Office Use Only
Unit must be rat to true north USGS map name DWR map no Surface elev.
Was GPS use dreded for above? 0 YES Remember to sat Datum to NADx3
5. Parcel On Which Well Will Be Located j\/ ( /-mot - Receipt area only
(YOU MUST ATTACH A CURRENT DEED FOR THE SUBJECT PARCEL)
A. Legal Description(may be provided as an attachment):
FERENGI ENTERPRISES, LLC. 1795
8573 W 84Th CIRCLE 303-918-7406 23-7/102010
ARVADA,CO 80005-2340 Oesne4131C
B. %of acres moercel -__-_-_ C. 1
DATE
/
La ja � C�& I sviLr $ Z
D. Wafts be the only well on this parcel?DYE: PAY TO THE
ORDER OF
i) C f(fA-� /Do /"2
b1r44 �/ 8 a A /L UULLnru - e
E. stale Pmcd am-no, a=v
V.i,;r r.1 atlsFswsaM,NS
rvu yr Colorado
welltbrgo.cottm� ^ y/-�'1) n" ( ,q '\/�/f `7 ' f(I'�fII,
FOR 0J�.41 6/4) k/ !`e 1 yyt.�+ �J�/�f#jLn^+� /�k C "Y IONIMIwmm can.
GWS 1
03/2005
STATE OF COLORADO
• OFFICE OF THE STATE ENGINEER
DIVISION OF WATER RESOURCES
1313 Sherman St. Room 821
Denver, CO 80203
(303)866-3581 Fax(303)866-3589
NONTRIBUTARY GROUND WATER LANDOWNERSHIP STATEMENT
I (We) vcr..w.es Grar..± t.-err,
(Name(s))
claim and say that I (we) am(are)the owner(s)of the following described property consisting of
)3•OS acres in the County of l) z,\
State of Colorado:
(Insert the property legal description)
Q Ro Q I ICo u,e ,,_} ,..0 ow sL 4 .Aa+ 1Q h1
5 \-✓ a 1 , od -,y.AL
•
and, that the ground water sought to be withdrawn from the rt r a w\; e — FO Y,\f,,
aquifer underlying the above-described land has not been conveyed or reserved to another, nor has
consent been given to its withdrawal by another.
Further, I (we)claim and say that I (we) have read the statements made herein; know the contents
hereof; and that the same are true to y(our)knowledge.
Qcjr-1"---/-P-1-rk 'do ~ owe
Sig ure Date
Signature Date
INSTRUCTIONS:
Please type or print neatly in black or blue ink. This form may be reproduced by photocopy or word
processing means. See additional information on the reverse side.
•
Form No.
GWS-43
Rev. 9/96
OFFICE OF THE STATE ENGINEER
•
818 Centennial Bldg.
1313 Sherman St.,Denver,Colorado 80203
13031888-3581
\NONTRIBUTARRY LANDOWNERSHIP OR CONSENT VERIFICATION NOTICE FICATION OF
I (We) -JCL es lr rot * 1c rf
(Name bf Well Permit Applicant)
claim and say that I (we) have given notice pursuant to CRS 37-90-137(4)(b.5) of the application for
a well permit by registered or certified mail, return receipt requested, no less than ten days prior to
making of the application for the permit, to every record owner of the overlying land and to every
person who has a lien or mortgage upon, or a deed of trust to, the overlying land recorded in the
county in which the overlying land Is located.
The names of the persons given notice are listed below:
A
•
Further, I (we) claim and say that I (we) have read the statements made herein; know the contents
hereof; and that the same e true to my(ow)own knowledge.
p - go -m00%
(Signature) (Date)
(Signature) (Date)
INSTRUCTIONS
PLEASE TYPE OR PRINT NEATLY IN BLACK INK. THIS FORM MAY BE REPRODUCED BY
PHOTOCOPY OR WORD PROCESSING MEANS. SEE ADDITIONAL INSTRUCTIONS ON BACK.
•
Colorado Division of Water Resources Apprrcaton Receipt No.
