HomeMy WebLinkAbout20222208.tiffForm No.
GWS-25
OFFICE OF THE STATE ENGINEER
COLORADO DIVISION OF WATER RESOURCES
APPLICANT
818 Centennial Bldg,, 1313 Sherman St, Denver, Colorado 00243
(303) 8663581
LIC
WELL PERMIT NUMBER 1S159J4
DIV. 1 CNTY, 62 WD 1 DES. BASIN MD
Lot; Sleek: Filing: Subdiv:
GERALD W & MARILYN F SPRINGER
4895 EASLEY RD
GOLDEN CO 8O4O3
(303)278-1047
PERMIT TO CONSTRUCT A WELL
APPROVED WELL LOCATION
WELD COUNTY
SW 1/4 NW 1/4 Section 25
Twp 1 N RANGE 65 W 6th P.M.
DISTANCES FROM SECTION LINES
1760 Ft. from North Section Line
325 Ft. from West Section Line
ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT
CONDRIIONS 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 the
permit does not assure the applicant 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 and Pump Installation 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 17.
3) Approved pursuant to CRS 37-92-602(3)(b)(il)(A) as the only well on a tract of land of 44 acres described as part
of the NW1/4 Section 25, Township 1 N, Range 65 West of the 6th P.M., more particularly described on the
attached exhibit A.
4) The use of ground water from this well is limited to ordinary household purposes inside three single family
dwellings, fire protection, the watering of poultry, domestic animals, and livestock on farms and ranches, and the
irrigation of not over one (1) acre of home gardens and lawns.
5) The total depth of the well shall not exceed 75 feet or the first shale layer, whichever conies first, which
corresponds to the base of the alluvial aquifer.
6) The maximum pumping rate shall not exceed 15 GPM.
7) The • return flow from the use of the 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.
8) This well shall be constructed not more than 200 feet from the location specified on this permit, 4,41.5 -
Note: To insure 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.
APPROVED
RAN
$tata15nphnoa
• Receipt No. 0381861 DATE ISSUED APR 0 5 1995
BY
EXPIRATION DATE APR 0 5 1997
ON -SITE WASTEWATER TREATMENT SYSTEM
RECOMMENDATIONS FOR
1644 COUNTY ROAD 47,
(HUDSON),
WELD COUNTY, COLORADO
FOR
STEVE ROLL
CDS ENGINEERING CORPORATION
LOVELAND, COLORADO
PROJECT NUMBER
18-9586
DECEMBER 31, 2018
CDSEngineering Corporation
December 31, 2018
Project No. 18-9586
Mr. Steve Roll
1644 County Road 47
Hudson, CO 80642
Dear Steve,
Enclosed is the report you requested of the on -site wastewater treatment system
recommendations for the proposed dog kennels to be located at 1644 County Road 47, Weld County,
Colorado.
The design criteria and recommendations provided in this report are in compliance with Weld
County regulations for On -site Wastewater Treatment Systems. The system should function
adequately if installed, operated, and maintained in accordance with this criteria.
If you should have any questions concerning the information in the report, please feel free to
contact this office.
Reviewed by:
l
1/„./
Kevin F. Becker, P.E.
Enclosures
Respectfully,
FOR AND ON BEHALF OF
CDS ENGINEERING CORPORATION
fff
Jose'Ex-iz, Engineering Technician
165 2nd Street S.W. • Loveland, CO 80537 • (970) 667-8010 • Fax (970) 667-8024 • www.cds-eng.net
TABLE C.F CONTENTS
Letter of Transmittal
Table of Contents
Scope
Site Investigation
Site Location and Description
Subsoils and Groundwater Conditions
Soil Treatment Area
Materials
Absorption Field
Backfilling and Site Grading
Conclusions
ATTACHMENTS
Site Drawing and Location of Test Pits
Septic System Design Details
OWTS Details
Septic Tank Details
General Notes
Log of Test Pits
Soil Treatment Area Calculations
General Maintenance Recommendations
ii
i
ii
1
1
1
2
2
2
3
4
4
Figure No. 1
Figure No. 2
Figure No. 3
Figure No. 4
Figure No. 5
Figure No. 6
Figure No. 7
Appendix I
1
SCOPE
This report provides on -site wastewater treatment system recommendations for the proposed
dog kennel to be located at 1644 County Road 47, Weld County, Colorado. It is our understanding
that this system will service a kennel for up to ten (10) dogs and two (2) part time employees, with
no future expansion planned at this time. The wastewater strength is anticipated to be typical for that
of domestic wastewater as defined by the State OWTS Regulations.
