HomeMy WebLinkAbout20010055.tiff 471,,t ,64M,,\ Memorandum
TO: M. J. Geile, Chair
' Board of County Commissioners
CDATE: December 20, 2000 .- - ^A -eQp it
COLORADO FROM: Mark E. Wallace, MD, MPH, Director,
Department of Public Health and Environment
SUBJECT: Waste Water Contracts
Enclosed for Board approval are Purchase of Services Agreements for the sampling and
analysis of waste water between the Weld County Department of Public Health and
Environment and the following:
Town of Pierce Greeley Washout
Hewlett Packard Madison Lake Ski Club
All fees are in accordance with the fees established in County Ordinance No. 82-W, however
some agreements reflect a discount based on volume. The agreements are in the same
format as the 2000 agreements.
The term of the agreements is from January 1, 2001 through December 31, 2001. If you have
any questions regarding these agreement, please contact Connie O'Neill, Laboratory
Supervisor, at (970) 304-6415 extension 2273.
I recommend approval of these agreements.
Enclosures
2001-0055
POLLUTANT DISCHARGE
AGREEMENT FOR THE SAMPLING AND ANALYSIS OF POLLUTANT DISCHARGE
BY THE WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
THIS AGREEMENT is made and entered into this // day of,(J-242 ,
20oO , by and between the TOWN OF PIERCE , whose address is
,QO lNu n of a o• &J 5"7 - e cc , hereinafter referred to as "System, "
and the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Weld County Department of Public
Health and Environment, whose office is located at 1555 North 17th Avenue,
Greeley, Colorado 80631, hereinafter referred to as "Health Department. "
WITNESSETH:
WHEREAS, Weld County Ordinance No. 60-B authorizes the Weld County Health
Department to perform by agreement the testing of drinking water for suppliers
thereof and the testing of pollutant discharges for those persons and entities
holding permits to discharge pollutants into state waters, and
WHEREAS, Health Department possesses the necessary equipment and expertise
required to perform the sampling and analysis of the water for System as required
by federal law, and
WHEREAS, the services provided by Health Department pursuant to this
Agreement shall benefit the health, safety, and welfare of those persons residing
within the area served by System.
NOW, THEREFORE, in consideration of mutual promises and covenants contained
herein, the parties hereto agree as follows:
Section 1 - Authorization to Act: The System hereby authorizes the Health
Department to perform the services listed in this Agreement and in Weld County
Ordinance No. 60-B, for the testing of water on behalf of System. The provisions
of Weld County Ordinance No. 60-B are incorporated herein in their entirety.
Health Department shall act as an independent contractor in relation to the
System in the performance of the services set forth in this Agreement. None of
the Health Department employees and/or agents shall become employees of System,
and no employees of System shall be deemed or become employees of the Health
Department by virtue of this Agreement.
Section 2 - Term: This Agreement shall become effective on January 1, 2001, and
shall remain in full force and effective until December 31, 2001, unless and
until otherwise terminated sooner, pursuant to the provisions of Section 5 below.
Page 1 of 3
Town of Pierce
Agreement for the Sampling and
Analysis of Pollutant Discharge
Section 3 - Services to be Provided by Health Department: Health Department
agrees to provide the following services to System during the term of this
Agreement:
Type of Test Contracted Number of Samples Contracted Fee
Influent
BOD Monthly - collected $15 .55 each
TSS $ 7 .35 each
Effluent
Total Coliform Monthly - collected $25 .90 each
Dilution Series
Nitrate " $10.50 each
Nitrite $ 9 . 15 each
pH $ 1.65 each
Total Dissolved solids " $ 7.35 each
Chloride cc " $ 9 . 10 each
Sulfate $ 8.80 each
Total Organic Carbon $57 .75 each
testing done by Reference Laboratory
Monitor Well
Total Coliform Quarterly - collected $33 .05 each
Most Probable Number
Nitrate $10.50 each
Nitrite $ 9.15 each
pH $ 1 . 65 each
Total Dissolved Solids $ 7 .35 each
Chloride
$ 9.10 each
Sulfate $ 8. 80 each
Total Organic Carbon " $57 .75 each
testing done by Reference Laboratory
Sampling Fee $35 . 00/hr
Methods used by Health Department in providing said services shall be in
accordance with Section I (b) of the Weld County Ordinance No. 60-B. Health
Department shall provide further services as mutually agreed upon by Health
Department and System at times and for compensation as agreed to by the parties
hereto. By signing this Agreement and providing the services herein, Health
Department does not insure the accuracy of the results of any tests performed by
Health Department and does not make any representations as to the adequacy of
Systems compliance with federal or state law governing the sampling and analysis
requirements of Pollutant Discharge.