1313 Sherman St.Rm.818 Denver,CO 80203 Applicants Name \J(T C.— W. e.s T-c.rri
(303)888-3581
http//water.state.co
COMMERCIAL SMALL CAPACITY WELL WATER USE BREAKDOWN WORKSHEET
(For Wells Located Within Designated Groundwater Basins)
Name and Type of T v k f1
Business 1 'e.rri Fa -INN4 Qr n �t 0 are. CQ 10%,Q
1. Is this application for a new well?
Yes
X No Iftnp,is this application for a change of use for an existing permitted 7q
Yes Permit Number of well(if applicable) I a1 10 —1"1
No For wells used prior to May 8, 1972 see form GWS-12 Registration of Existing Well for
further infommtion.
2. Type of disposal system:
>< Septic tank/absorption leach field
Central System(districtfwne:)
Vault(location sewage hauled to:)
Other(attach copy of ergineed g design)
3. Water Demand Calculations(for average factors for water demand see below)
Employees
Number of Employees X Number of Gallons per X Number of Days Employee = Gallons per Year
Employee per Day Works per Year
,3103 = 5 L! 7.s' A
Customers
Number of X Number of Gallons per X Number of Days Business = Gallons per Year
• Customers per Day Customer is Open per Year X / 0 x 5a— = S B
Outside
Square Feet of X Number of Gallons per X Number of Days landscape = Gallons per Year
Irrigated Landscape square foot per day is irrigated
— 0-- X — 0 — X U —
Other Uses-Provide breakdowns for all other substantial water usage(i.e.veterinary dint,green houses,etc.)
Type of Use X Gallons per Use per X Days per Year = Gallons per Year
Day
K42. v`h>: 1 x 3 L I rat! X ,3 lo.s �_= 122 /eCg D
Total amount of water required: I o gallons per year
(A +C+D)
•US1-1 14 acre-ft per year
(1 acre-ft=325,851 gallons)
For all small capacity commercial wells:
1. The pumping rate shall not exceed 50 gallons per minute and may be further limited by Water Management District
Rules.
General Guidelines for Water Demand Si Gallons Der Day
Day Wodmrs at Omces—15 geflonstpeisSday
Food Service Establishments(with toilet and Idtchen wastes)—10 gallons/patron/day
Churches(does not include food service)—5 gallons/seat/day
Overnight Lodging—50 gallons/customer/ay
Landscape Irrigation—45 gallons/1,000 square feet/day
• OnSIte Proprietor of Overnight Lodging(i.e.one owner of a Bed&Breakfast)—80 galons4 etswilday
Additional water demand tgrres may be obtained from a private water consultant orfrorn a!ethnical reference on this subject. GWS-81
03/03
• Request for change of exempt well permit to non exempt well permit
Purpose: Dog Breeding Business
Calculated water requirements for kennel operations:
Daily waster consumption is approximately 1 ounce per pound of weight
100 dogs with an average weight of 30 lbs equals 3000 oz per day or 23.5 gallons/year
Dog bathing 5 gallons per dog times 100 dogs bathed 6 times a year equals 3000
gallons/year
Power washing 16' X 110' kennel floor 1 hour at 3 gallons a min 6 times a year equals
1080 gallons/year
Water livid per year:
Drinking water: 8577.5 gallons
Bathing 3000 gallons
Cleaning 1080 gallons
• Yearly Total 12,657.5 gallons or .0388 acre feed
This is a family operations and very minimal impact from additional humane use will
occur.
It is projected that there will be an average of one visiting person a week visiting the
kennel.
•
• Sewage Disposal
There is an existing septic at our location. Presently only
one person uses the septic. There will be the addition of one
part time employee and 1-2 customers per week. The
present septic is sufficient.
WELD COUNTY HEALTH DEPARTMENT ,��
1516 Hospital Road 7 ;--j
Greeley,.Colorado PERMIT NO.