SITE INVESTIGATION
A field investigation, performed on November 26, 2018, consisted of logging two (2) test pits
to a depth of eight (8) feet. The Location of the Test Pits is shown on Figure No. 1. A Log of Test
Pits is shown on Figure No. 6. The descriptions of the soils are based, primarily, on visual and
tactual methods which are subject to interpretation.
Other than the distances to setback objects indicated on the design documents, no other
objects requiring setbacks from the proposed on -site wastewater treatment system (OWTS), as
indicated in Tables 30-7-1 and 30-7-2 of the Weld County Regulations, have been located or
observed during our exploration.
SITE LOCATION AND DESCRIPTION
The site is located south of Hudson, south of County Road 6 and on the east side of
County Road 47, Weld County, Colorado. The site is generally in a plains region with dirt roads
and utilities, and vegetation was largely nonexistent. The site has an approximate 1% slope to
the south. An existing residence and several out buildings are located on the site. The house has
a water well associated with it and the Box Elder Lateral is located to the north.
Based on information available to us at the time of this report, easements are not noted on the
property. However, we recommend title work, or other means, be completed prior to construction to
ensure the property is clear of easements. From information provided on the County Property
Information Portal Maps, this property is not located in a floodplain.
2
SUBSOILS AND GROUNDWA'I'LR CONDITIONS
Based on the test pits logged within the proposed soil treatment area, the subsurface
conditions at the site consist of clay loam and loam. Based on the soil texture and structure within
the soil horizon observed in the test pits, the classification used for this design is Soil Type 2A.
Groundwater levels were recorded at the time of our field exploration. During our field
explorations groundwater was not encountered in the test pits. We do not anticipate the high
groundwater level to be within four (4) feet of the infiltrative surface.
Based on the conditions described above, an absorption system should be suitable for this
site.
SOIL TREATMENT AREA
Based on the conditions in the test pits, the infiltrative surface shall be placed between three
and one-half (31/2) and four (4) feet below existing grades.
MATERIALS
The materials used in construction of the on -site wastewater treatment system shall be new,
durable and not subject to corrosion, such as concrete, fiberglass or plastic. All materials shall be
installed per manufacturer specifications. All connections between components shall be water tight
to prevent leaks and infiltration.
Piping
Unperforated plastic pipe used in gravity flow beds shall have a nominal diameter of four (4)
inches, and a wall thickness of 0.120 inches, or greater. SDR 35 or Schedule 40 pipe could
be used. The piping from the building to the septic tank and from the tank to the field shall
have a minimum fall of/S-inch per foot ('14 inch per foot preferred). Perforated piping used
in the absorption bed or trench shall have a minimum nominal diameter of three (3) inches,
and a wall thickness of 0.070 inches, or greater. ASTM D2729 sewer and drain pipe is
acceptable for this application. Piping under pressure in a pressurized system shall be a
minimum of Class 200 PVC. Pipe lain in beds or trenches shall be level. The terminal ends
of all lines shall be capped. Pipe bends shall be limited to 45 degrees or sweeping 90 degree
3
"L"s. Gravity flow building sewer and effluent lines shall be buried a minimum of one (1)
foot. All pipe bedding and trench compaction shall be in accordance with the manufacturer
guidelines.
