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Home My WebLink About20232279.tiffWeld County Environmental Hea fth Services Department 1555 N. 17th Avenue Greeley, CO 80631 Phone: (970) 304-6415 Fax: (970) 304-6411 Web: weldhealth.org Septic Permit - Final Application Number: SP -1100101 Owner Name: LAZAR° LARA Site Address: 10409 CR 20 FORT LUPTON, CO 80520 App Type: Health\Residential\New\Septic LAZARC LARA 4951 F1LLMORE DENVER, CO 80216 Parcel #: 131114300001-R4482906 Legal Desc: PT S2SW4 14-2-67 LOT A REC EXEMPT RE -4147 App Specific Info: fina led Application Status: Ready to Final Applied Date: 0612412011 Issued Date: 10/10/2011 Finaled algid Date : (eli‘01 Location Description 10409 CR 20, FT LUPTON Associated Building Permit Yes Associated Building Permit Number MFG11-00043 Application Date 0+6/2412011 Septic Permit Expiration Date 06/24/2012 Waive Fees No Number of Persons 6 Number of Bedrooms 3 Basement Plumbing Yes Full Bathrooms 1 3/4 Bathrooms 0 1/2 Bathrooms 2 Private Water Supply Well Private Water Supply Permit Reference Number 266150 Parcel Acres 9.75 Actual Installation: Septic Tank: 7 D gallons Absorption Trench: sq ft Absorption Bed : 4411 b Chamber Model Design Type: E77415 sq ft Chambers NOTICE The issuance of this permit does riot imply compliance with other state, county, or local regulatory or building requirements, nor shall it act to certify that the subject system will operate in compliance with applicable state, county and local regulations adopted persuant to Article 10, Title 25, CRS as amended, except for the purpose of establishing final approval of installed system for issuance of a local occupancy permit persuant to CRS 1973 25-10-111 (2) This permit is non -transferable and non-refundable. The Weld County Department of Public Health and Environment reserves the right to impose additional terms and conditions required to meet our regulations on a continuing basis. Final permit approval was contingent upon the final inspection of the completed system by the Weld County Department of Public Hearth and Environment. t_gti 6,//41- Environptbyftal Health Specialist Date Report ID: EHS00033v006 Print Date Time: 4/30/2012 9:06:51 AM Page 1 of 2 Application Number: SP -1100101 Owner Name: LAZAR° LARA Site Address: 10409 CR 20 FORT LUPTON, CO 80520 „ida jags( Z. W Le" 4fsgA% 114-46 }ku ?o i'4l lb\ 100 411 eivik 11KOup how *0 4, revfrit d lc- 14 cow cc/ Er s eis e rot wie COALre '1'• 64y Aft ee /Wu 7k. k_, --I a , -Pd -c' ,. Lacc., ,e Z.,- , ., , C) exit.., -,c' `- 2e ibj ',o „it J's r y R Gam-" ri - '.�� air- `"t' 1 e ta( 63) snerarer ,stv ct r fah rizr-of � W!s1/a- ��'.ja PaAMen unG Aewittor! Kiva hp hued, ,•••- J4avo 34--eytea t1/4 tatei ettelet tae Sca i)A, &A.Per ;ftIN4C ofe-ebovo-n) Eee-oftei yrs b 'tots /me iier‘da.7 /At ipeurnk dm, bee 614% 47, � � �f� w""r rST [at' toisba 0611x* etc to /S0a 7; a el ID 0-4--1 etkav e -D- 2,4 f -et) 1-4-11 Semi .- crate, 171 eint --� ice, AL-) S -6,,,f0 tee 0- 54p2e eseL- ),jvL - a' - � Y rY granft-a rJ,�i�� c epee - "ate a r‘se l_afier (.\\0 ta• r S2CX 3i 1 r 4=•-/St)Asof ip-ethcvo de ler — __ - ___ .W —a wore 0I I I I I MI Is • 0O 4 - Irma I Report ID: EHS00033v006 Print Date Time: 4/30/2012 9: 00: 81 AM Page 2 of 2 sr<iNsir HIGH PLAINS ENGINEERING &_DESIGN, LLC 721 4th STREET, SUITE D, FORT LIPTON, CO 80621 • PHONE: (303)-857-9280 • FAX: (303)-857-9►238 June 5, 2012 Mr. Adame Lazaro Lara 4957 Fillmore lmore Street Denver, CO 80216 RE: Observation of the septic system for the house located at 10409 Weld County Road 20, Weld County, Co. Job #11-2396 To Whom It May Concern: We made an observation on June 4, 2012 of the septic system at the above -described site and found that it was constructed in an adequate manner. The system consisted of a 1000 -gallon two -compartment septic tank, distribution box, and a 30' x 80' rock -and - pipe bed with five 4 -inch perforated lines. Positive slope of the septic line was confirmed from the house to the septic tank, and tank to absorption field. The system will be covered with geotextile fabric and backfilled with suitable E.T. sand supplied by L.G. Everist company (50/50 mix wicking sand) from the WCR 18 plant, and Select Materials company. Please call this office if you have any questions or concerns. Sincerely, Todd M. Schroeder, PE Copy: Governing Health Department, file This report was prepared for the exclusive use of our client and is not intended for any other purpose. Our report is based on the information made available to us at this time. Should additional information become available, we reserve the right to determine the impact, if any, of the new information on our opinions and conclusions, and to revise our opinions and conclusions if necessary and warranted by the discovery of additional information. { 'Me COLORADO Application Number: Owner Name: Site Address: App Type: Applicant Name: Parcel Number Legal Desc: Weld County Environmental Health_ Secea Dep Martment 1555 N. 17th Avenue Greeley, CO 80631 Phone: (970) 304-6415 Fax: (970) 304-6411 Web: weldhealth.org ealth . o rg Septic Permit New SP -1100101 LAZAR ° LARA 10409 CR 20 FORT LUPTON, CO 80520 Health\Residential\New\Septic LAZAR° LARA 4951 FILLMORE DENVER, CO 80216 131114300001-84482900 PT S2SW4 14-2-67 LOT A REC EXEMPT RE -4147 App Specific Info: Location Description 10409 CR 20, FT LUPTON Application Date 00/2412011 Septic Permit Expiration Date 06/24/2012 Waive Fees No Number of Persons 6 Number of Bedrooms 3 Basement Plumbing