Ph. 353-0540
ilplication for permit to I�ns�l_ Construct, an Individual Sewage Disposal System;- )
y� l � 7Cv`Tb
Owner /41 '` -/4 --/V A-T °-Address/H7>f=' .4,73-.2- Phone tsy'�'&flf_
E ,(
Direction to site;-,Hwy= " Rd. %^ N_mi.,-E_mi., S_mi., W mi.£to,/A64
i � 4. q
Legal Description Ptn✓.� Sec._Z. , T,LN, R7!VJ Subdiv;. Lot Bikr
f7It
General- Information
Dept Use Only-
i No Be o c No. Persons . ":
7. "Pere. Rate=( 4vg of 3) , >4r dirt,..--'"-:''''
No. Baths IBasement:P,lumbing
� :SO:Type:Type . ��j'.z -r �tGl i,>,� .
Size of Lot " T '2-'4.A / '.k20 Table Depth ' 7 '
H20 supply 4if well.•give'depth) tcty.7 6 PO- �' -y
Lat•Grade- STD
New Horne . Mobile.Home /vlodglar—,__Add'n Requires Etiditreer Design sYes �o
Type of sewage disposal requested It_yes].. , reason -
Septic tank''// _ Privy .:O:ther .- .-
Ctimrrients:
e w fN ;,—
:Installaitioni Instructions 'tMinimuriA`Requirements) z J
Septic Tank 2 r�. Gals: Absorption .Trenches Sq E t
br
Other Seepage bed ', ,,:$
afl �'
Sp�aF Instructions . 771717. lc _, �:
, `fit � ,��: z , ,
This syst �t fl{be constructed;and installed l acco dance-with the above speccifications'andt regulationsr re i
4ttrding.i� d aal sewage dtspo of systems in t urnty,-Colorado:
This ►iermt ish al xpire at the some time-as the building rmit or, ifv no building permit is issued, the perni : '
shall explte 20 dbys a its'i'ss ance,sjif�constr ion Ii*hot beenF c merh,e��`" s §'-v .-' -
Date, :; v"c P,.d 4 l•::,/r 7 t'ek ear ' :, a ' a+ e - -
- ,'',... ',;,%,',,,,: is FM1 S 4 S₹ A f�Sv
1
,+ Y
pth _ rophrtaltt _ ff ;7 y
Tli r nd sp cifications as shown ore ap vt d,per`dl payment of permitfee.
tx S v 4 1'" ate :r 4: J ST U'0
- s ,; ' + ; rJDr Fltal"ia�e�' 4;:c!1:?": ".--,,e,]i iiie 8,o 3s tt4"'e ---
Th above system ins ' ed and founi to cari'iply with,planiand desct'i ion f + Vh.:
` t a r �,f t. .'"'.'47-:::;:i` Y UzS<l,� i ate' <P> _` A' ,
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it Fee $eJC tO�
Received by / Yf date:- 7i�
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CHURCH OWC, LLC
• Onsite Wastewater Consultants
October 18, 2010
Terry Kennels
ATTN: Ms. Sharol Terry Pestotnik
8573 W. 84th Circle
Arvada, CO 80005
Subject: Assessment of Existing OWS
10711 CR-52
Weld County, Colorado
Job No. B831
Ms. Pestotnik,
CHURCH Onsite Wastewater Consultants, LLC (COWC) is providing this letter, at your request,
as a requirement of Weld County Department of Public Health and Environment to verify that
the existing onsite wastewater system (OWS) is functioning.
BACKGROUND
The property is a 13.25 acre parcel located on the north side of Colorado Highway 52,
• approximately 1,400-feet west of County Road 23. The property is developed with a small
single story residential structure, a wood barn, a large metal building and several small sheds.
The property is on a rise in the topography from the east, and appears to be fairly dry. The site
slopes from south to north at less than 2% grade. It is our understanding that the property is
Intended to be used as a site for a new kennel to house and raise not more than 99-dogs at any
time.
ASSESSMENT
COWC has conducted an a«sment of the existing system and the intended use of the system
through a review of materials submitted by the dient, Assessor's records and a site visit to the
property to observe the tank and drainfield.