Septic Tank
Septic tanks can consist of concrete or plastic and shall meet the provisions set forth in the
county on -site wastewater treatment regulations, and concrete tanks shall be constructed in
accordance with ASTM O1227. Tanks shall be placed a minimum of five (5) feet from any
dwelling or building with a permanent foundation. The tank shall have a minimum of two
(2) compartments. Tank size is based on design flow. See Figure No. 2 for specific tank size.
The tank lid shall be able to support a minimum of four (4) feet of soil cover. Tank
manufacturer shall provide specifications on maximum cover depth and other design
features. These should be provided to the engineer prior to delivery. Access risers shall be
provided for each compartment of the septic tank. Risers shall have a minimum 24 -inch
diameter opening and extend to, or above, ground level. Riser lids shall have a secure
closing mechanism to prevent unauthorized access. Tanks should be sold and delivered by
the manufacturer or manufacturer's representative.
Distribution Box
Distribution boxes shall be placed on solid, level ground to provide uniform distribution of
the effluent. Flow equalizers, such as speed levelers, shall be installed. The box shall be a
minimum of five (5) feet from the septic tank, and be sufficient size to provide outlets for all
lateral lines, otherwise additional distribution boxes may be required. Access to the
distribution box shall be provided by a riser, similar to that described for septic tanks.
ABSORPTION FIELD
The absorption field shall be placed a minimum of twenty (20) feet from a structure with a
basement, crawl space or foundation drain. The distance can be decreased to ten (10) feet from
structures without a basement, crawl space or foundation drain. The field shall be constructed in
accordance with this report and the drawings provided. The infiltrative surface and distribution
4
lines, or chambers, must be level.
Trenches shall be no wider than three (3) feet; beds shall be no wider than twelve (12) feet.
Beds shall be separated by six (6) feet, of soil, sidewall to sidewall. Trenches shall be separated by
four (4) feet of soil.
Inspection ports, accessible from the ground surface must be installed at the terminal end of
each line in a trench system and each corner of a bed system. The inspection port tube must extend
to the bottom of the infiltrative surface and not be connected to the end of the distribution pipe. The
bottom of the inspection ports in contact with the media shall be perforated or saw cut. Where
chambers are used, the inspection ports shall be installed per the manufacturer's recommendations, at
the end of each line.
See Figure No. 2 for information specific to this project.
BACKFILLING AND SITE GRADING
All major grading shall be accomplished before construction of the sewage disposal system.
Backfilling around septic tanks shall be accomplished before the installation of the piping. Backfill
around the tank shall be in a manner to prevent settlement and avoid undue strain on the tank.
Positive drainage from, and around, the bed must be provided by sloping, mounding, ditching or
berming.
CONCLUSIONS
The system should be constructed by a licensed septic system installer, in accordance with the
County On -Site Wastewater Treatment Regulations. An effluent filter could be installed in or after
the septic tank and may provide a longer life for the system. Minimum dimensions and setback
requirements specified by the state or county health department regulations shall be upheld. It is the
contractor's/owner's responsibility to inform the engineer or health department of anything not
mentioned in this report that may impact the performance of the septic system. This system is to
meet all rules and regulations set forth by the County Health Department. The system is to be
inspected by a representative of the County Health Department and Engineer, prior to backfilling.
5
All future owners are to be directed to information in Appendix I (General Maintenance
Recommendations) of this report. These tests are only valid for the areas tested. Additional
percolation tests and soil profile information will be required if the septic system is to be constructed
in a different location than covered by this exploration. The findings and recommendations of this
report have been obtained in accordance with accepted engineering practices in the field of
Geotechnical Engineering. There is no other warranty, either expressed or implied. The county
health department has final acceptance over these test results and referenced system. All
construction shall be in compliance with the septic system permit.
PROPOSED
—BUILDING
r---
N
PI1
N
N
of
J Aid/. N
Site Drawing and Location of Test Pits
Client: Steve Roll
Project: 1644 County Road 47 (Hudson)
Weld County, Colorado
\\-SEE FIGURE - 2
100
0
100
SCALE 1 "=100'
Engineering
Corporation
Date:
12/31/18
Project No.
