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Home My WebLink About20221352.tiffAccount Number Description 003229-01 1000 Gallons Meter Readings Previous Present 134 135 Usage 1 Read Code Actual Read Dates Previous Present 10/21/2021 11/18/2021 Previous Balance • Payment — Check Water Minimum Charge Water Usage Charge CBT Surcharge $2223 --$22.23 $19.27 $0.00 $0.00 Lot A Water Bill Total Current Charges $19.27 Total Amount Due $19.27 Please write Account Number on all check payments and on all correspondence. Please use the Bill ID to set up Auto Pay. Auto Pay is deducted the 15th al each month. You may pay your bill & setup AutoPay at www.cwcwd.com Water JASON NDJFMAMJ EBill Bill ID 0432 00007327 Customer Sandberg Irrevocable Trust Service Address 17215 County Rd 46 Billing Date 11/22/2021 Due Date 12/15/2021 Account Number 003229-01 Amount Due $19.27 Annual Allocation YTD Usage **Surcharges apply if Allocation is exceeded** 300 45 Central Weld County Water District 2235 2nd Avenue Greeley, CO 80631 970-352-1284 WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 North 17th Avenue, Greeley, CO S0b31 www.weldhealih.vrg Septic Permit s Final Application Number:SP-1700352 Owner Name:SANDBERG GEORGE L IRREVOCABLE TRUST Site Address: 17215 CR 46 LASALLE, CO 80845 App Type: HealthlCommercialtiNew OWTSISeptic JIM CLARK CLARK ENTERPRISES COST CO 80 FACTORY ROAD EATON, CO 80615 Parcel #: 105712300009-R8948334 Legal Desc: PT SW4 12-4-66 LOT REC EXEMPT RECX17-0013 Work Description: OFFICE/ WAREHOUSE EHS SEPTIC GENERAL: Associated Disaster Permit Number of Persons Parcel Acres Public Water Supply Public Water Supply Utility EHS SEPTIC ACTUAL (FINAL): Septic Tank Size, gallons Absorption Trench, sgft Chamber Model Number of Chambers Installed Design Type NOTICE The issuance of this permit does not imply compliance with other stale, county, or local regulatory or building requirements, nor shall it act to certify that the subject system will operate in cornpG2uxe with applicable state. County end local regulations adopted persuant to Article 10, Title 25, CRS as amended, except for the purpeseTer.esieblishin j tirral approval of, Installed System for Issuance of a local occupancy permit persuant to 25-10-112(1)(b), C.R.S. This permit is son4mnsfarahtd arrdforl-re ilndable: The Weld County Department of Public Health and Envindrlmerlt reserves the right to impose additlonal.lemrs and conditions required to meet our,regulations on a continuing basis. Final permit:approval wai contir.gent upon the final inspection of the completed system by the Weld County Department of Public Health and Environment Na 1 8.90 Yes CWCWt] 750 84 Quick4 Plus Standard 7 Chambers -Trench Application Status: Finaled Applied Date: 1011812017 Issued Date: 1D/23/2017 Finaled Date : 01/11/2018 Alex Clemments January 11, 2018 Environmental Health Specialist Date NecHhAdefinalrelloe Wel Racarda rele: 970-304:.4410 Fax 970-204-6412 Public Hwkth a CFnieed Safvie.s. IVe..9711•3174.647' ;cr. 970-.20441 td. Emrlruernantra M4roih Saevieae Tele:970,304-6115 Gomnnu nq o 1ton, Eduesien a Mannino Tele:P70-30+-6179 Fax: 970-304-64 I : Fa:c 970.304-6452 Emarganey Tveper*dnea■ S Rerponse Tale: 970-304-6470 Fen: 970-.3N-6452 PbbtlCHaalth Scanned by CamScanner May 4, 2017 Clark Enterprises 80 Factory Road Eaton, Colorado 80615 Northern Colorado At\l, Geotech 2956 29th Street, knit 21 Greeley, Colorado 80631 Ph 506-9244 Fax: {970) 506-9242 Attn: Jim Clark Re: Percolation Test and Septic System Design Proposed Winter Seed Facility Highway 85 and Weld County Road 46 Northern Colorado Geotech Project No. 868-17 Northern Colorado Geotech has performed a prco5aotuotnof L SalieeColoradsystem o. The design spatta�hed sed seed facility office at the above referenced project with this letter. If you have any questions or if we may be of further assistance, please do not hesitate to contact us at (970) 506-9244. Sincerely, NORTHERN COLORADO GEOTECH Doug Leafgren, P.G. President Reviewed by: Gary G. Weeks, P.E. Vice President Attachments: Site Plan Logs of Borings Septic System Design Criteria Septic System Cross Sections cc: Addressee (4) Clark Enterprises Winter Seed Facility - WCR 46 and Hwy 85 Northern Colorado Geotech Project No. 068-17 SITE CONDITIONS l have a small It is our understanding that a post and beam storagebl have onell be bathorggmucted and will agenlerally be used office on the south end of the structure. The office wng by 4 by a maximum of 2 employees. A "worst ca cultural #ield" scenarioW thaoult isave the currently restroom egetat d.usSurface people during the day. The site is an agCounty ltural drainage is poor to the east. The site is�o Railrd to the south Weload tracks and H ghway 85 are togheuwest. ground is located north and east of the site. We are unaware of an existing septic permit for the site or the presence