Section 4 - Release and Hold Harmless: The System agrees to release and hold
harmless Health Department from any and all liability and/or damages resulting
from the acts or omissions of Health Department in performing the services set
forth in this Agreement.
Section 5 - Termination: Either party may terminate this Agreement upon 30 days
written notice to the other party at the addresses set forth below.
Section 6 - Obligations and Duties of System: System shall perform all of the
obligations and duties set forth in Section II (c) of Weld County Ordinance 60-B.
In addition, System shall pay for the services rendered by Health Department
pursuant to this Agreement according to the contracted amount set forth in
Section 3, above, and/or as may be mutually agreed to by the parties hereto.
Payment shall be due within ten (10) days upon of receipt of the bill. Billing
will be sent within ten (10) days of the quarter ending; i .e. , March 31, June 30,
September 30, and December 31, 2001 .
Page 2 of 3
Town of Pierce
Agreement for the Sampling and
Analysis of Pollutant Discharge
Section 7 - Waiver of Immunities/Duty of Care: No portion of this Agreement
shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may now possess, nor shall any portion of this Agreement
be deemed to or created a duty of care with the respect to any persons not a
party to this Agreement.
Section 8 - Severability: If any section, subsection, paragraph, sentence,
clause, or phrase of the Agreement is for any reason held or decided to be
invalid or unconstitutional, such decision shall not affect the validity of the
remaining portions hereof. The parties hereto declare that they would have
entered into this Agreement and each and every section, subsection, paragraph,
sentence, clause, and phrase thereof irrespective of the fact that any one or
more sections, subsection, paragraphs, sentences, clauses, or phrases may be
declared to be unconstitutional or invalid.
Section 9 - Notices: All notices to the parties shall be sent to the following:
Entity: Town of Pierce Entity: Weld County Department of
Public Health and Environment
Contact Person: Ms. Lois Souther Contact Person: Connie O'Neill
Address: P. O. Box 57 Address: 1555 North 17th Avenue
City, State, Zip: Pierce, CO 80650 City, State, Zip: Greeley, CO 80631
Phone: (303) 834-2851 Phone: (970) 304-6415 ext 2273
pp�
Signed this /41 day of 41,U'c.�“.ui , 20 (Pc .
BY: / ,� �ttPi?-
J COUNTY OF WELD, STATE OF COLORADO BY
' SYSTEM" AND THROUGH THE BOARD OF COUNTY
COMMISSIONERS OF WELD COUNTY ON
BEHALF OF THE ELD COUNTY DEPARTMENT
TITLE OF AUTHORITY: OF PUBL C HE TH AND ENVIRONMENT
BY:
i , M. J. Geile�,*1s;r.1
!LH:L:12
ATTES Wel. C. nt erv�jJ o
"Th
BY:
Deputy Clerk to t
Approved by:
WELD COUNTY DEPARTMENT OF PUBLIC
HEALTH AND ENVIRONMENT
IMOLAI& f lk*C-m-'4&
Mark E. Wallace, MD, MPH
Director
Weld County Department of Public
Health and Environment
Paae 3 of 3
POLLUTANT DISCHARGE
AGREEMENT FOR THE SAMPLING AND ANALYSIS OF POLLUTANT DISCHARGE
BY THE WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
THIS AGREEMENT is made and entered into this 0 a.day of * ,
be een the GREELEY WASHOUT whose addrela
by is
20YO S , hereinafter referred to as "System, "
and the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Weld County Department of Public
Health and Environment, whose office is located at 1555 North 17th Avenue,
Greeley, Colorado 80631, hereinafter referred to as "Health Department. "
WITNESSETH:
WHEREAS, Weld County Ordinance No. 60-B authorizes the Weld County Health
Department to perform by agreement the testing of drinking water for suppliers
thereof and the testing of pollutant discharges for those persons and entities
holding permits to discharge pollutants into state waters, and
WHEREAS, Health Department possesses the necessary equipment and expertise
required to perform the sampling and analysis of the water for System as required
by federal law, and
WHEREAS, the services provided by Health Department pursuant to this
Agreement shall benefit the health, safety, and welfare of those persons residing
within the area served by System.