18-9586
Drawn:
JOE
165 2nd St. S.R.,
Loveland, Colorado 60537
Tele: (970) $67-9010
Figure: 1
30 30
SCALE 1 '�30'
CLEANOUI
L
P
70'BLO SETBACK, STA
1000 GALLON
SEPTIC TANK
W/FILTER
PROPOSED
KENNELS,
SLAB ON GRADE
O
D•B0SC
TP-2
• 1
76
19I.JNITS
INSPECTION
POOl.TYP
l!k\-TP-1
E:XI S'1I IO
POLE.. LUARN
DOGS+EMPL: 10+2 GPD:400 LTAR: 0.50 SOIL:2A
ABSORPTION AREA: 684 sq. ft. CHAMBERS: 57
SEPTIC TANK: 1000 gal. PUMP TANK: NA
LIMITING LAYER: NA STA DEPTH: 3.5' - 4' MAX,
Septic System Design Details
Client: Steve Roil
Project: 1644 County Road 47 (Hudson)
Weld County, Colorado
Engineering
Corporation
Date:
Project No.
12/31/18
18-9586
Drawn.
JOE
165 2nd St. S.W.,
Loveland, Colorado B0537
Tele! (970) 687-8010
Figure:
2
SLOPE SURFACE TO
PREVENT PONDING AND
PROMOTE RUNOFF
w
Typical Cross Section
FINISH GRADE
4' PIPE FROM
TANK
INFILTRATIVE
SURFACE
Y
GRAVITY CHAMBERS i
ESTABLISH VEGETATIVE COVER
NATIVE BACKFILL
1
SLOPE TO STA
12' Maximum
CHAMBERS
PER REPORT
OBSERVATION PIPE (4)
6' MIN
BETWEEN BEDS
4" OBSERVATION PIPE (4),
,- NOTCH BOTTOM
PIPE TO ENTER TOP
HOLE OF END CAP.
IN -SITU
MATERIAL
OWTS Details
Client: Steve Roll
Project: 1644 County Road 47 (Hudson)
Weld County, Colorado
Engineering
Corporation
Date:
12/31/18
Project No,
18-9586
Drawn:
JDE
165 2nd St. S.R.,
Loveland, Colorado 90537
Tele: (970) 667-8010
Figure:
3
TYPICAL CONCRETE SEPTIC TANK
INSPECTION ACCESS
RISER TO GRADE,
WITH LID
SEALED WATER TIGHT
TO TOP OF TANK
INLET PIPE, 4" 0
D-3034 OR SCH 40.
MIN y" PER FT. WITH
NO PORTION LESS
THAN }a" PER FT
24" MIN
4' tti4Ak
L prsd Level
INLET TEE,
SWEEPING BEND
State and county approved precast concrete or plastic tank required.
Tank must be placed level.
Tanks must be watertight.
LID AT GRADE
FILTER HANDLE, PLACE
WITHIN 1' OF TOP
4"0 ASTM D-3034
OR SCH 40 FOR GRAVITY.
FOR PRESSURE SYSTEM
SCH 40 SEE REPORT
FOR SIZE.
EFFLUENT FILTER,
REQUIRED FOR
PRESSURIZED SYSTEM
4. Must have two or more compartments or more than one tank can be used in series, The first compartment of a two -compartment
tank or the the first tank in a series must hold no less than one-half of the required effective volume.
5 Inlet invert must be at least two inches higher than the outlet.
6 At least one access opening no less than 20 inches across must be provided in each compartment of the tank.
7. Septic tanks must have watertight riser over each access manhole and and all risers must extend to or above final grade.
8. Each riser lid must be watertight, brought to or above the surface, and must have a secure closing mechanism.
9. For new construction, the top of any septic tank, dosing tank or vault must be no deeper than four feet below finished grade.