of natural or cultural features at the site. A total of three percolation test borings drilled boriApril 6, 2017 and ngs were drilled at depthseangiing frglle test m of 3 tqit was 5 feet excavated on April 14, 2017. The percolation 9at the and the sail profile test pit was excavated to a Soils intth of 8 t. The borings were proposed absorption bedlcgnsisted locations show on the Site Plan, Figure 1. hearea of the of silty sand to a depth of 8 feet. Summary boring logs are attached with this report. Groundwater conditions were evaluated in each bfeaturesat the lme of p present from past hace xgphlograoio�ds�aate one day after the drilling. Groundwater, or the physical were not observed to a depth of 8 feet. The borings were located in the field by pacing from property lines ameasdements or existing wi h an engineer's features.Relative surface elevations at the boring locations were obtained by level from a temporary bench mark (TBM�ssumed to the level shown on the Site Pmpli dhbyathermethodsy of the usedboring to locations and elevations should only be determine each. SEPTIC SYSTEM DESIGN CRITERIA 1. Percolation Test Results: Tesfi Borin No. 3 4 5 Percolation Rate minlin 5 6 6 Design Rate, Avg perc rate = 6 min/in. = Soil Type 1 with a LTAR of 0.8 2. Min Bed Area: Q = 4 employees at 20 gal/person/day = 80 gallons per day Area = 80 / 0.8 = 100 * 1.2 (Bed) = 120 sf Infiltrators = 120 * 0.7 = 84 / 12 = 7 Standard Quick 4's Clark Enterprises Winter Seed Facility- WCR 46 and Hwy 85 Northern Colorado Geotech Project No. 068-17 SEPTIC SYSTEM DESIGN SPECIFICATIONS 1. Septic Tank — Minimum = Commercial Design requires a minimum of 48 hours of effluent storage in the tank with a minimum capacity of 400 gallons, 80 gallons per day x days = 160 gallons. Therefore, a minimum 400 gallon tank is needed. The tank will need to meet the specifications of Weld County Regulations 30-9-20. The lid of the tank must be sufficient to withstand the load created by the burial depth of soil, We are not aware of water soluble sulfate concentrations that would significantly affect a concrete septic tank. Risers must be used to provide access to the tank. 2. Infiltrators - Minimum of 7 Standard Quick 4 infiltrators in an absorption bed (2 rows wide by 3 and 4 long = 7 Quick 4's for an absorption bed) 3. Distribution Box - Installed level to provide equal distribution of effluent. Riser must be used to provide access to D -Box. 4. Backfill - 12 inches (minimum) to 36 inches (maximum) of on -site soil. The top 4 inches shall be organic topsoil. 5. The system should maintain a minimum 1/4 -inch per foot slope from the house to the septic tank. The slope of the effluent line from the tank to the absorption bed should be a minimum of 1/8 -inch per foot. 6. Each run of infiltrators must have an inspection port at the end of the run. GENERAL NOTES 1. All construction shall be in compliance with Weld County Health Dept and State regulations. 2. Any deviation from the plan must be approved by WCHD and/or Northern Colorado Geotech prior to construction. 3. No groundwater or bedrock was encountered in the soil profile test pit located at the proposed soil absorption bed. We are unaware of any limiting layers within 8 feet of the existing site grade. Accordingly, the leach field may be constructed to a depth 4 feet below finished grade. 4. All parts of the field shall be located the minimum distances from land features including 100' from any well, 50' from the on -site pond or ditch, 20' from all dwellings and 10' from all property lines. 5. The system shall be inspected by WCHD and/or Northern Colorado Geotech during critical phases of construction. 6. Positive drainage shall be provided to minimize surface runoff from entering the system. 7. The top of the field shall be seeded or sodded with low-water demand vegetation to control erosion and aid evapo-transpiration. Large trees or shrubs should not be planted within 6 feet of the field. 8. The completed leach field should not be paved or driven over at any time. 9. A licensed septic system installer should be chosen by the client. A list of licensed installers is available from WCHD. The installer should use best construction practices during all phases of the septic system construction. 10. Proper maintenance of the septic system will help lengthen effective life of the system. Information regarding septic system maintenance can be found through various on-line guides including the EPA manual "A Homeowner's Guide to Septic Systems". http://www.epa.gov/owm/septic/pubs/homeowner_guide_Iong.pdf Clark Enterprises Winter Seed Facility - WCR 46 and Hwy 85 Northern Colorado Geotech Project No. 468-17 INSTALLATION INSTRUCTIONS t. Excavation should be performed in such a way as to limit/eliminate traffic over the area of the absorption bed. 2. Ali wastewater lines shall be constructed of compatible pipe, primer, bonding agent and fittings. 