Yes Full Bathrooms 1 3/4 Bathrooms 0 1/2 Bathrooms 2 Private Water Supply Well Private Water Supply Permit Reference Number 266150 Parcel Acres 9.75 Application Status: Final Pending Applied Date: 06/24/2011 Intake Person: SCERRILLO Permit Expiration Date: 06/24/2012 Report ID: EHS00027v005 Print Date - Time: 10/10/2011 2:51:02PM Page 1 of 2 let* Wf`O� COLORADO Application Number: Owner Name: Site Address: Percolation Rate % Ground Slope Weld County Environmental Health Services_tent b 1555 N. 17th Avenue Greeley, CO 80631 Phone: (970) 304-6415 Fax: (970) 304-6411 Web: we ld health . o rg Septic Permit New SP -1100101 LAZAFD LARA 10409 CR 20 FORT LIPTON, CO 80520 ej Engineering Design Required Limiting Zone ft in Description Direction Soil Suitable (YV N) _ In 100 Year Flood Plain ( From the application information supplied and the on -site soil percolation data the following minimum installation specifications are required: Septic Tank gallons Absorption Trench sq ft Chambers: Standard Biodiffuser Infiltrator Quick4 Standard or Hi Capacity BioDiffuser Arc 36 Standard or Hi Capacity Infiltrator Quick4 EQ36 Infiltrator Quick4 Plus Standard Low Profile or Absorption Bed sg ft Trench Bed Trench Bed Trench Trench Trench All Weld County ISDS regulations apply. In addition, this permit is subject to the following additional terms and conditions: Bed Bed Bed NOTICE This permit is granted temporarily to allow construction to commence. This permit may be revoked or suspended by the Weld County Department of Public Health and Environment for reasons set forlh in the Weld County Individual Sewage Disposal System Regulations including failure to meet any term or condition imposed thereon during temporary or final approval. The issuance of this permit does not constitute assumption by the department or its employees of liability for the fail rue or inadequacy of the sewage disposal system. jas rmit is non-trawl/enable and non-refjOable. Before issuing final approval of this permit the Weld County Department of Public Health and Evnironment reserves the right to impose additional terms and conditions required to meet our regulations on a continuing basis Final permit approval is contingent upon the final inspection of the completed system by the Weld aunty Departm -rt of Public Health and Environment. X Environmental Health Specialist Date Report ID: EHS00027v005 Print Date - Time: 10/10/2011 2:51:02PM Page 2 of 2 WiDe COLORADO Application Number: Owner Name: Site Address: App Type: Applicant Name: Parcel Number: Legal Desc: V e!d _county Environmental Health Services De 3artme nt 1555 N. 17th Avenue Greeley, Co 80631 Phone: (970) 304-6415 Fax: (970) 304-6411 Web: weIdhealtfi .org Septic Permit New SP -1100101 LAZARO LARA 10409 CR 20 FORT LUPTON, Co 80520 Health\Resi den tial\ Nevi\Septic LAZARO LARA 4981 FILLMORE DENVER, Co 80216 1311143000Q1-84482906 PT S2SW4 14-2-67 LOT A REC 7MPT RE -4147 Application Status: In Review Applied Date: 06/24/2011 Intake Person: SERRILLO Permit Expiration Date: 06/24/2012 App Specific Info: Location Description Application Date Septic Permit Expiration Date Waive Fees N umber of Persons N umber of Bedrooms Basement Plumbing Full Bathrooms 3/4 Bathrooms 1/2 Bathrooms P rivate Water Supply Private Water Supply Permit ReferencO Number 266150 Parcel Acres f 9.75 f r 104008 20, FT LUPTON 0012412011 06/ 412012 lie 3 Yes 1 0 2 Well Report ID: EHS00027v005 Print Date - Time: 6/24/2011 2:25:59PM Page 1 of 2 tvJAPc Weld County Environmental Health Services Department 1555 N. 17th Avenue Greeley, CO 80631 Phone: (970) 304-6415 Fax: (970) 304-6411 Web: weldhealth.org Ith . o rg Septic Permit New Applic. ion Number: SP -1100101 ner Name: LAZAR° LARA SitAddress: 10409 CR 20 FORT LIPTON, CO 80520 a Percolation Ra - Limiting Zone W ft in Description % Ground Slope Direction P3 -E.- Engineering Design equired N Soil Suitable (Y In 100 Year Flood Plain (Y/0) From the application inforrnat .n supplied ang thg on -site oil percolation.data the followin m as lc%) •No-A-titi Ciev't ctioi Septic Tank g:lions Absorption Trench sq ft Chambers: Standard Biodi fuser Infiltrator Quick Standard or Hi Capacity BioDiffuser Arc 3; Standard or Hi Capacity Infiltrator Quick4 E 36 Infiltrator Quick4 Plus\Standard Low Profile imum ip,stallapas ifica or Absorption Bed Trench Trend Trench nch Trench ors ar equired: i‘\qC) sq ft Bed Be Be Bed All Weld County 'SOS regulations apply. In addition, this permit is st. bject to the following additional terms and 14‘.n0A-P RN%)rl 1:11)tAr), conditions: M�-‘. -ro ttislG' DkS v.1 C_ S NO T IC E This permit is granted temporarily to allow construction to commence. -Rikpermit may be revoked or suspended by the Weld County Department of Public Health and Environment for reasons set forth in the Weld County lgctividu al Sewage Disposal System Regulations including failure to meet any term or condition imposed thereon during temporary or final approval. Theisuance of this permit does not constitute assumption by the department or its employees of liability for the failrue or inadequacy of the sewag gisposal system. This rmit i mart-trransf cable and non-refundable. Before issuing final approval of this perrnit the Weld County Dep went of Public Health and Fvnironment reserves the right to impose additional terms and conditions required to meet our regulations on a continuin basis. Final permit approval is contingent upon the final inspection of the completed system by the Weld Cty Departme of Public Health annvironment. X Environmental Health Specialist Report la EHS00027v005 Print Date - Time: 612412011 2:26:59PM 26: 59 P M Date N ti Page 2 of 2 ....'