10. See report and state or county regulations for additional information.
Septic Tank Detail
Client: Steve Roll
Project: 1644 County Road 47 (Hudson)
Weld County, Colorado
Engineering
Corporation
Date: 12/31/18
Project No. 18-9586
Drawn: JDE
185 2nd St. S.lr.,
Loveland, Colorado 80537
Tele: (970) 887—B01D
Figure: 4
1. Topsoil should be saved for final cover.
2. SEPTIC TANK: 2 compartment tank. Locate a minimum of 5' from residence and/or distribution box.
Manhole lids and risers shall extend to the surface. Inlet tee must consist of a sweeping bend.
3. ABSORPTION AREA: Shall not be excavated in a manner that will compact or smear the infiltrative surface,
i.e. no wheel loads. Infiltrative surface to be level. Bed area and dimensions are provided on this drawing.
4. SUPPLY LINE: Shall be solid ASTM D3034 (SDR 35) or Schedule 40 PVC laid with a minimum fall of 1/4"
per foot (with no portion less than 1/8" per foot). Pipe shall be a minimum of 4" in diameter. All pipes,
except distribution laterals, shall be bedded with select materials. See county regulations. Bedding and
backfill material shall be compacted to reduce settlement.
5. Sewer line between the building and the septic tank shall be a minimum of 22" deep or protected from
freezing.
6. CLEANOUTS: Required between the building and the septic tank. Shall be installed within 5' of the building
and at intervals not to exceed 100'. Also any change in direction greater than 45 degrees. See county
regulations for additional requirements.
7, DISTRIBUTION BOX: If used, shall be laid level for uniform distribution of effluent. Flow equalizers shall be
installed. Install riser to surface.
8. CHAMBERS: Quick 4 Standard Chambers. Chamber information based on published material by Infiltrator
Systems, Inc., and State Regulation 43, Section 43.13 (e)(1)(d). If alternate chambers are to be used notify
engineer prior to construction as bed configuration may change.
9. STA width shall not exceed 12' and shall be no deeper than 4'. Minimum distance between beds is 6'
sidewall to sidewall. Minimum distances between trenches is 4', sidewall to sidewall.
10. INSPECTION PORTS: Shall be accessible from the surface. To be installed at the terminal end of each line
or chamber row for a trench system; or at each corner of a bed system. They shall extend to the infiltrative
surface. Ports shall be perforated or saw cut on the bottom portion in contact with the media. May be
installed directly into chamber per. mfr. specifications if the infiltrative surface can be seen.
11. COVER: Cover material to consist of native soils capable of supporting vegetation. Vegetation should be a
drought resistant grass such as a tall fescue. Installer & owner shall coordinate on planting and maintaining
seeds to germination. Tall grass shall be kept short during the winter months.