NOW, THEREFORE, in consideration of mutual promises and covenants contained
herein, the parties hereto agree as follows:
Section 1 - Authorization to Act: The System hereby authorizes the Health
Department to perform the services listed in this Agreement and in Weld County
Ordinance No. 60-B, for the testing of water on behalf of System. The provisions
of Weld County Ordinance No. 60-B are incorporated herein in their entirety.
Health Department shall act as an independent contractor in relation to the
System in the performance of the services set forth in this Agreement. None of
the Health Department employees and/or agents shall become employees of System,
and no employees of System shall be deemed or become employees of the Health
Department by virtue of this Agreement.
Section 2 - Term: This Agreement shall become effective on January 1, 2001, and
shall remain in full force and effective until December 31, 2001, unless and
•
until otherwise terminated sooner, pursuant to the provisions of Section 5 below.
Page 1 of 3
Greeley Washout
Agreement for the Sampling and
Analysis of Pollutant Discharge
Section 3 - Services to be Provided by Health Department: Health Department
agrees to provide the following services to System during the term of this
Agreement:
Type of Test Contracted Number of Samples Contracted Fee
Monitor Well Quarterly - as submitted
TDS
Ammonia $ 7.35 each
pH $11. 60 each
Chloride $ 1. 65 each
Nitrate $ 9. 10 each
$ 10.50 each
Oil & Grease (Visual) $ 1. 65 each
Fecal Coliform
$25. 90 each
Methods used by Health Department in providing said services shall be in
accordance with Section I (b) of the Weld County Ordinance No. 60-B. Health
Department shall provide further services as mutually agreed upon by Health
Department and System at times and for compensation as agreed to by the parties
hereto. By signing this Agreement and providing the services herein, Health
Department does not insure the accuracy of the results of any tests performed by
Health Department and does not make any representations as to the adequacy of
Systems compliance with federal or state law governing the sampling and analysis
requirements of Pollutant Discharge.
Section 4 - Release and Hold Harmless: The System agrees to release and hold
harmless Health Department from any and all liability and/or damages resulting
from the acts or omissions of Health Department in performing the services set
forth in this Agreement.
Section 5 - Termination: Either party may terminate this Agreement upon 30 days
written notice to the other party at the addresses set forth below.
Section 6 - Obligations and Duties of System: System shall perform all of the
obligations and duties set forth in Section II (c) of Weld County Ordinance 60-B.
In addition, System shall pay for the services rendered by Health Department
pursuant to this Agreement according to the contracted amount set forth in
Section 3, above, and/or as may be mutually agreed to by the parties hereto.
Payment shall be due within ten (10) days upon of receipt of the bill. Billing
will be sent within ten (10) days of the quarter ending; i.e. , March 31, June 30,
September 30, and December 31, 2001.
Section 7 - Waiver of Immunities/Duty of Care: No portion of this Agreement
shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may now possess, nor shall any portion of this Agreement
be deemed to or created a duty of care with the respect to any persons not a
party to this Agreement.
Section 8 - Severability: If any section, subsection, paragraph, sentence,
clause, or phrase of the Agreement is for any reason held or decided to be
invalid or unconstitutional, such decision shall not affect the validity of the
remaining portions hereof. The parties hereto declare that they would have
entered into this Agreement and each and every section, subsection, paragraph,
sentence, clause, and phrase thereof irrespective of the fact that any one or
more sections, subsection, paragraphs, sentences, clauses, or phrases may be
declared to be unconstitutional or invalid.
Page 2 of 3
Greeley Washout
Agreement for the Sampling and
Analysis of Pollutant Discharge
Section 9 - Notices: All notices to the parties shall be sent to the following:
Entity: Greeley Washout/Ed Duggan Inc. Entity: Weld County Department of
Public Health and Environment
Contact Person: Ed Duggan Contact Person: Connie O'Neill
Address: P. 0. Box 340 Address: 1555 North 17th Avenue
City, State, Zip: Windsor, CO 80550 City, State, Zip: Greeley, CO 80631
Phone: (970) 686-7403 Phone: (970) 304-6415 ext 2273
Signed this d- `, day of J�,y,,,,,� „ , 200/ .