3. Use Schedule 35 pipe except where piping is placed under driveways or roadways — in these locations use Schedule 40 pipe. 4. All system piping shall be bedded with select, granular material. Material may be on -site or imported material. 5. Compact soils around tank and distribution box to ensure piping will remain level and settlement vvill not create bellies within the piping. P� O '23 OWNER: JEFF WINTER SW QTR SEC. 12, T4N, R66W 100' 0 100' 200' Other than the distances to setback objects indicated an the design documents, no other objects requiring setbacks from the proposed OWTS, as indicated in Table 30-7-1 of Chapter 30 of the Weld County Code, have been located or observed during our preliminary investigation, reconnaissance or detailed soil Envestiga@on TBM = PROPERTY PIN ELEV. = 100.0 <1% SLOPE WE ARE UNAWARE OF ANY RIGHT OF WAY SETBACKS ON THE PARCEL THAT COULD AFFECT THE PLACEMENT OF THE PROPOSED OWTS BORING LOCATION PLAN PROPOSED SEED FACILITY AND SEPTIC SYSTEM HWY 85 AND WCR 46 LASALLE, COLORADO FOR CLARK ENTERPRISES ,loorthem oloradn Geotech 2956 29th Street, tin!! 21 Greeley, Colorado 80631 Phone: (970)506-9244 Fax: (970)506-9242 Project No. Stela: 068.17 1' = 200' Date: 5-4.17 Project Mgr. Figure No. DML O018 3OV?:1O1S 033S 0 T1 m rn SEPTIC TANK D -BOX 7 QUICK 4 INFILTRATORS (2 ROWS WIDE BY 3 8r 4 LONG) 20' 55' r]a.5 No.Bt9 13o.T� No.1 5' 16' TEST PIT INSPECTION PORTS OWNER: JEFF WINTER SW QTR SEC. 12, T4N, R66W 2s a WELD COUNTY ROAD 46 25' 50 Other titan the distances to setback objects indicated on the design documents, no other objects requiring setbacks from the proposed OWTS. as indicated in Table 30-7-1 of Chapter 30 or the Weld County Code. have been located or observed dudng our preliminary investigation, reconnaissance or detailed sal invsstigabon WE ARE UNAWARE OF ANY RIGHT OF WAY SETBACKS ON THE PARCEL THAT COULD AFFECT THE PLACEMENT OF THE PROPOSED OWTS BORING LOCATION PLAN PROPOSED SEED FACILITY AND SEPTIC SYSTEM HWY 85 AND WC 46 LASALLE, COLORADO FOR CLARK ENTERPRISES Northern Colorado Geotech 2956 29th Street, Unit 2i Greeley, Colorado 80631 Phone, (970)506-9244 Fax', (970)506-9242 Project No. 088-17 Scale: 1"=50, Date: 5-4-17 Project Mgr: DML Figure No. 2 CLIENT LOG OF BORING No. Test Pit Clark Enterprises SITE Weld County Road 46 & Highway 85 LaSalle, Colorado e_ m Approx. Surface Elev.: 100.3 ft. 6° TOPSOIL 0 5 SILTY CLAYEY SAND Tan, moist, loose 99.8 3.0 97.3 SILTY SAND Tan, moist, loose 5.0 92.3 BOTTOM OF BORING WATER LEVEL OBSERVATIONS WL None w.D. WL None A.B. VVhen Checked 1 Day A.B. GRAPHIC LOG y L. ARCHITECT/ENGINEER PROJECT Winter Seed Facility SAMPLES Sheet 1 of 1 TESTS r 2 r a w 5 - Northern Colorado Geotech 2956 29th Street, Unit 21 Greeley, Colorado 80631 Phone. 970-506-9244 Fax: 970-506-9242 N rw C11 D 3,71 CO Ir w m a z w a STARTED w CC zj WQ J U OC 2 z MOISTURE, % C Z W D oa 4/14/17 w cif w� Z W wF d W Q FINISHED 4/14/17 DRILL CO. DRILL RIG Backhoe LOGGED BY TK APPROVED DML NCG PROJECT NO. 068-17 CLIENT Clark Enterprises LOG OF BORING No, 5 d SITE Weld County Road 46 & Highway 85 LaSalle, Colorado Approx. Surface Elev.. 99.6 ft. 6" TOPSOIL 0 5 3.0 SILTY CLAYEY SAND Brown, moist, loose BOTTOM OF BORING WATER LEVEL OBSERVATIONS wL None w.0. WL None A.B. When Checked 6 Days A.B. 99.1 96.6 ARCHITECT/ENGINEER PROJECT r v z nr. w 0 Northern Colorado Geotech 2956 29th Street, Unit 21 Greeley, Colorado 80631 Phone: 970-506-9244 Fax: 970-506-9242 EN - co z Winter Seed Facility SAMPLES w m z w 0. MOISTURE, STARTED 4/6/17 Sheet 1 of 1 TESTS a Z W dw Q� x 1 - FINISHED 4/6/17 DRILL co. Drilling Eng DRILL RIG CME-55 LOGGED BY TK APPROVED DML NOG PROJECT NO. 068-17 CLIENT Clark Enterprises LOG OF BORING No. 6 SITE Weld County Road 46 & Highway 85 LaSalle, Colorado Approx. Surface Elev.: 100.4 ft. TOPSOIL 0.5 3.0 5.0 SILTY CLAYEY SAND Brown, moist. loose SILTY SAND Tan, moist, loose GRAPHIC LOG y 4 99-9 .4, 97.4 95.4 BOTTOIVI OF BORING WATER LEVEL OBSERVATIONS WL None W.D. WL None A.B. VVhen Checked 6 Days A.B. ARCHITECT/ENGINEER PROJECT Winter Seed Facility SAMPLES Sheet 1 of 1 TESTS LL s a d 5 - Northern Colorado Geotech 2956 29th Street, Unit 21 Greeley, Colorado 50631 Phone: 970-506-9244 Fax: 970-506-9242 (V W 3� O¢ m Z w CO 2 Z W d n W Ce Z W W 0 U oo� ZZ MOISTURE, % STARTED 4/6/17 N d w Zw W dw zo T� FINISHED 4/6/17 DRILL ca. Drilling Eng DRILL RIG CME-55 LOGGED BY TK APPROVED DML NCG PROJECT NO. 068-17 I G68-17 GPJ CLIENT Clark Enterprises LOG OF BORING No. 7 SITE Weld County Road 46 & Highway 85 LaSalle, Colorado Approx. Surface Elev.: 100.3 ft. 6" TOPSOIL 0 5 3.0 SILTY CLAYEY SAND Brown, moist, loose BOTTOM OF BORING WATER LEVEL OBSERVATIONS WL None W p. AIL None A.B. When Checked 6 Days A.B. 0 O J U 2 a 99.86 i •• 97.37f1 ARCHITECT/ENGINEER PROJECT U_ 2 Q w 0 Winter