...r p: r L .....—::1 �.:�:_.. .�+. r�kS.�iFaV-V ��vw N�iLA=-0�' �F - : ' .' - •. . p- J.:.. F••••• •••••: P :: �.A: a•'�SC•'.4rAY'. = M... �. Weld County Environmental Health Services .Department 1555 N. 17th Avenue Greeley, CO 80631 Phone: (970) 304-6415 Fax: (970) 304-6411 www.co.weld.co. us Septic Permit Application Application Number: SP -1199101 App Type: Flealth\Resit ential\Ne r1 eptic Applicant Name: LAZARO LARA 4981 FILLMORE DENVER, CO 80216 Owner Name: Parcel #: Legal Desc: Site Address: App Specific Info: LAZARO LARA 181114800001-84482906 PT S2SW4 14-2-87 LOT A REC EXEMPT RE -4147 10409 CR 20 FORT LUPTON, CO 80520 1/2 Bathrooms 814 Bathrooms Basement Plumbing Full Bathrooms Location Description N umber of Bedrooms N umber of Persons Parcel Acres P rivate Water Supply 2 0 Yes 1 10409 CR 20, FT LUPTON 3 6 9.75 Well TERMS AND CONDITIONS A permit fee, as set by separate ordiance of the Board of Weld County Commissioners, shall be required of applicants for new individual sewage disposal systems (ISDS), payable at time of application. Permit fees are non-refundable; permit applications are non -transferable. If both a building permit and an ISDS are issued for the same property and construction is not commenced prior to the expiration date of the building permit, the ISDS permit shall expire at the same time as the building permit. If an ISDS permit is issued for a property that does not require a building permit, the ISDS permit shall empire one year after its issuance if construction on the septic system has not commenced. Any change in plans or specifications after the permit has been issued invalidates the permit unless approval is secured from the Health Officer or his/her designated agent. Expired permits can be renewed by payment of the permit fee only if: A. There has been no change in the plans and specifications of the proposed system as set out in the original application or such change is reviewed and approved by a Division Representative. B. The surrounding land, its use or zoning has not changed so -as -to cause the original application not to be acceptable under these regulations. NOTICE The completeness of this application is conditional upon further mandatory and additional tests and reports as may be required by the Weld County Department of Public Health and Environment (WCDPHE). The issuance of the permit is subject to such terms and conditions as deemed necessary to insure compliance with rules and regulations adopted under article 10 title 25, CRS as amended. The applicant certfies that the proposed system will not be located within 400 feet of a community sewage system. The undersigned certifies that all statements made, information and reports submitted herewith are, or will be, represented to be true and correct to the best of his/her knowledge and are designed to be relied on by the WCDPHE for evaluation for purposes of issuing the permit applied for herein. Applicant further understands that falsification or misrepresentation may result in the denial of the application or revocation of any permit granted, and in legal action or perjury as provided by law. X Owner/Applicant Date CCLORADO SEPTIC PERMIT [NFORMATION FORM To obtain an I.S.D.S, permit, one must file an "application for Individual Sewage Disposal System" at the Weld County Environmental Health Services office and pay the application fee. A "repair" fee shall be charged for the expansion, replacement, or repair of an existing system. The following information must be provided on the septic information form. COMMERCIAL PERMIT NEW or REPAIR $850.00 VAULT PERMIT NEW or REPAIR $250:00 ENTIAL PERMIT r REPAIR S750.00 MINOR REPAIR PERMIT Sl00 _00 PARCEL NO.: I? J LI 3 to() (12 DIGIT WLB ER LEGAL DESCRIPTION: SECTION a... T��N P RANGE ACRD SUBDIVISION' LOT BLOCK FILING THIS INFORMATION CAN BE OBTAINED FROM THE ASSESSOR'S OFFICE AT (970)353-3845 EXT 3650 SiiL ADDRESS 1 C 0 cA cle-L ? let 4\3 DIRECTIONS TO SITE PROPERTY OWNER: Lest- C. MAILING ADDRESS: Y&j �I HOME PHONE: ( ) WORK PHONE OO) WO 9 79 3 FAX EMAIL ADDRESS: 043/44r. et, CITY Sgaiti • 5T CLiC5 ZIP APPLICANT NAME: MAILING ADDRESS: CITY HONE PHONE: ( ) WORK PHONE ( )---_ _ EMAIL ADDRESS: DESCRIPTION OF BE.DIN (EX: HOUSE, MOBILE HOME, MODULAR, SHOP, at - ICE) ST ZIP FAX ( ) IF OBTAINING A REPAIR PERMIT, WHAT IS BEING REPAIRED? NUMBER OF PERSONS NUMBER OF BEDROOMS a#3 BASEMENT PLU vIBL C S r NO BATHROOMS: FULL 3A 1 PUBLIC WATER SUPPLY YES 1+. N 11 PRIVATE WATER SUPPLY S i NO NAME IN FLOOD PLAN AREA? YES /NO PERCOLATION HOLES MUST BE MARKED FOR INSPECTION OR A S50.00 FEE WILL a CHARGED CENSUS TRACT PERMIT # 2b(c713'O fht)ititi__ ) ats .raare es. r+ } • ce•-1/6 NO' -r-s1 .HIGH PLAINS ENGINEERING & DESIGN, LLC 721 4th STREET, SUITE D, FORT LUPTON, CO 80621 • PHONE: (303)-857-9280 • FAX: (303)-857-9238 October 3, 2011 Mr. Ada me Laza ro Cara 4957 Fillmore Street Denver, CO 30216 r, 790- 7°-8793 RE: To provide an ensue wastewater system for the proposed 3 bedroom home at 10409 WCR 20, Weld County, CO Job # 11-2396 SEPTIC SYSTEM DESIGN DATA: The purpose of this design is to provide a septic system for a 3 bedroom single family home. The percolation test for the site performed by High Plains Engineering & Design had an average percolation rate of 74.1 minutes per inch (MEl). FOR TRI-COUNTY: ABSORPTION AREA (A) : The evapotranspiration