( "SYSTEM"
COUNTY OF WELD, STATE OF COLORADO BY
"SYSTEM" AND THROUGH THE BOARD OF COUNTY
COMMISSIONERS OF WELD COUNTY ON
BEHALF OF THE W LD COUNTY DEPARTMENT
TITLE OF AUTHORITY: OF PUBLIC HEA H AND ENVIRONMENT
6� BY: �1
Chair M.`� ile (01/08[2001)
44)./(cfeg.4 I ~�
ATTEST• Weld County
Boa
BY:
Deputy Clerk to tee' :
Approved by:
WELD COUNTY DEPARTMENT OF PUBLIC
HEALTH AND ENVIRONMENT
1A0\C•tAk. /k0112-120tA
Mark E. Wallace, MD, MPH
Director
Weld County Department of Public
Health and Environment
Page 3 of 3
POLLUTANT DISCHARGE
AGREEMENT FOR THE SAMPLING AND ANALYSIS OF POLLUTANT DISCHARGE
BY THE WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
THIS AGREEMENT is made and entered into this 10 day of December
20 0Q1_, by and between the HEWLETT PACKARD whose address is
70U ist Ave. Greeley, CO , hereinafter referred to as "System, "
and the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Weld County Department of Public
Health and Environment, whose office is located at 1555 North 17th Avenue,
Greeley, Colorado 80631, hereinafter referred to as "Health Department. "
WITNESSETH:
WHEREAS, Weld County Ordinance No. 60-B authorizes the Weld County Health
Department to perform by agreement the testing of drinking water for suppliers
thereof and the testing of pollutant discharges for those persons and entities
holding permits to discharge pollutants into state waters, and
WHEREAS, Health Department possesses the necessary equipment and expertise
required to perform the sampling and analysis of the water for System as required
by federal law, and
WHEREAS, the services provided by Health Department pursuant to this
Agreement shall benefit the health, safety, and welfare of those persons residing
within the area served by System.
NOW, THEREFORE, in consideration of mutual promises and covenants contained
herein, the parties hereto agree as follows:
Section 1 - Authorization to Act: The System hereby authorizes the Health
Department to perform the services listed in this Agreement and in Weld County
Ordinance No. 60-B, for the testing of water on behalf of System. The provisions
of Weld County Ordinance No. 60-B are incorporated herein in their entirety.
Health Department shall act as an independent contractor in relation to the
System in the performance of the services set forth in this Agreement. None of
the Health Department employees and/or agents shall become employees of System,
and no employees of System shall be deemed or become employees of the Health
Department by virtue of this Agreement.
Section 2 - Term: This Agreement shall become effective on January 1, 2001, and
shall remain in full force and effective until December 31, 2001, unless and
until otherwise terminated sooner, pursuant to the provisions of Section 5 below.
Page 1 of 3
Hewlett Packard
Agreement for the Sampling and
Analysis of Pollutant Discharge
Section 3 - Services to be Provided by Health Department: Health Department
agrees to provide the following services to System during the term of this
Agreement:
Type of Teat Contracted Number of Samples Contracted Fee
Effluent
Chemical Oil & Grease Monthly $44.75 each
Differentiated Oil & Grease As required $44.75 each
pH Quarterly $ 1.65 each
BOD Quarterly $15.55 each
Total Suspended Solids Quarterly $ 7.35 each
Hexavalent Chromium Twice per Year $11.60 each
Methods used by Health Department in providing said services shall be in
accordance with Section I (b) of the Weld County Ordinance No. 60-B. Health
Department shall provide further services as mutually agreed upon by Health
Department and System at times and for compensation as agreed to by the parties
hereto. By signing this Agreement and providing the services herein, Health
Department does not insure the accuracy of the results of any tests performed by
Health Department and does not make any representations as to the adequacy of
Systems compliance with federal or state law governing the sampling and analysis
requirements of Pollutant Discharge.
Section 4 - Release and Hold Harmless: The System agrees to release and hold
harmless Health Department from any and all liability and/or damages resulting
from the acts or omissions of Health Department in performing the services set
forth in this Agreement.
Section 5 - Termination: Either party may terminate this Agreement upon 30 days
written notice to the other party at the addresses set forth below.
Section 6 - Obligations and Duties of System: System shall perform all of the
obligations and duties set forth in Section II (c) of Weld County Ordinance 60-B.