Seed Facility SAMPLES Sheet 1 of 1 TESTS Northern ISNCkolorado Geotech 2956 29th Street, Unit 21 Greeley. Colorado 80631 Phone: 970-506-9244 Fax: 970-506-9242 N w Oj mz CC w m 2 z w a O w zw Wp U Cr 00CC zz MOISTURE, % z w O as STARTED 4/6/17 w n UJ CC Z wr d w Qa FINISHED 4/6/17 DRILL CO. Drilling Eng DRILL RIG CME-55 LOGGED BY TK APPROVED DML NCG PROJECT NO. 068-17 SEED OR SOD TOP OF BED SOON AFTER CONSTRUCTION TO CONTROL EROSION AND AID EVAPO-TRANSPIRATION SEPTIC TANK SPEC. 1 BOTTOM OF TANK MAY BE PLACED AT A DEPTH UP TO 8'0" BELOW EXISTING SITE GRADE ma N D -BOX SPEC. 3 EXISTING GRADE SLOPE FOR POSITIVE DRAINAGE O -BOX ELEV. MAY 9E FIELD ADJUSTED AS NECESSARY FOR POSITIVE FLOW SEPTIC SYSTEM CROSS -SECTIONS APPROVED BACKFILL SPEC.4 INFILTRATORS SPEC. 2 SILTY SAND WE DID NOT ENCOUNTER LIMITING ZONES WITHIN 8'0" OF THE EXISTING SITE GRADE SEPTIC SYSTEM DESIGN PROPOSED SEPTIC SYSTEM WINTER SEED FACILITY - HWY 85 AND WCR 46 LASALLE, COLORADO FOR CLARK ENTERPRISES Northern Colorado Geotech 2956 29th Street, Unit 21 Greeley, Colorado 80631 Phone: (970)506-9244 Fax: {970) 506-9242 Project No. 068-17 Sr;% 1"_3, Dale 5-4-17 Project Mgr. DML Figure No - 3 r! WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT f 55.3 North! 17th Ave?r`iUE.a Greeley, CO3vv,,,,,/,, ;Net health;.orp Septic Permit - Final Application Number:SP-1700353 Owner Name:SANDBERG GEORGE L IRREVOCABLE TRUST Site Address: 17215 CR 46 LASALLE, CO 80645 App Type: HealthlResidentiallRepair OWTS1Vault JIM CLARK CLARK ENTERPRISES 80 FACTORY ROAD EATON, CO 80615 Parcel#: 105712300009-R8948334 Legal Desc: PT SW4 12-4-66 LOT A REC EXEMPT RECX17-0013 Work Description: COMMERCIAL- RV DUMP VAULT EHS SEPTIC GENERAL: Associated Disaster Permit No Parcel Acres 6.90 Public Water Supply Yes Public Water Supply Utility CWCWD EHS SEPTIC ACTUAL (FINAL): Septic Tank Size, gallons 2500 Application Status: Finaled Applied Date: 10/18/2017 Issued Date: 10/20/2017 Finaled Date : 01/25/2018 NOTICE The issuance of this permit does not 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 25-10-112(1)(b), C.R.S. 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 Health and Environment. Alex Clemments January 25, 2018 Environmental Health Specialist Henllh a 3dmrrnisirafion Vilest Reea,rdt Publ:t Health $ ` tinmced Serekes Date;' 7 ,32, .._ Environrnwnial Health Camrnunkation Emergency Neparedniaz Seev4e.: fclucalfAn 6 Plurulinq d Respanse Public Hull Application Number: Owner Name: Site Address: App Type: Parcel Number: Legal Desc: WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 North 17th Avenue_ Greeley, 8CI631 www.welcihealth.org Septic Repair Permit SP -1700353 SANDBERG GEORGE L IRREVOCABLE TRUST 17215 CR 45 LASALLE, CO 80645 HealthlResidentiallRepair OWTS1Vault JIM CLARK CLARK ENTERPRISES 80 FACTORY ROAD EATON, CO 80615 105712300609-88948334 PT SW4 12-4-66 LOT A REC EXEMPT RECX17-0013 Work Description: COMMERCIAL- RV DUMP VAULT EHS SEPTIC GENERAL: Application Status: Final Pending Applied Date: 10/18/2017 Intake Person: SMONGE Permit Expiration Date: Associated Disaster Permit Parcel Acres Public Water Supply Public Water Supply Utility No 6,90 Yes CWCWD Health Adrniniafration Publ7e Hcolih8 Vik0 Roeoreis CZkk' I5ervic@; Enwiranrnanpol Health SOr V IC bi CommunioalSon, im.rgpncv Prgpargdnvii Education S PSanr,;ng gazpan.a Page 1 of 2 Public Health e 1161z31/7O /6:? -7-m14. EHS PERC TEST (SITE) : SEPTIC SIZING INFORMATION: From the application information supplied and the on -site soil percolation data the following minimum installation specifications are required according to the Engineer's evaluation: Engineer's Specified Installation Recommendations: Additional Terms & Conditions Engineer Septic System Design Type Specified Septic Tank Size RV Dump Station Vault with traffic rated lid and high water alarm Other, See Comments 2500 CONDITIONS: Description: RV Dump Station Vault Comment: All Weld County regulations are applicable. Septic Vault must be at least 10 feet from any potable water line, unless water line is encased. Septic Vault must be at least 50 feet from any lake, pond or detention pond. Alarm must be installed/wired for final inspection. 