computations are from the Tri-county Health Department Guidance Manual For Sizing E.T.. Beds. An allowable soil absorption rate of 0.20 GPD/SQ.F 60 to 90 I PI) was used for our computations. Therefore; use one E.T. bed 27' x 90' backfilledand as _specified. DOTE: An E.T. sand sample will be submitted to the Engineer for analysis before being placed in the bed. The Engineer and Health Department will inspect the site when infiltrators, plastic liner (if required), septic tank and all components are in place. A final inspection may be made when the system is completed. A 10 Mil. (min) plastic liner may be required because of the existing slope of natural ground and the limiting bed depth of the E.T. system. Place the liner around the perimeter of the bed where finished E.T. bed grades are filled above existing natural grades (Typj. One absorption bed is required, with 3 rows of 21 High Capacity Q4HC Infiltrators installed in the bed for a total of 63 Q4HC Infiltrators ALTERNATE 301 x 8Ot ROCK & PIPE BED DESI : On9 e bed is required, with 5 rows of perforated pipe in a "Rock and Pipe" absorption f a • • a i •e will be encased in 3/4}' to 2-1/2" gravel per governing specifications and backfilled Sri • E.T. sand . detailed in the cross section. The 12 -inch layer of aggregate shall consist of clean, washed, graded gravel or rock to range in size from 3/4 inch to 2-1/2 inches with an average size of 1-1/2 inches. The rock shall extend from 2 inches above the top of the pipe, level across the bed, to 6 inches below the bottom of the pipe. The top of the rock shall be covered with landscape fabric to prevent the gravel from becoming clogged by earth backfill. SEPTIC TANK SPECIFICATIONS: 4 Install a 1000 -gallon min. capacity septic tank, with two (2) compartments or units in series. **A lift pump may be required if the Weld County minimum specifications of 1/8" per toot of fall between the house, septic tank and the distribution system cannot be met, (See lift pump detail) All construction is to be in accordance with Weld County Colorado Department of Public Health and Environment's Individual Sewage Disposal System Regulations. Certification: I hereby certify that the septi � .- =�i , own on this plan was made by me or under my direct supervision and is °courat fi Todd M. Schroeder, P y knowledge or belief. E.T. (Evapotranspiration) Sand Specifications: SIEVE SIZE % PASSING 4 40 200 100 50-55 <1S Attachments: E.T. bed water balance sizing spreadsheet Figure 1: Chamber & Rock & Pipe bed section views Figure 2: Lift pump detail (if needed) Figure 3: Septic system site plan Profile Hole Log i _ 3 4 5 9 SANDY SILT ( M) 13 CLAY WIN LOW PLASTICITY (CL) 2 1 P- 4_ • • a. t. ■ ; br c; ler - h l rv. {C 4'• a A 4 - - r - TIII-COUNTY HEALTH DEPARTMENT 1 - EVAPOTRANSPIRATION BED WATER RA.LAU CE SIZING Sf'ftEADSt1EET - --- 1 1 — , 1 - USER INPUT PARAMETERS _ i _-�-._ f _. . T TRIAL I At Dale Flow A Cell - Allow, . Soto MONTHLY MONTHLY BEO AREA, f . �c-Qri& 1.Z per Badm rov7 Flaw Abf Rata 7 PREQt 7 I ET inau44-_lea (13P19 sIViligtll (SEE ?Emily) BELOW}.__ .2 (SEA WO 3 - _ 150 (54 0,201 I ■Irntl, nu 1 TOTAL _ %TATU M' BED 1 - _-_ _iv PQROSLTY7 _ 4.2. 0.4117 ^� MOTfili FRECLP..* RUNOFFS NET OUTPUT PUT r1 t 17PPEJ% UPPER - 1PtftLTRa- tEmig ' � Pc' rrt 40% tcnwria. WA cam. 11044 14%.COWS), I0tit L LL, t t n41 i Lelia! r ... _ f"''cHt1I l YEL Mt — - __ _____ JANUARY usa 0.09 0A9 I 030 vTL CD FEB 0.93 0.21 0.72 JANUARY I MARCH I- 4, 0ili< 37 _.�1 i 4.69 Fl=S SS% APRIL 1 2.0'5 •- 0.04 --- $.01 1,10 '_ 1Cfl It -1.41$ � lb 14 511 2.09 APRIL ..mmai ON JUNE 1..6 0.03 113 4.57 MAY .,. 41114 -. ULY 2.45 : -0.06 1 2.39 52$ - NE 657 AUGi1ST I 1.78 0.04 1.72 2..53 JI.&Y 15% EFT __- 1.76 0.04 1,72 3.62 AUGUST �CS% _ OCT i ` 110 0.02 1.4}e 2.04 SEPT ;St UOV 1.02 0.01 1.01 0.72 OCT 45% 0.71 - - DEC 1—... .j. 4.05 0,66 it -61 N0V 4S%. TOTAL _. 71 OM 2031 27 CC 5S% WATER AND EFFLUENT INTO BED MONTHLY P1 CIPITAUON INFILTRATION MONTHLY AV'ERACE EFFLUENT WO BED arm M4TO BED Mat+L1l•1 4rrr�la. s I Canino I eiticb4c r -.a tae 3 Gallons Culrtc Feot JAd4UART 0.40 Tn. 911 9.32 13950 1865 E6 0.72 1077 144 t-42 I2'690 11.$84 _ ARCH - 137 2050 274 0-32 135i50 1665 APRIL Z01 3007 402 4.0.2 139]4 _14O5 AY 5.21 779-4 1042 11.32 13954 1865 1.t.] 2738 366 0.02 113.504 111 ' - - ULY 7.3Q 3575 478 132 139543 1865 AUGUST 1-72 344 t-32 13950 1065 _2573 SEP i 1- 2573 344 4.021$t3 C2 13500 5 '- 0CT 9.0* 16616 _ 2113 14.32 13950 1465 OW • 1.41 1st 1 202 4.02 13500 1$135 FEC - 01-@ 957 132"" 4..32 13997 1065 WATER OUT OF BED • MOUfil ' S ABSORPTION RATE MONTHLY EVAPOITRAKIPIRATION RASE - ,AINUA43Y 9.95 - 14080 1984 050 744 100 ED 11.93 17440 17$7 0.45 689 92 ARCH 4.45 141w) 1989 0.69 1032 �. 138 PR& 4.63 14400 inS 1..18 1765 230 Y I 9.05 148410 1009 2i91 - - 312:7 414 NNE 1.63 14400 1.2'S 4.67 6986 434. _ Y 0.95 146110 1988 112$ 12342 1650 °GUST _ 4 .95 14840 19.9 2..53 3785 506 SEPT 0.63 14400 11125 3.42 5.4416 724 OCT cos' 14da4T 19.03 2.04 3+,752 404 CV • 11.663 14400 1025 0.i 2 ---- i 977 144 'F G 1?.9'S 1 840 1889 0,41 413 T22 I -- . 1 -111 -- .. ° 1 -COUNTY HEALTl- DEPARTMENT EVAPOTRANSPIRATION BED WATER BALANCE sing° SPREADSHEET INITIAL WATER CONTENT WITHIN TOTAL AEU TOTAL STOtiAGE WISED _ BED VOLUME (No Water In Bed) (Assumo n Bad Kee Operated Tot 1 �. is k f..q voulecit, rrnmij viewing I aria: hi t r 4 ++ ++ c+rarc It + I 5400 0.417 11.50 17651 2360 • 0.285 1154✓, 1543 -, TOM AVAR-AKE StOFIAQE lt4 BED (INCHES) 1 % TOTAL ` 7,72 STORAGE _ �, ._l . {-� M{}l_dlf INCHES ! a*u 1a1I1t_ PT I `. _. ' 65% sillitia�2 &4g+--4 5107 516 — � �-�. _ _ I - - J L-. I!, _{ WATER STORAGE IN BED AT END OF MONTH lial ACTUAL ACTUAL ACTUAL TQTAL -- . - STORAGE STQRAGSTORAGE,' Cubic STORAGE STORAGE All 1y^ { 410 l+tcitea Gallons 1 eackisli Feat ' Cri! f4L1 M_d_'T_RJIZEt IN' e. 8 1154[4 11544 I 15043 1541 _ 65% 4 NUA1 T 7 4. .. 