In addition, System shall pay for the services rendered by Health Department
pursuant to this Agreement according to the contracted amount set forth in
Section 3, above, and/or as may be mutually agreed to by the parties hereto.
Payment shall be due within ten (10) days upon of receipt of the bill. Billing
will be sent within ten (10) days of the quarter ending; i.e., March 31, June 30,
September 30, and December 31, 2001.
Section 7 - Waiver of Immunities/Duty of Care: No portion of this Agreement
shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may now possess, nor shall any portion of this Agreement
be deemed to or created a duty of care with the respect to any persons not a
party to this Agreement.
Section 8 - Severability: If any section, subsection, paragraph, sentence,
clause, or phrase of the Agreement is for any reason held or decided to be
invalid or unconstitutional/ such decision shall not affect the validity of the
remaining portions hereof. The parties hereto declare that they would have
entered into this Agreement and each and every section, subsection, paragraph,
sentence, clause, and phrase thereof irrespective of the fact that any one or
more sections, subsection, paragraphs, sentences, clauses, or phrases may be
declared to be unconstitutional or invalid. _
Page 2 of 3
Hewlett Packard
Agreement for the Sampling and
Analysis of Pollutant Discharge
Section 9 - Notices: All notices to the parties shall be sent to the following:
Entity: Hewlett Packard Entity: Weld County Department of
Public Health and Environment
Contact Person: John Hughes Contact Person: Connie O'Neill
Address: 700 71st Avenue Address: 1555 North 17th Avenue
City, State, Zip: Greeley, CO 80634 City, State, Zip: Greeley, CO 80631
Phone: (970) 350-4411 Phone: (970)304-6415 ext 2273
/ 111
Signed this /e/1 day of Cyre''e-L- , 201, .
BY: 1y COUNTY OF WELD, STATE OF COLORADO BY
" Y TEM" AND THROUGH THE BOARD OF COUNTY
COMMISSIONERS OF WELD COUNTY ON
BEHALF OF THE LD COUNTY DEPARTMENT
TITLE OF AUTHORITY: OF PUBLIC HE H AND ENVIRONMENT
BY:
' i Geile (01/08/2001)
61,114/0 /3v_, x4c-c(42- 64- C t M.
ATTEST Weld Co my
Bo
►1i1_, ,i_ ,, ,,,.ti �1
861
OBY:
Deputy Clerk to t ..r ..
ll
Approved by:
�.r
WELD COUNTY DEPARTMENT OF PUBLIC
HEALTH w _ - +�
AND ENVIRRONMENT
UV\ ` 1O04-e--&-C-)'&
Mark E. Wallace, MD, MPH
Director
Weld County Department of Public
Health and Environment
Page 3 of 3
POLLUTANT DISCHARGE
AGREEMENT FOR THE SAMPLING AND ANALYSIS OF POLLUTANT DISCHARGE
BY THE WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
THIS AGREEMENT is made an4et eked into this 5- day of Y Cefm
20OO, by and between the TER SKI CLUB , whose address is
BUte.� ( , hereinafter referred to as "System, "
and the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Weld County Department of Public
Health and Environment, whose office is located at 1555 North 17th Avenue,
Greeley, Colorado 80631, hereinafter referred to as "Health Department. "
WITNESSETH:
WHEREAS, Weld County Ordinance No. 60-B authorizes the Weld County Health
Department to perform by agreement the testing of drinking water for suppliers
thereof and the testing of pollutant discharges for those persons and entities
holding permits to discharge pollutants into state waters, and
WHEREAS, Health Department possesses the necessary equipment and expertise
required to perform the sampling and analysis of the water for System as required
by federal law, and
WHEREAS, the services provided by Health Department pursuant to this
Agreement shall benefit the health, safety, and welfare of those persons residing
within the area served by System.
NOW, THEREFORE, in consideration of mutual promises and covenants contained
herein, the parties hereto agree as follows:
Section 1 - Authorization to Act: The System hereby authorizes the Health
Department to perform the services listed in this Agreement and in Weld County
Ordinance No. 60-B, for the testing of water on behalf of System. The provisions
of Weld County Ordinance No. 60-B are incorporated herein in their entirety.
Health Department shall act as an independent contractor in relation to the
System in the performance of the services set forth in this Agreement. None of
the Health Department employees and/or agents shall become employees of System,
and no employees of System shall be deemed or become employees of the Health
Department by virtue of this Agreement.