2500 gallon traffic rated RV Dump Station vault to be installed. INSPECTION RESULT: Description: Site In Office Inspection Comment: Status: Approved 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 forth in the Weld County Onsite Wastewater Treatment 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 failure or inadequacy of the sewage disposal system. This permit is non=transferable and non-refundable. Before issuing final approval of this permit the Usleld 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 is contingent upon the final inspection of the completed system by the Weld County Department of Public Health and Environment. Katie Sall October 20, 2017 Environmental Health Specialist Date Heollh ddminishalian Vilol Roeoida a Public Health a Clinical Services €nvironmen?al Health Commvnicn, Services Educntion b Henning Rolporue Emergency PropP.radnv_c Page 2 of 2 PublicHealth DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 N. 17th Avenue Greeley, CO 80631 www.weldhealth.org neann Administration Vital Records Tele. 970 304.6410 Fax. 970 304 6412 Public Health S Clinical Services Tele 97G.304 6426 Fax: 970.304 6416 i Environmental Hearth Services Tele. 970.304.64 t5 Fax 970 304 6411 Communication, Education S Planning Tele- 970.304.647 Fax- 970.304.6452 Public [ Icalth Emergency Preparedness Is Response Tele, 970.394 6420 Fax: 970 304 6459 pur vision. Together..v,th the communities we servewe are working to make il/eld County the healthiest place to live. learn, work and play Application Number: App Type: Owner Name: Parcel #: Legal Desc: Work Description: Site Address: App Specific Info: Septic Permit Application SP -1700353 HealthlResidentiallRepair OWTSIVault JIM CLARK CLARK ENTERPRISES 80 FACTORY ROAD EATON, CO 80615 SANDBERG GEORGE L IRREVOCABLE TRUST 105712300009-R8948334 PT SW4 12-4-66 LOT A REC EXEMPT RECX17-0013 COMMERCIAL- RV DUMP VAULT 17215 CR 45 LASALLE, CO 80645 Parcel Acres Public Water Supply Public Water Supply Utility 6.90 Yes CWCWD TERMS AND CONDITIONS A permit fee, as set by separate ordinance of the Board of Weld County Commissioners, shall be required of applicants for onsite wastewater treatment systems. payable at time of application. Permit fees are non-refundable; permit applications are non -transferable. If both a building permit and an OVVTS are issued for th same property and construction is not commenced prior to the expiration date of the building permit, the OWTS permit shall expire at the same time as the building permit. If an OV TS permit is issued for a property that does not require a building permit, the OWTS permit shall expire 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 adapted under article 10 title 25, CRS as amended. The applicant certfies that the proposed system will not be located within 400 feet of a communih 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 1NCDPH E 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. 0 /O -IS -t7 r/Applicant Date Page 1 of 1 WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT nsE {1i-. i rt':` 'f lit �.. _. .. [, o.,,YHJ RECEIPT October 18, 2017 Application Number: SP -1700353 App Type: HealthlResidentiallRepair OWTSIVauIt Owner Name: SANDBERG GEORGE L IRREVOCABLE TRUST PO BOX 663 LA SALLE, CO 806450663 Site Address: 17215 CR 45 LASALLE, CO 80645 Rcgt # Pmt Tyne Pmt Method Ref # Pmt Date Amount Cashier EHS-1700576 Paid Credit Car( VISA -44 10/18/2017 $350.00 SMONGE Total Payments: $350.00 Comments NeaE'h 6dmint:ifi Lion Pvbi;C ieaNh $ 4'r�rs «®roads Envircrin'on.di NcaNh Camununicafori Erne.fjun-cy. P+gpa•rrinoes arwe o� Education 8 P!on,,ing g gcs onrin Public Fittaltb VAULT PERMIT APPLICATION FORM NEW AND REPAIR VAULT PERMIT FEE: $350,00 • All payments are due at the time of application submittal; by cash, check or credit card • Incomplete applications will not be accepted (Site plan must be included) PARCEL NO.: 105712300009 (12 DIGIT NUMBER) LEGAL DESCRIPTION: SECTION sw1/4 sec12TOWNSHIP 4N RANGE 66\A/ ACRES 68982c. SUBDIVISION LOT A BLOCK FILING RECX17-0013 INFORMATION CAN BE OBTAINED FROM THE ASSESSOR'S OFFICE AT (970) 353-3$45 EXT 3650, OR ON THE COUNTY WEBS[TE UNDER PROPERTY INFORMATION. Link to property information: lntp:: /wyN n .co.v,,eld.eo.uslirraps/propertvinformationi SITE ADDRESS 17215 WCR 46, LaSalle, Co. 80645 DETAILED DIRECTIONS 'TO Slit (A"LI ACH MAP) NORTH SIDE OF CR46 DIRECTLY EAST OF HWY 85 PROPERTY OWNER: Geo. L. Sanderberg Irrevocable Trust MAILING; ADDRESS: PO BOX 663 CITY LaSalle ST CO ZIP 80645 I [OME PHONE: ( ) WORK PHONE ( Ira 573 - l�vQ FAX ( EMAIL ADDRESS: leff.winter@plantpioneer.com APPLICANT NAME: Jim Clark- Clark Enterprises Cost. CO. } _ MAILING ADDRESS: 80 FACTORY RD CITY EATON ST CO ZIP 80615 HOME PHONE: ( 970-p39-0400 WORK PI [ONE (970 ) 454-2400 FAX ( 970) 454-2407 EMAIL. ADDRESS: jimclarkAslbbi.com PROPOSED USE: O RESIDENTIAL. O NUMBER OF PERSONS NUMBER OF BEDROOMS: TYPE OF STRUCTURE (Ex. house. mobile home. duplex, personal shop, ) �1 COMMERCIAL/INDUSTRIAL/INSTITUTIONAL TYPE OF USE.,: RV DUMP VAULT NUMBER OF PERSONS (Ex. Full-time and part-time employees, drivers, patrons) TYPE OF STRUCTURE (Ex. Mechanics shop, kennel, office) BATHROOMS WITI I SHOWERS: YES,NO_ NO 40 - 200 RV'S WATER SOURCE: 9 PUBLIC WATER SUPPLY (NAME OF SUPPLY) CENTRAI WELD COUNTY WATFR DISTRICT O INDIVIDUAL WELL (PERMIT #) O CISTERN (PERMIT R) JEFF WINTER USR 17-0003 MAP CR 46 LASALLF', WF.1.1? COUNTY, COLORADO VICINITYMAP M ARNMG COMMISSION CERTIFICATION TNs c RE coley that Ye Weld Cosily Ram:q Commit:. Ras °.tilled