10.599 11544 I 14417 1$41 irk Val - 7 i 1t. 11093 11S44 1443 114-1 45 MARCH 8 ________A_____, 1 1161 11431 1555 15ss 4$3; AAPRIL 1 __ 4 11473 11473 1604 � --_ 1401 J IC. . `MAY ° 11 t 1 i 15711 15711 2100 21014 i4 -DUNE I 7 4 10562 11$44 1412 1943 (5% ' JULY 1 1 44.47 115 _ 241 1 S 05 4lUGIJST 6 I r $402 11544 1257 1513 SS`,G SEPT 5 It 7502 11544 $043 1.543 - —5616 OCT 5 44 017a -m-114 1227 1641 ISV. N0V 7 4 11073 11544 1481 1543 15% DEC 7 4 • 10689 11544 1420 1143 651%1. - r i 1 EXISTING _ c�J M•l d i 2% BACKFILL 'l E.T. SAND. 30' 4" SANDY TOPSOIL \. / 2% 3/4" TO 2-1/2" GRAVEL (TYP. FIGURE 1: BED CROSS SECTION SCALE: 1/4" = 1t-0" 61 GEOTEXTILE FABRIC EXISTING GROUND PLACE 10 MIL (MN) PLASTIC LINER 1' BELOW EX. GRADE WHEN BED DEPTHS ARE RAISED ABOVE HIGH PLAINS ENGINEERING & DESIGN, LLC 721 4th STREET, SUITE D, FORT LUPTON, CO 80621 PHONE - (303) 857-9280 FAX (303) 857-9238 HIGH CAPACITY INFILTRATOR (TYR ) 2% ( BACKFILL WI E.T. SAND ) 4" SANDY TOPSOIL 2% 4:76„ f •t -f" EXISTING PLACE 10 MIL (MIN) PLASTIC LINER WHEN E.T. BED GRADES ARE FILLED ABOVE EXISTING GRADE, FIGURE 1: CHAMBER BED CROSS SECTION SCALE: 1/4"-I1 GROUND HIGH PLAINS ENGINEERING &DESIGN, LLC 721 4th STREET, SUITE D, FORT LUPTON, CO 80621 PHONE - (303) 857-9280 FAX - (303) 857-9238 22"LID LITTLE GIANT 101 HW ALARM & CONNECTION BOX MOUNTED INHOUSE SE (OR EQUIVALENT) -.---- - - -I 1 I� ALLOW SUFFICIENT�CABLE'fQ REMOVE PUMP UNDERGROUND CABLE RAM -NECK & GROUT WATER TIGHT 9 4" C . P.I INLET FROM SEPTIC TANK 300 GAL. TANK (MTN) ELBOW MAYARA SEALED AC'S -1 CONTROL & - CONNECTION BOX 2" SCH 40 P.V.C. PIPE (TYP.) HIGH WATER ALARM FLOAT OOULDS MODEL 3871 (MIN.OR EQUIV.) SUBMERSIBLE PUMP 8" CONC. BLOCKS 11" ftL CONCRETE BRICK OR BLOCK RISER 24" CLEAR AS REQUIRED THREADED UNION FOR PUMP DISCONNECTION GATE OR GLOBE VALVE 2" SCH 40 P.V.C. PIPE (TYP.) BUSHING ADAPTER 4" C.I.P. TO if- SOLID GROUND MALE ADAPTERS r PUMP ON LEVEL E PUMP ON I, LEVEL MALE ADAPTER 300 GAL. MIN PUMP TANK DETAIL SCALE: N.T.S. FIGURE 2 RAM -NECK & GROUT BOTH INLET & OUTLET WATERTIGHT DRILL I" HOLE N BOTTOM OF PIPE LEVEL CONTROL SWITCH SITE MAID FROPOSED HOME 11511N1 POLE BARN LEGEND 10409 Weld County Road 20 Weld County, CO c.o. i 54' 96' 1000 GAL. (MIN.) SEPTIC TANK �. ..� LIFT PUMP 1F NECESSARY r J 27 - TO PERC PROFILE • -Percolation Test Hole X -Percolation Profile Hole A Soil Profile Hole X - fence 90' DISTRIBUTION BOX 2T X 90' BED WITH 3 ROWS OF 21 "QUICK 4" HIGFI CAPACITY INFILTRATORS or 301X 80' BECK WITH 5 ROWS OF 4" PERE. 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S "• . . :'.Yd9>/S}F,`t�r�4ei'i<:> : r.arga Or tarxl£,-i�,iry-' %pc.• Yair .a. 1$11:;..r.:214114:•>:;:a.471:fr4:•44104,41/iiir&ltd;" • • • • • 08/29/2011 MON 9:28 FAX 303 857 9238 High Plains Engr. &Design 2002/011 Weld County Health Department Percolation Test and Soils Data 7/11/2011 HGH PLAINS ENGINEERING 8c DESIGN LLC 721 4th SZR�EEi', SUITE D, FORT UPTON, CO 80621 • PHONE (343)-$57-9280 • FAX: (303)-857-9238 FILE NO. 11-2396 • roped Ad* ress 10409 WELD COUNTY ROAD 20 ega , escrnp ion WELD COUNTY, CO Corrtac rrfr� nation Name ADAM E LAZARC SARA Street 4957 FILLMORE STREET City, State, Zip DENVER, CC) 80216 Phon - (720) 470-9793 Saturation and3`�ling I Smeared Surfaces Removed; YES and 6iGrave& Added:INO Groundwater Encountered at REATER THAN 9 idfeet Date and Time Presoak, 6/30/2011 date Water Added:! rime Amount of Presoak Water Added: 15 gallons Estimated depth to maximum seasonal water table if not: encountered in profile:; Date and Time Percolation Test 71112011 date Started: 11:00 time - Is area believed to be subject to seasonal fluctuations which could result in a seasonal water table within 80 of surface? Did Water Remain in Hole After the Overnight Swelling Period? oe 'Fiore Z" NO Hole 3 YES YES Hole 4 NO Hole 5 _ e e a uo ate _ Measurement YES YES Deep (In) Slope Determination in Absorption Area to the 1.0 NORTHEAST direction Bedrock Encountered • GREATER THAN 13 feet rercoiatiorl Rate (miniin) Estimated depth if not encountered in profile: Hole 1 Hole 2 Hole 3 36 55.50 36 83.33 36 83.33 Hole 4i Hole 5 36 55.56 36 83.33 Hole 6 36 83.33 Average 74.07 Type of Bedrock: Is bedrock fractured or weathered? _ Is bedrock believed to be permeable' (mac rate c 60 min/in)? 08/29/2011 MON 9:28 FAX 303 857 9238 High Plains Engr. &Design 0003/011 Depth in Feet Weld County Health Department Percolation Test and Soils Data Profile Hole Information (10nt1) Note: Soils must be classified using unified system ASTM 02487 Profile Hole Log 7/11/2011 SANDY SILT (SM) 13 CLAY WITH LOW PLASTICITY (CL) ertification I certify that the above information is correct and complete to the best of my knowledge and that all tests were performed in the accordance with the provisions of Weld County Health Department individual sewage disposal regulations by myself . or under my supervision. Signature Date High Plains Engineering & Design LW 721 4th Street, Suite D Ft. Lupton, CO 80621 303-857-9280 08/29/2011 MON 9128 FAX 303 857 9238 High Plains Engr. &design 1004/011 SITE MAF' 0409 Weld County Road 20 Weld County, CO I -I POLE LBAgIN O a 5 ...4 0 0 X 4J0' LP COUN1Y ROAD 20 LEGEND o - Percolation Test Hole X - Percolation Profile Hole A- Soil Profile Hole X -Fence AR Locations shown above are based on specific is information furnished by others or estimates made in the field by ligh Pains Engineering & Design personnel. The locations, distances, directions, etc, are not the result of a property survey but are approximations and are not warranted to be exact. It is the owner/builder's responsibility to define property - boundaries and ensure all onsite improvements are located within the platted site rind out of inappropriate easements. AR distances are to be verified prior to excavation. 