12. SITE DRAINAGE: drainage shall promote water runoff over the bed and prevent bonding within 10' of bed.
13. SITE USAGE: Vehicle and hoofed animal traffic shall be prohibited over top of bed.
14. See Report and County or State Regulations for additional information,
D./O-S General Notes
Client: Steve Roll
Project: 1644 County Road 47 (Hudson)
Weld County, Colorado
Engineering
Corporation
Date: 12/31/18
Project No. 18-9586
Drawn:
JDE
185 2nd St, S.A.,
Loveland, Colorado 80537
Tele: (970) dal -0010
Figure: 5
TP-1
TP-2
a'
5'
6'
Clay loam, brown, damp, firm
Shape: Prismaic Grade: Weak
Soil Type: 3A
Clay loam, brown, damp, firm
Shape: Prismaic Grade: Weak
Soil Type: 3A
3.5' 1 3.5'
Loam, dk. brown, moist, friable
Shape: Massive Grade: Structurless
Soil Type: 2A
8'
Loam, dk. brown, moist, friable
Shape: Massive Grade: Structurless
Soil Type: 2A
Limiting layer: NA Depth: NA Groundwater NA
Type:
Limiting layer: NA Depth: NA Groundwater NA
Type:
Date of Excavation
01/01/18
Date of Investigation
11/26/18
Equipment
Backhoe
Technician
JDE
Solt Type CNRCS)
Vona sandy loam, 0 to 1
LOG OF TEST PITS
Client: Steve Roll
Project: 1644 County Road 47 (Hudson)
Weld County, Colorado
Engineering
Corporation
Date: 12/31/18
Project No. 18-9586
Drawn: JDE
165 2nd St. S.W.,
Loveland, Colorado 80537
Tele: (970) 667-8010
Figure: 6
SOIL TREATMENT AREA CALCULATIONS
Number of Dogs:
Minimum Septic Tank Size:
10 No. Employees: 2 part time
1000
Design Flow 400 (Tables 30-6-1 & 30-6-2, WCHD On -site Wastewater Regulations)
LTAR
0.5 (Table 30-10-1, WCHD On -Site Wastewater Regulations)
Adjustment Factors (Tables 30-10-2 & 30-10-3, WCHD On -site Wastewater Regulations)
Gravity
Chambers
1.2
0.7
Type of Chamber used: Infiltrator Quick 4 Standard
Effective Area of Chamber: 12
Minimum STA (sq. ft.):
672
Soil Type: 2A
Bed Configuration
Bed Number
Length (ft)
Width (ft)
Number of Rows
Chambers per
Row
Bed Size (ft2)
1
76
9
3
19
684
Total Infiltrative Surface
Area (ft2)
684
Designed Number of
Chambers
57
Calculation Formulas
Minimum Absorption Field Size (ft 2)
Design Flow
LTAR
Adjustment
x
Factors
400
0.50
x 1.2 x 0.7 = 672
Minimum Number of Chambers
Bed Area
Effective Area
672
12
= 56 Units
CLIENT:
Steve Roll
CDSPROJECT
Engineering Corporation
NO.
18-9586
LOCATION:
1644 County Road 47
165 2nd St SW • Loveland, CO • 80537 • 970-667-8010 • www.cds-eng.net
Fig. No.: 7
\\SERVER\CDS Files\structural-Geotech\Projects\Roll, Steve\1644 County Road 47, Weld\18-9586 OWTS Calc.xlsx
APPENDIX I
GENERAL MAINTENANCE RECOMMENDATIONS FOR
INDIVIDUAL SEWAGE DISPOSAL SYSTEMS
The following minimum recommendations, if followed, should help increase the lifetime of the
system:
1. Septic tanks should be pumped as often as needed based on usage. Generally, when
the scum layer plus the sludge layer equals 25% of the liquid depth in the tanks, it
should be pumped out.
2, Septic tanks and distribution boxes should be checked at least once a year for sludge
accumulation which may clog the soil treatment area if overflow occurs.
3. The soil treatment area should not be used for grazing, sports activities, traffic, or
other activity which may compact the soils.
4, Schedule 40 pipe should be used if lines are to be placed under driveways.
5. Trees should not be planted within 10 feet of the soil treatment area so as to prevent
roots from clogging the system. -
6. If trees are to be planted nearby, they should be located so that the soil treatment area
is not shaded.
7. Overuse of strong chemicals, which may kill the bacteria in the system and inhibit
decomposition of the sewage, should be avoided.
8. Positive drainage should be maintained over and around the absorption field area to
prevent pooling of water.