ab doss homy r.mnmsnd in iIa BCNd U Cooly Conlminicnare, new Cush Csbnsio. to la mnmwim. sppantl and aopiun aAa Sea Speck Derdoprcg.' Plan and the b' Special Reeler as shown and *wind ihneoN Cis _ day of 20 Choc Maid Coolly Plnsip Commission BOARD Of Ca1N TI COM MOSSONERS CERT*ICAYION TNs is b cerYa/ Met M fiord a Cola* COI..h.iu Me. Weld C ssdy. Ccibado dos hereby canton in adopt Mie Efts Special De eicam.e Plan and use by spsleV Rein and A._ta...va geneerde a shown Midis =lei heten *0/ .29 Omar Rased al Cn nti Cmnlissioneea ATTEST: r�AN Caking Curio io eie Board Dna, Gat to Me Board Web PROPERTY OWNER'S CERTIh ICA TION The undersigned meet Kimsey nwnals do hereby agree to die site SpeK.As Dwwsoprrwre Man and Ilse by Special Ratiiew Daealcomeri MaIdemi as daaolted boom Mie _ day of 2tr Syyhse Signa^vo r(� t • ,/K0b0kvI? / rQprridiC R4{8-/ y( rf3+ ` 1 / 1 i / `'°°-1-4-ta4.- ix X ./ STORMWATER RU OFF DIRECION / }r ' /: --1 y/ t T 1 A X 1/ / c / G K� / �� • . . . . . . .Q. . LEGAL DESCRIPTION: _CT "A" RECX17-0013 PART or sw 1/4 OF S'=C T4N R 66W WELD COUNTY COLORADO -----'—'• . .. Book b PACE 357 `�. - D• m _...—_� < 991 /' /' '---rrn - -'—' .>&a. — LEGEND SWALE PROPERTY LINE EDGE ROW CULVERT .ROFOSED G. FENCE EX STING FIBER 7PTIC --+P �r XIST1NG GAS LINE — SEEDED LANDSCAPE CONCRETE SURFACE UETENTON POND, MIN VOLUME — 51, 138 CU FT NC BUILD, PARKING OR SEORAGE AREA (C YEL 51ti ACI — -- — — — _ . — ' TANK BAVTFRY Y _ I a - — — — v_ ACCESS PERMIT AP17-00070 F� DATE 3/fd/20f1 SCALA T - 50' - [OTC, Slim's Sanitation, Inc. PO Box 997 Johnstown CO 80534 970) 284-6951 Bid Sheet Customer Name & Address: Date: 10/17/17 JEFF WINTER Phone: 970-573-0840 Job Site: Contact Person: 17215 CR 46 JEFF LASALLE CO 80645 Work to be performed: Date work is to be done: PUMP DUMP STATION AT RV STORAGE UPON APPROVAL Approximate Gallons: 2500 Price per Gallon: Price per Hour: Variables that can change price: Total Price: $675.00 The amount of gallons pumped, if we need extra men or an extra truck, if we have to add water to the tank that will increase the amount of gallons, pumping the tank after hours. Thank you for allowing us to submit this bid. We look forward to doing businesss with you. Slims Sanitation, inc. Quoted prices are valid for 30 days. DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 North 17th Avenue Greeley, CO 80631 Web www weldhealth.orq PublicHeaith Health Administration Public Health & Clinical Environmental Health Communication, Emergency Preparedness Vital Retards Services Services Education S Planning & Response Tele. 970-304.6410 Tele. 970.304.6426 Tele 976.3049415 Tehe 970 304 6470 Tele: 970.300.6420 Fax_ 970.3046412 Fax 9;03046416 Fax: 970.304.5411 Fax. 970.304 6452 Fax. 970.304.5469 Our vision. Together •wtth the communities WEI serve. we are working to make Weld County the healthtes! place to live. learn. work agtl play. Date Submitted: Address of Property Served by Lift Station: 17215 WCR 46, LaSalle, Co. 80645 Systems Contractor/Installer Information Name: MATT CARROLL- CARROLL EXCAVATION Phone: 970-371-3092 Fax: 970-834-2295 E -Mail: mcarrollex@yahoo.com Reason for Installing Lift Station (delivering sewage to the septic tank or septic tank effluent to a non - engineered soil treatment area where gravity flow is not possible): Pump manufacturer and model: N/A Note: Non -clog pump opening shall have at least 2 inch diameter solids handling capacity where raw wastewater is pumped, and a pump opening shall not have more than Y4 inch diameter solids handling capacity if previously settled effluent is pumped. The pump must be equipped with an audible and visual alarm in the event a high water condition occurs. Lift station tank manufacturer and construction: Lift station tank size in gallons: 2000 Is pump being installed in the septic tank? yes NO no Number of compartments, 1 Note: A three -compartment septic tank, sized to provide the required minimum capacity in the first two compartments with the pump in the third compartment is acceptable. The second compartment of the septic tank shall not be used as the lift station unless it can be demonstrated that the minimum 48 -hour detention time will not be decreased. When the lift station pump is installed in the final compartment of the septic tank, an effluent screen must be provided prior to the pump, or a pump vault equipped with a filter cartridge is acceptable. All chambers/compartments of lift station tanks shall have a minimum 24 -inch diameter access riser extended to or above finished grade. Type, schedule and diameter of discharge pipe: Elevation (vertical height) difference between bottom of lift station and invert of distribution box or drop box inlet or bottom of soil treatment area distribution pipe (feet): Horizontal distance from lift station to soil treatment area (feet): It shall be the responsibility of