Section 2 - Term: This Agreement shall become effective on May 22, 2001, and
shall remain in full force and effective until December 31, 2001, unless and
until otherwise terminated sooner, pursuant to the provisions of Section 5 below.
Page 1 of 3
Rocky Mountain Water Ski Club
Agreement for the Sampling and
Analysis of Pollutant Discharge
Section 3 - Services to be Provided by Health Department: Health Department
agrees to provide the following services to System during the term of this
Agreement:
Type of Test Contracted Number of Samples Contracted Fee
Bacteriological One per month (May through $11. 05 each
(E.coli - Quantitray) August)
Bacteriological
(Total Coliform - Drinking Water) as requested $8 . 50 each
Sampling Fee $35. 00 per hour
Methods used by Health Department in providing said services shall be in
accordance with Section I (b) of the Weld County Ordinance No. 60-B. Health
Department shall provide further services as mutually agreed upon by Health
Department and System at times and for compensation as agreed to by the parties
hereto. By signing this Agreement and providing the services herein, Health
Department does not insure the accuracy of the results of any tests performed by
Health Department and does not make any representations as to the adequacy of
Systems compliance with federal or state law governing the sampling and analysis
requirements of Pollutant Discharge.
Section 4 - Release and Hold Harmless: The System agrees to release and hold
harmless Health Department from any and all liability and/or damages resulting
from the acts or omissions of Health Department in performing the services set
forth in this Agreement.
Section 5 - Termination: Either party may terminate this Agreement upon 30 days
written notice to the other party at the addresses set forth below.
Section 6 - Obligations and Duties of System: System shall perform all of the
obligations and duties set forth in Section II (c) of Weld County Ordinance 60-B.
In addition, System shall pay for the services rendered by Health Department
pursuant to this Agreement according to the contracted amount set forth in
Section 3, above, and/or as may be mutually agreed to by the parties hereto.
Payment shall be due within ten (10) days upon of receipt of the bill. Billing
will be sent within ten (10) days of the quarter ending; i.e. , March 31, June 30,
September 30, and December 31, 2001.
Section 7 - Waiver of Immunities/Duty of Care: No portion of this Agreement
shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may now possess, nor shall any portion of this Agreement
be deemed to or created a duty of care with the respect to any persons not a
party to this Agreement.
Section 8 - Severability: If any section, subsection, paragraph, sentence,
clause, or phrase of the Agreement is for any reason held or decided to be
invalid or unconstitutional, such decision shall not affect the validity of the
remaining portions hereof. The parties hereto declare that they would have
entered into this Agreement and each and every section, subsection, paragraph,
sentence, clause, and phrase thereof irrespective of the fact that any one or
more sections, subsection, paragraphs, sentences, clauses, or phrases may be
declared to be unconstitutional or invalid.
Page 2 of 3
Rocky Mountain Water Ski Club
Agreement for the Sampling and
Analysis of Pollutant Discharge
Section 9 - Notices: All notices to the parties shall be sent to the following:
Wl udtSc, i Lktc c 5K,
Entity: .&.ockv Mou„tain, Ski Club Entity: Weld County Department of
Public Health and Environment
Contact Person: Amber & Grea Denzel Contact Person: Connie O'Neill
Address: 727 East 27th Street Address: 1555 North 17th Avenue
City, State, Zip: Greeley, CO 80631 City, State, Zip: Greeley, CO 80631
Phone: (970] 356-0001 Phone: (970) 304-6415 ext 2273
Signed this day of D-'` kr'if're- , 20 60 .
COUNTY OF WELD, STATE OF COLORADO BY
"SYSTEM" AND THROUGH THE BOARD OF COUNTY
COMMISSIONERS OF WELD COUNTY ON
BEHALF OF THE LD COUNTY DEPARTMENT
TITLE OF AUTHORITY: OF PUBLIC HE H AND ENVIRONMENT
BY:
ai , M. . Geile / 2001)
ATTEST Weld Co nt } EL
L ' lI
B•a' d
11 I�
BY:
Deputy Clerk t
Approved by: lJ
WELD COUNTY DEPARTMENT OF PUBLIC
HEALTH AND ENVIRONMENT
IA-A-Mt-A&
Mark Wallace MD, MPH
Director
Weld County Department of Public
Health and Environment
Page 3 of 3
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