REV 09/21/17
Work Description:
ENS SEPTIC GENERAL:
Application Number:
Owner Name:
Site Address;
App Type:
WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
1555 North 17th Avenue, Greeley. CO 80631 www.weldheaEth.org
Septic Permit New
SP -1900090
ROLL STEVEN
1644 CR 47
HUDSON, CO 80642
Health\Commercial\New OWTSISeptic
MICKY MCKEE
15759 CR 4
BRIGHTON, CO 80603
Parcel Number: 147325000040-R0125295
Legal Desc: 10840-B PT NW4 25 1 65 LYING S OF N LN BOX ELDER
LATERAL DESC AS BEG S2031.6' OF N4 COR SEC WLY ALG
N LN LATERAL S72D32'W 49.19' S85D59'W 95.43' N67D58'W
108.48' N55D15'W 189.3' N73D41'W 50.72' N86D30'W 726.25'
N77D23'W 82.98' N85D23'W 72.52' S72D24'W 136.15'
S52D55'W 97,96' S41 D30'W 167.45' $65D01'W 79.9'
N70D55'W 97.87' N53D44'W 417.15' N64D23'W 59.47'
N79D36'W 85.93' N85D01'W 200.35' N69O31'W 30.02' SOD03'E
929.09' TO S LN NW4 E2505.02' TO SE COR NW4 NOD28'E
631.07' TO POB (.64R 3.6D)
SHOP WASH STATION FOR ANIMALS
Application Status:
Final Pending
Applied Date;
03/25/2019
Intake Person:
LNIX
Permit Expiration Date:
Application Date
Full Bathrooms
Parcel Acres
Private Water Supply
Private Water Supply Permit Reference
03/25/2019
1
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Well
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Page 1 of 3
Public Health
ENS PERC TEST (SITE) :
% Ground Slope
Enginoor Design Required
Engineer Job Number
Limiting Zone Feet
Limiting Zone Qualifier
Long Term Acceptance Rate
Profile Pits
Slope Direction
Soil Description
Soil Type
Soil Type Suitable
1
Yes
18-9586
8
Greater Than
0.5
2
South
Clay loam/loam
2A
Yes
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:
Absorption Bed 684
Engineer Design Absorption Area Specified 684
Engineer Design Chamber Specified Quick4 Plus Standard
Engineer Design Number of Chambers Specified 57
Engineer Septic System Design Type Specified Chambers -Bed
Septic Tank Size 1000
CONDITIONS:
Description: New Permit Conditions
Comment: Onsite wastewater treatment system must be 10 feet from property line. Install the soil
treatment area within 50 feet of the soils test location. Construct onsite wastewater treatment
system according to Engineer design. An engineer approval letter approving system as
installed per engineer design is required. Engineer designed OWTS must be inspected by
the design Engineer prior to backfilling. Place bottom of soil treatment area between 3.5 and
4 feet below original grade. Septic tank must be at least 50 feet from any well. Soil
treatment area must be at least 100 feet from any well. Building sewer or effluent lines must
be 50 feet from any well unless the lines are encased. Septic tank must be at least 10 feet
from any potable water line, unless water line is encased. Building sewer or effluent lines
must be at least 5 feet from any potable water line, unless water line or sewer line are
encased. Soil treatment area must be 25 feet from any potable water line, unless water line
is encased. Septic tank, soil treatment area, building sewer line, and effluent line must be at
least 50 feet from any unlined ditch. Sewer line to septic tank must have at least 1/flinch/ft.
fall. Effluent line from septic tank to distribution box must have at least 1/8inch/ft. fall. Install
inspection ports at the ends of each trench or corners of each bed. All Weld County
regulations are applicable.
INSPECTION RESULT:
Description: Site Status: Approved to Issue
Comment:
HeaIth Administration
Vital Record'
Public Health 8 Envconrnentol H*akh Communication Ernvrpanov Propar►dnesa
ciinieal Sir! vie as Savoie,' Education a Ptonnin4 L Naponsa
Page 2 of 3
Public Health
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 meat
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 petinll Is non -transferable and
non-refundable, Before issuing final approval of this permit 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 is contingent upon the final
inspection of the completed system by the Weld County Department of Public Health and Environment.