08/29/2011 MON 9: 28 FAX 303 857 9238 High Plains Engr. &Design IZ005/011 HIGH PLAINS ENGINEER MG .& DESIGN, LIC 7214th STREET, SUITE D, FORT LItF'TON, CO 80621 # PHONE: (303)-857-9280 • FAX; (303)-857-9238 August 4, 2011 Adame Lazaro Lara 4957 Fillmore Street Denver, CO 80216 a—Drip-Ir- -ati n- SiteWastewater-SysteirrOWS5 10409 Weld County Road 20, Weld County, CO. Job #11-2396 To Whom It May Concern. Based on a Percolation Test and Soils Data Form Job No. 11-2396, by High Plains Engineering Design, LL, we have designed an on -site wastewater system for your consideration. SITE CONDITIONS The site was vacant at the time of the investigation. The slope at the proposed absorption field is approximately 1% to the northeast. The groundcover consists of native grasses and weeds. PROPOSED CONSTRUCTION A three (3) bedroom single family home is planned for this site. Water wit] be provided to the site by an on -site well. The welt must be a minimum of 100 feet from the absorption field(s). if the owner is anticipating future finishing ng of additionalbedrooms in unfinished areas, we recommend the OWS be designed and constructed to handle the additional loading. The installation of aproperly g . sized OWS to serve future build -out would be cost effective. SUBSURFACE CONDITIONS Subsurface conditions were examined by drilling one 13' profile hole and six percolatio r ti at the location of the proposed disposal field. Results of this subsurface examination can be nand ' the above referenced percolation report. The report indicated an average percolation rate . x'4.1 `I _ No free water was found. RECOMMENDATIONS We recommend a low pressure drip irrigation OWS be installed in the natural soils. We recommend that this system be designed based on the maximum reading of 83.3 MPI percolation rate, which corresponds to a 0.26 gallons per square foot per day application rate. This application rate is based on evapotranspiration and absorption. The system should be designed for the average daily sewage load of g 450 gallons per day using the Weld County guidelines. Two 1000 -gallon, two pre -cast compartment P concrete septic tanks with an effluent pump in the second compartment of the second tank is required for this system. A low pressure drip irrigation disposal system design is presented on Figs. 1 through 4. � g please note that the location and configuration may be revised by the engineer should site condition dictate. 08/29/2011 MON 9:28 FAX 303 857 9238 High Plains Engr. &Design 2OO6/011 We recommend that the surface of the disposal field be seeded after installation of the drip irrigation ation system. A good native grass cover will promote evapotranspiration from the field and reduce erosion, We recommend using a seed mix such as a "Foothills, Pasture, or Prairie" mixes available at local feed and seed stores. These mixes do not require irrigation and develop a growth 10 to 15 inches high. No automatic sprinkler system should be installed above the disposal field. OPERATION AND MAINTENANCE The owner must realize an OWS is considerably different from public sewer services. The owner must be aware of and assume the responsibility for continued maintenance of the system. The system is relatively maintenance free, but the owner must have the septic tanks pumped, We recommend the septic tank be pumped1st P �� - pp p at the end of the year of use to monitor sludge buildup and then at a minimum of every 2 years, Effluent filter anthscitenetvaults, as applicable, are -to -be cleared at -the -time -of pumping or as needed, Distribution valves should be rotated every 6 months to allow drying of sections of the drain field. There are also daily considerations, such as not putting plastic or other non - biodegradable material down the sewage disposal system. Also, water use must be carefully monitored so toilets are not allowed to run when seals m.alfu.nction+ To illustrate the point, a running toilet will consume in excess of 1000 gallons per day if allowed to run. As the system is designed for only 450 GPD, an excess 1000 GPD will flood and irreparably harm the system. We also caution against installation of water softener. The high levels of salt from the backwash of a water softener is detrimental to all on -site sewage disposal systems and a separate drywell should be constructed for the backwash waste if a water softener is installed. No landscaping or plastic can be used over the disposal field which will reduce evapotranspiration from the disposal field. Chemically y treated water from a swimming pool or spas should not be introduced into the OWS, Livestock and vehicular traffic must be fenced out from the absorption field area. LIMITATIONS A drip irrigation design requires installation by a contractor who is experienced in its installation. AD construction should be in accordance with the IDS regulations, the septic permit from