the System Contractor to ensure that all electrical components are permitted, inspected and approved by the electrical inspector from the agency having jurisdiction. If no electrical permit for the structure will be issued, it shall be the responsibility of a licensed electrical contractor to obtain an electrical permit for the lift station from the agency having jurisdiction. The System Contractor shall refer to the Weld County On -site Wastewater Treatment System Regulations for lift station requirements. Reviewed by: Comments: Date: N w CC H Z Q U d w D_ d O 0 z d CO CO 0O r a 7 d w O_ OL 14'-0" FLOOR 13' 8" 13'-0" `{1} ADD'L #6 REBAR EACH SIDE OF OPENINGS T T1 LID: #6 REBAR ® 8" D.C.E.W., SHORT BAR AT 135" OFF BOTTOM OF LID, LONG BAR ABOVE SHORT BAR II -� to I I a: I L 5" k PLAN VIEW ASC Ya"x6X" GALV. WIRE tr1 ROPE LOOP LIFTER CAST INTO CONC. PLUGS ST2500L 2'-10" v TYP. 20°0 TAPERED CONCRETE CAPS L ®� 1 5'-3" TO FL 4'-9" TO FL wL SV2500 REINFORCEMENT: WALLS: #4 U -BAR EXTENDED FROM FLOOR © 12" O.C., 2" OFF INSIDE FACE OF WALL FLOOR: #4 U -BAR 0 12" D.C., SHORT BAR 1X" OFF TOP OF FLOOR, LONG BAR BELOW SHORT BAR rr'�a a o 1, WALL THICKNESS: 4" 2. FLOOR THICKNESS: 6" 3. HOLE SIZE: 16'-0"x9'-0" 4. 6" THICK LID IS RATED FOR OCCASIONAL LIGHT TRAFFIC ONLY 5. 2' MAX COVER. 13'-0" 13'-8" 14'-0" SECTION VIEW WEIGHT/CONCRETE LID 6,362 LBS 1.57 CY WALLS FLOOR WALLS+FLOOR 10,802 LBS 2.67 CY 7,350 LBS 1.81 CY 18,152 LBS 4.48 CY TOTAL 24,514 LBS 6.05 CY 0:\CATAI CG -DRAW NOS \SEP"IC\SEPTIC VAULT \25C0 GAI SEPTIC VAULT 12/6/2011 8:36 AM i 1 ®A TUF-TITE RUBBER BOOT FOR 4"0 PIPE O 4 TON #4UA444 UTILITY ANCHOR IN TOP OF FLOOR 1/2 TON #4UA444 UTILITY ANCHOR IN TOP OF LID COLORADO PRECAST CONCRETE, Inc. 1 820 E. HIGHWAY 402, LOVELAND, CO 80537 (970) 669-0535 FAX (970) 669-0674 www.coloprecast.com ASPEN ITEM NAME: 2500 GALLON SEPTIC VAULT THis ODCu61ENT IS THE PROPERTY OF COLORADO PRECAST CONCRETE, INC. (C.P.C.) AND IS TO HE USED FOR REFERENCE ONLY. R SHALL NOT HE REHROOUCEO IN Arty WAr HARµFAL TO THE INTERESTS OF C, P.C. OPTIONS 0011*Iff TANK ALERT® XT Installation Instructions This alarm system monitors liquid levels in lift pump chambers, sump pump basins, holding tanks, sewage, agricultural, and other non -potable water applications. The Tank Alert e XT indoor/outdoor alarm can serve as a high or low level alarm depending on the float switch model used. The alarm horn sounds and the red beacon illuminates when a potentially threatening liquid level condition occurs. A "power on" light on the switch indicates power to the alarm panel. TANK ALERT® XT ALARM 1 Voltage: 120 VAC, 50/60 Hz, 7 watts maximum (alarm condition) (circuit not supervised) N Enclosure meets Type 3R water -tight standard. X Automatic alarm reset, horn silence switch, and alarm test switch. X Alarm horn sounds at 85 decibels at 10 feet (3 meters). ■ Alarm system (when installed on separate circuit) operates even if pump circuit fails. Maximum line impedance for initiating device: 100 ohms. • Complete package includes standard Sensor Float® control switch with 15 feet (4.57 meters) of cable (other lengths available) and mounting clamp. 1 Three-year limited warranty. When ordered with the alarm, the system is available with: ▪ alternate float switch models for high or low liquid level warning. 1 auxiliary alarm contacts for easy attachment of remote devices: (circuit not supervised) 120 VAC, 5 amps max., 50/60 Hz 1 premounted terminal block so enclosure can also be used as a junction box for splicing pump, pump switch, and pump power. Meets NEC standard for junction boxes. 20 amps, 120/230 VAC. 1 6 foot (1.8 meter) power cord with 120 VAC plug and liquid -tight connectors. PREVENTATNE MAINTENANCE ' Periodically inspect the product. Check that the cable has not became wom or that the housing has not been damaged so as to impair the protection of the product. Replace the product immediately If any damage Is found or suspected. • Periodically check to see that the float is free to move end operate the switch. • Use only SJE-Rhombuse replacement parts. SJE-RHOMBUS') THREE-YEAR LIMITED WARRANTY SJE-RHOMBUSg. warrants to the original consumer that this product shall be free of manufacturing defects for three years after the date of consumer purchase. During that time period and subject to the condi- tions set forth below, SJE-RHOMBUS® will repair or replace, for the original consumer, any component which proves to be defective due to defective materials or workmanship of SJE-RHOMBUS®. THIS EXPRESS WARRANTY DOES NOT APPLY TO THE MOTOR START KIT COMPONENT. SJE-RHOMBUV MAKES NO WARRAN- TIES OF ANY TYPE WITH RESPECT TO THE MOTOR START KIT, ELECTRICAL WIRING AND SERVICING OF THIS PRODUCT MUST BE PERFORMED BY LICENSED ELECTRICIAN. THIS WARRANTY DOES NOT APPLY: (A) to damage due to lightning or conditions beyond the control of SJE-RHOMBUS®; (B) to