The existing OWS was installed in 1975 under Weld County Permit No. 797. The system
consists of a 750-gallon, single compartment, concrete tank that is located about 90-feet
northeast of the house. There is an inlet and outlet bend that provide a down-leg to draw
effluent from below the scum layer. The pipe material appears to be PVC. The tank appears to
be in good condition. No corrosion or spalling was observed.
The drainfield is located about 40-feet north of the existing tank. estimating from the depth of
the tank outlet, about 2.5-feet, and assuming 2% minimum slope on the discharge pipe, we
estimate that the drainfield is approximately 3-feet to 3.5-feet below existing grade. The as-
built drawing indicates that the drainfield contains 630 SF or absorption area. The 1975 Weld
County ISDS permit indicates that the soils are silty sands, and that 430 SF of area are
required. The drainfield appears to be about 1.5X larger than the design requires. Our
• observations of the surface soils at the site are consistent with the classification provided in the
9590 West 14th Avenue Ste. 100, Lakewood, CO 80215 Voice 720-898-3434 FAX: 720-898-3455
8831,Terry OWS McPcsment
October 18, 2010, Page 2
• permit documents. There are no vent or monitoring pipes extended to the surface in the
drainfleld to observe the field conditions. The drainfield area was walked and observed. No
signs of effluent surfacing were noted. Mr. Terry indicated that he has never seen ponding on
the drainfield area. And that the system has not given him any trouble in the years he has lived
at the site.
The as-built drawing from the 1975 installation indicates a `house' nearer the existing tank than
the current residence. In discussing this with the client, there was a trailer at the as-built
location that was moved, and the existing house was then connected to the system.
CONCLUSIONS AND RECOMMENDATIONS
COWC has reviewed the information provided by the client regarding the estimated water use
for the kennel operation. It is our understanding that there will be one, full-time occupant of
the residence, and one, part-time employee with an estimated 2-patrons per week accessing
the site. Dogs will be washed approximately six-times each, per year.
From the permit information, the system is designed to support a wastewater flow from 2-
bedrooms, which is 2-bedrooms X 2-persons X 75 GPD/person= 300 gallons average flow per
day, and 450 peak gallons per day, using a 1.5 peaking factor.
Kennel use wastewater generation is estimated to be:
1 full-time person X 75 GPD/person + 1 part-time employee X 15 GPD/person + 2 patrons X 5
• GPD/patron/5days= 92 GPD
COWC believes that the estimate of 5 gallons per wash for a dog weighing less than 30-lbs is
excessive. Using a nozzle that stops flow when the dog is not being wetted or rinsed would limit
the volume of water used, per dog, to more like 3 gallons each. Assuming that a dog will be
washed every 3.65-days we can round down to every 3-days to be conservative. On each dog
washing day, the total estimated flow to the OWS would be 95-gallons.
With a total of 300 GPD available, and using 95-gallons per day for the resident, worker and
patrons, a total of 205-gallons is available to wash dogs, which equates to 205-gallons/3-
gallons/dog= 68 dogs/day possible to remain within the design capacity of the system.
COWC discussed the kennel operation with Mr. Terry and MS. Pestotnik while at the property.
Both are aware of the volume of wastewater available per day, and have expressed concern
over using too much water at the site, due to the size of the well pump (5 HP), and the cost of
running it.
From the information provided and the calculations provided above, it appears that the existing
OWS can support the kennel operation that the client is proposing.
This letter provides an engineer's assessment of the condition of the existing OWS drainfleld
based on observed conditions and information obtained from the client and Weld County
Department of Public Health & Environment. No other information has been obtained, observed
or considered. This letter is not intended as a design, and should not be used to obtain installer
•
bids for a replacement drainfield.
B831, Terry OWS Assessment
October 18, 2010, Page 3
• If there are questions, or if you would like additional information, please feel free to contact us
at your convenience.
Sincerely,
CHURCH Onsite Wastewater ' I ultants, LLC ,/
•►•
Robert W. Wright, , '•
Principal /
- •
ec: Ms. Sharol Terry P- brequeenl@aol.com
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•
Hello