the governing Health Department and this design. Our investigation, layout, desi.gn and recommendations are based on data submitted. This office shall be notified a minimum of 24 hours in advance_ of a required installation observation. This observation shall be called prior to backfill, with all appurtenances in place, If subsurface conditions are considerably different from those described in this report are encountered, we should be notified to evaluate the affect of the changes on the proposed sewage disposal system. If modifications to this design are made by the governing Health Department, we should be contacted to evaluate the impact on the performance of our OWS design, Pipe type and size, burial requirements, septic tank construction, and other specifications that are not depicted in our report shall conform to the requirements of the ISDS regulations. If there are any questions, or if we can be of further service, • please call. Sincerely, Todd M. Schroeder, PE Attachments: Calculations, Site Map, Field Plan & Section, valve retail, Tank Section 08/29/2011 MON 9:29 FAX 303 857 9238 High Plains Engr. &Design [Z007/011 TREATMENT UNIT 1. Two ION -gallon 2 compartment septic tanks in series with an effluent pump and a Biotube® filter located in the second chamber of the tank. 2. One 0.5 HP (miry.) effluent pump Orenco P30 series or equivalent. 3. Alarm indicator (Tank Alert 1 Alarm System) or any specifications approved by the regulatoty agency. The alarm box must be located at a place where it is easily heard. 4. Risers: Two to surface. 5. Pressure release valve at high point. 6. Drainback to septic tank and field. DRIP IRRIGATION CALCULATIONS: NUMBER OF BEDROOMS GALLONS PER DAY = (0) PERCOLATION RATE DISPOSAL RATE = R = AREA = PR) X 1.5 X 1.6 X 0.75X 1.17= MINIMUM FIELD AREA LINE LENGTH = TRENCH WIDTH 6 INCH MIN 31 450 83.3 0.26 3645 SO FT 000 2000 L The absorption field will consist of: 5 sections of 4 laterals at 100 feet = 200O LE THE PUMP DOSE SHOULD BE SIZED FOR APPROXIMATELY 1/2 OF WASTE LINE CAPACITY 160 GALLONS (BASED ON 2" PERFORATED PIPE DRIP LINES WITH ONE SECTION TURNED OFF, DOES NOT INCLUDE PIPE FROM TANK TO SEPTIC FIELD - MODIFY DOSE IN FIELD) The installer is to provide schedule 80 pipe when trenching below any road or driveway. The absorption bed shall be isolated from all vehicular travel, parking, livestock � � and storage areas. Al! construction is to be in accordance with Weld County Colorado Health Departments Individual Sewage Disposal System Regulations. 08/29/2011 MON 9: 29 FAX 303 857 9238 High Plains Engr. &design IZ00B/011 SITE MAC I 0409 Weld County Road 20 Weld County, CO LEGEND • -Percolation Test Hole -Percolation Profile Hate A- Soil Profile Hole -Fence EC(SIING POI f I3ARN C.0, 5:- 40' TO PERC PROFILE 2-1000 GAL. SEPTIC TANKS (MIN) We EFFLUENT PUMP IN 2nd CHAMBER OF SECOND TANK DESTR1B UTEON VALVE BOX ' 5 SECTIONS Wi 4 LINES EACH r70' WELD COUNTY ROAD 20 MIMP All locations shown above are based on specific information furnished by others or estimates made in the field by High Plains Engineering personnel. The locations, distances, directions, etc. are not the result of a property s+ ey but are approximations and are not warranted to be exact. It is the ownerlbuilde?s responsibility to define property - boundaries and ensure all onsite improvements are located within the platted site and out of inappropriate easements. All distances are to be verfied prior to excavation. FIGURE 1 08/29/201.1 MON 9:29 FAX 303 857 9238 High Plains Engr. &Design 2009/011 LATERAL (TYP.) i DISTRIBUTION VALVE BOX HEADER GRAVITY FLOW= MIN. 1/8" / 1' (SOLID SCH. 40 PIPE) LEVEL MANIFOLD (SOLID SCH. 40 PIPE) A. TYPICAL FIELD PLAN #SECTIONS rc"1 LINES ,2_ Jj0oo )0.--1 GALLON TWO COMPARTMENT SEPTIC TANKS WITH A EFFLUENT PUMP [N THE SECOND TANK -41 2 INCH GABS 200 sDR 21 PVC WI l/4 INCH INFLUENT LINE HODS ON 8 INCH CENTERS (HOLES DOWN) �f INSTALL LATERALS LEVEL f I LATERALS AT TWO FEET ON CENTER SPACING MIN. Mt) /1 Apo MIN. • MIN. B. TYPICAL FIELD CROSS SECTION 41 MIN_ MIN. GROUND LEVEL • FIGURE 2 08/29/2011 MON 91 29 FAX 303 857 9238 High Plains Engr. &Design ZI0L0/011 • P 2" SCH. 40 PVC LINE FROM PUMP CHAMBER IMINIMNIEM rill TEE EXIT TO ABSORPTION FIELD DISTRIBUTION VALVE BOX LINES PER SECTION cl 90 DEGREE U ELBOW .J 1 2" BALL VALVE TYPICAL DETAIL OF DISTRIBUTION VALVES NOTE: ONE VALVE WILL BE SHUT OFF FOLLOWING INSTALLATION OF SYSTEM,, THE OWNER SHALL ROTATE THE T OFF" VALVE EVERY 6 MONTHS TO ALLOW THE DRYING OF SECTIONS OF THE DRAIN FIELD, FIGURE 3 ODD -GALLON, TWO -COMPARTMENT, PRECAST CONCRETE 5ePTrc TANK fOLLOWED 5Y 1000 -GALLON, TWO -COMPARTMENT, PRECAST CONCRETE SEPTIC TANK WITH EFFUEOJT PUMP IN cao D CHAMBER Inlet Tee - Slope Ground MST clrAR ZONE- ontrftJG IN Trif BA&l7r rs AID! rcarrAect MTrRNArrti+t t0 rvG Tfrs 5CCLRE CONCRETE OR rIeeRGLAe3 LID PVC R,i5er'nth ornrreUs) (cord to tank adapter with recommended adhesive) YANK At AP,rR or NECESSARY) rtilet Ice FIGURE 4 Skye Wound Skint CoMdint Seal CorldvIt to Control. Panel Mo sture Prod 5phce {May 12e located on exterior with Separate acce55} 5etvlt CONCRETC CItnb&.GAS uD PVC Riser with Grtxnmet(s) (t'cttd to tank ad.tptcr with recOlr mened adhesive) 0wick Qrct Di char a As*emlaty {Optimal) 3Ct1 4O PVC PIPE ant DtScharee 1/4' weir I1OLC tjs cie TANK Level Coi VOl Float Asi.ambly Muent Pump 30 6Pfie+i at 15 feet of head Concrete Nock ufiT acp? •ixbua - i p Weld County Health Department Percolation Test and Soils data 6/15/2011 en HIGH PLAINS ENGINEERING & DESIGN, LLC 7214th STREET, SUITE D, FORT LUPTON, CO 80621 • PHONE: (303)-857-9280 • FAX: (303)-857-9238 I -.,, ,.::..n: f�Y>^iCi:.C..... [':OCif.