defects or malfunctions resulting from failure to properly install, operate or main- tain the unit in accordance with printed instructions provided; (C) to failures resulting from abuse, misuse, accident, or negligence; (D) to units which are not installed in accordance with applicable local codes, ordinances, or accepted trade practices, and (E) to units repaired and/ or modified without prior authorization from SJE-RHOMBUS®. Some states do not allow limitations on how long an implied warranty lasts, so the above limitation may not apply to you. Some states do not allow the exclusion or limitation of incidental or consequential damages, so the above limitation or exclusion may not apply to you. This warranty gives you specific legal rights, and you may also have other rights which vary from state to state. TO OBTAIN WARRANTY SERVICE: The consumer shall assume all responsibility and expense for removal, reinstallation, and freight. Any item to be repaired or replaced under this warranty must be returned to SJE-RHOMBUS°, or such place as designated by SJE-RHOMBUS®. ANY IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS ARE UMITEDTOTHE DURATION OFTHIS WRfTTENWARRANTY. SJE-RHOM- BUS'°SHALL NOT, IN ANY MANNER, BE LIABLE FOR ANY INCIDENTAL OR CONSEQUENTIAL DAMAGES AS A RESULT OF A BREACH OF THIS WRITTEN WARRANTY OR ANY IMPLIED WARRANTY. 105 ELECTRICALSHOCK HAZARD Disconnect power before installing or servicing this EXPLOSION OR FIRE HAZARD Do not use this product with flammable liquids. product. A qualified service person must install and •;1;e - Do not install in hazardous locations as defined by service this product according to applicable electrical and plumbing codes. 0 National Electrical Code, ANSI/NFPA 70. Failure to fo low these precautions could result in serious Injury or death. Replace product immediately if switch cable becomes damaged or severed. Keep these instructions with warranty after installation. This product must be Installed in accordance with National Electric Code, ANSI/NFPA 70 so as to prevent moisture from entering or accumulating within boxes, conduit bodies, fittings, float housing, or cable. For detailed specifications on this product, or for the complete line of SJE Rhombus® panel, alarm, and switch products, visit our web -site at www.sjerhombus.com. INSTALLING THE FLOAT SWITCH 1. Place the cord into the clamp as shown in Figure A. 2. Locate the clamp at the desired activation level and secure the clamp to the discharge pipe as shown in see Figure A. Note: Do not install cord under hose clamp. 3. Tighten the hose clamp using a screwdriver. Over tightening may result in damage to the plastic clamp. Make sure the float cable is not allowed to touch the excess hose clamp band during operation. 4. Wire cable leads directly into control device as shown in Figure B. 5. Check installation. Allow system to cycle to insure proper operation. Note: All hose clamp components are made of 18-8 stainless steel material. See your SJE-Rhombus"' supplier for replacements. INSTALLING THE ALARM 1. Mount alarm box using existing holes in back of box. To ensure water -tight seal, use screws and sealing washers included with alarm. Note: Screws are to be located over wall stud or used with a wall anchor sized for a #8 x 1.25 self tapping screw. 2. Determine "conduit -in" locations on alarm as shown in Figure B. Note: When used with a pump application, connect alarm to a circuit separate from the pump circuit. This allows alarm to continue to operate if the pump circuit fails. 3. Drill holes for conduit entry, taking care not to damage bosses inside alarm box. 4. Attach conduit. I If alarm includes premounted terminal block option, refer now to the Terminal Block Option Wiring Instructions. 5. Bring float switch cable through conduit and wire to terminal block positions 1 and 2 as shown in Figure B. 6. Wire power conductors to terminal block positions 3 and 4 and ground wire to ground termination post as shown in Figure B. Note: If terminal block option is used, attach ground wire as shown in Figure A of Terminal Block Option Wiring Instructions. 7. If remote device is used, connect wires as shown in Figure B using supplied wire nuts. 8. Attach alarm box cover using the four pre -installed screws. 9. Tum on power. Light on switch should come on. 10. Check installation by manually tipping the float. The horn and beacon should turn on. 11. Push silence switch to test silence feature. 12. Test unit once per week to insure proper operation. Figure A Figure B Y IIomI c jil .. 3.5 inch (9 cm) tether iengih SAiithompAg 22650 County Highway 6 P.O. Box 1708 1 Detroit Lakes, Minnesota 56502 USA 1-888-DIAL-SJE(1-888-342-5753)1 Phone:218-847-1317 ■ Fax:218-847-4617 E -malt: sje@sJerhombus.com 106 ®SJE-Rhombus Printed in USA 02/03 Effective 02/G3 Intl. Instr_ P 1011979A Hello