`a;•;;; Y •: .. •.•o: .V:'::..... ••aw •na ':'•`.>"`' v YC'rrY: C: • v •. x;vv*Yv)J.n•• 1>:>C>C• n: _`% . ni n.r r....Y cyorcy Yc....•' :>f>c: c[•.< rr r^rr7 rr ,T. 10e2085 LOT A OF RE -41147, PART OF THE S1/2 OF THE 1 /4 OF SECTION 14, T2N, • • ::;.1 .gal a C%puon R67W OF THE 6TH P.M., 10409 WELD COUNTY ROAD 20, WELD COUNTY, CO n - • .• . .- • . }.4n.•.. •.4..• . • ,.V....:e... 6199 NORTH FEDERAL BOULEVARD DENVER, CO 80221 (303) 430-0337 •S :.<J[atC X:•:Ww:i:) ..c:w[..-... c:a. :w: a,[J .o<aY:YJa Jx JJ(o.J w•• .•,• ••• ,v••••a••• •r•naw•, •-.••.•V•O•. •y • ••r. y••.•V• ., a•. i ., ... ..... .........r.. a. ..x., .,<..,.R. S. .J<J%J%.Rf ..R. •.\..aC .%f •f ):%CRf %: :::::: •aR: a • • •. •. ... .• • .• •• •• • •• • •• •• •• •• •• ••••• •••u.•••• • • •• u•• u. •[ .6 :J :J :J :: •• :JK: .. .. 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Note:Sob. b. r U 't• be 1assi Ted .rust t 9 u nied system TM 02487 P:;of Ip i00: c , • • %: ,• .••• ,• .J ... n........ ...... ........ ...v• ... .. ... • ....v........v ..<-':.ti pia t.`<' ... <i -'-i.. J .. :^ix,r4.. .. .: ... ... .. .. o:. ... ... . ..• ..• f.. J .C .. ... .. ..... .. .. .. ... • ... .: .. .... ...:::. .:. .. ..... i. .>..: ........•. v., ... .. ..... ... .. .... ... . ...• . to r -C -•- . • a . - .. ,. ... .. ..'.� ... ... .... .... �. • ♦. .. ....;. ion a ImmM la a a W alai 1 SANDY CLAY (SC) 2 10 SANDY SILT (M) CLAY WITH LOW PLASTICITY (CL) WATER TABLE ceitifica�i e I certify that the above information is correct and complete to the best of my knowledge and that all tests were performed in the accordance with the provisions of Weld County Health Department individual sewage disposal regulations by myself or under my supervision. : ! h Mins.E'n ine r n ::.esignLLC 721: 4th Street, Suit F#: Lipton, CO 8 303457-,9280 6/15/2011 SITE Aim Lot A of RE -4 147, Part of the 51/2 of the SWI/4 of Section 14, T2N, KG7W of the Gth P.M. 1 0409 Weld County Road 20, Weld County, CO O O o O O o X WELD COUNTY ROAD 20 LEGEND o - Percolation Test Hole X - Percolation Profile Hole A --soil Profile Hole X Fence AU locations shown above are based on specific information Furnished by others or estimates made in the field by High Plains Engineering IL Design personnel. The Locations, distances, directions, etc, are not the result of a property survey but are approximations and are not warranted to be exx.ct. It is the owner/builder`s responsibility to define property - boundaries and ensure GU onsite improvements are located within the plotted site and out of inappropriate easements. All distances are to be verified prior to excavation. ,* Form No. GWS-25 APPLICANT OFFICE OF THE STATE ENGINEER COLORADO DIVISION OF WATER RESOURCES 818 Centennial Bldg., 1313 Sherman St.. Denver, Colorado 80203 (303) 866-3581 EARL R BERGLAND 474 WELD COUNTY ROAD 30 LONGMONT, CO 80504- (303) 564-1499 PERMIT TO CONSTRUCT A WELL LIC WELL PERMIT NUMBER 266150 DIV. 1 WD 2 DES. BASIN MD APPROVED WELL LOCATION WELD COUNTY SE 1/4 SW 1/4 Section 14 Township 2 N Range 67 W Sixth P.M. DISTANCES FROM SECTION LINES 650 Ft. from South 3290 Ft. from East Section Line Section Line UTM COORDINATES (Meters,Zone:13,NAD83) Easting: Northing: ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT CONDITIONS OF APPROVAL 1) This well shall be used in such a way as to cause no material injury to existing water rights. 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 in a civil court action. 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 Installation Contractors in accordance with Rule 18. 3) Approved pursuant to CRS 37-92-602(3)(b)(II)(A) as the only well on a tract of land of 43.95 acre(s) described as that portion of the SW 1/4, Sec. 14, Twp. 2 N, Rng. 67 W, Sixth P.M., Weld County, more particularly described on the attached exhibit A. 4) The use of ground water from this well is limited to fire protection, ordinary household purposes inside not more than three (3) single family dwellings, the watering of poultry, domestic animals and livestock on a farm or ranch and the irrigation of not more than one (1) acre of home gardens and lawns. 5) Production from this well is restricted to the Laramie -Fox Hills aquifer, which corresponds to the interval between 280 feet and 600 feet below the ground surface. Plain casing shall be installed and grouted to prevent production from other zones. 6) The depth to the top of the Laramie -Fox Hills aquifer is approximate. To ensure the exclusion of poor quality water from zones immediately above the aquifer, plain casing and grout shall extend through the lowermost coal and/or carbonaceous shale that overlies the Laramie sand portion of the aquifer. 7) The pumping rate of this well shall not exceed 15 GPM. 8) The return flow from the use of this well must be through an individual waste water disposal system of the non -evaporative type where the water is returned to the same stream system in which the well is located. 9) This well shall be constructed not more than 200 feet from the location specified on this permit. NOTE: To ensure a maximum productive life of this well, perforated casing should be set through the entire producing interval of the approved zone or aquifer indicated above. 1U•2.t• 2O0 5. APPROVED PAT via State Engineer dza , Receipt No. 0542004 DATE ISSUED e 10-21-2005 EXPIRATION DATE 10-21-2007 Hello