Jon Deak March 28, 2019
Environmental Health Specialist Date
Page 3 of 3
Health Administration
vlial Records
Public Health a
Clinical Services
I.d
Environmeniall.a% Carnmunieofion,
Services
I„i_,. q '1
f OF V +C'4 ,,I'
Education s /Kenning
Emergency Prepareanrss
I Response
I. -I, y"HI r.4Ja
Pub8Cliealth
,Scanning Cover Sheet
for
Septic Permits
Permit #
Permit Type:
G19950076
Health / EHS History I EHS Conversion History
Situs Street Address 1844 CR 47
Situs City, State, Zip
Sec/Town/Range: 25 -01N -65W Application Status: Fineled
Application Date: 03/11/1996
Parcel # (12 digits) 147325000040-80125295
Owner Full Name:
Owner Address:
Contact Name:
Contact Address:
SPRINGER GERALD/MARILYN
4895 EASLEY RD
GOLDEN,CO 60403
Owner Phone #: 303 2781047
Contact Phone#
Information above has been Verified in Accela by employee noted below
x
August 12, 2008
Processed b Date
Report ID: EHS00024v003
Print Date -Time: 6/12/2008 11:30:45AM
Page 1 of 1
HSP1r:I6P
INDIVIDUAL SEWAGE DISPOSAL. SYSTEM PERMIT NO. (3--•950076
WELD COUNT Y HEAL1 I•a DEF'AR FMENI
ENVIRONMENTAL_. HEALTH SERVICES
1.517 16T1-1 AVENUE COURT, GREEL..E:Y.. CO ci{=>ism
:� 53--C1fa3 5 ElC'T'.Z;:.?5
NEW FERMI F
OWNER SF'RIN(3FRH GERALD/MARILYN ADDRESS 4595 E.A{:,I,,.EY RD PH (30: 275•--1047
Y�
GOLDEN // /// CO 804[0:3
ADDRESS OF PROPOSED SYSTEM h._,...'h,.�.�.- - r,l. ,! G. lr J95 6e.a / h "
4.
HUDSON CO 50642
LEGAL... DESCRIPTION OF SITE° SEC `5 TWP 1 RNE 65
SL1BDIVISION° LOT 0 BLOCK 0 FILING 0
USE TYP'E: RE;s:[DEN1 AL. HOUSE
S E'RVICEE PERSONS 2 BATHROOMS 1.75 LOT SIZE 44.01 ACRES
BEDROOMS 3 BASEMENT' PLUMBING NO WATER SUPPLY PWIE L.,L
APPLICATION FEE 43150.00
RE.C'I:) BY
DATE 03/06/95
SIGNED BY GERALD W. SPRINGER
DATE 03/06/95
PERCOLATION RATE. 40.0 MIN PER INCH LIMITING ZONE :L0 FEET
SCUT._ TYPE„: SUITABLE PERCENT GROUND SLOPE 0% DIRECTION
REQUIRES ENGINEER DESIGN NO IN 100 YEAR FLOOD PLAIN ZONE NO
FROM THE APPLICATION INFORMATION SUPPL..,I D AND THE ON —SITE SOIL E='I_ERCOLA TERN DATA
A
THE FOLLOWING MINIMUM INSTALLATION SPECIFICATIONS ARE REQUIRED:
SEPTIC TANK 1.000 GAL._L.ONS, ABSORPTION TRENCH SQ. FT'„
OR
ABSORPTION BED 1;_:c:,5 SO„
IN ADIT[T'ION, THIS PERMIT IS SUBJECT TO TI.1E FOLLOWING ADOli':I:`7NAL TERMS AND
CONDITIONSa
THIS PL•-..RNIIT IS GRANTED TEMPORARILY TO ALLOW CONSTRUCTION TO COMMENCE. THIS PERMIT
MAY BE REVOKED OR SUSPENDED BY THE WELD COUNTY HEALTH DEPARTMENT FOR REASONS SET
FORTH IN THE WELL) COUNTY INDIVIDUAL SEWAGE DISPOSAL. SYSTEM REGULATIONS INCLUDING
FAILURE: TO MEET ANY TERM UR CONDITION IMPOSED THEREON DURING TEMPORARY OR FINAL..
APPROVAL._„ THE ISSUANCE OF THIS P='ERM'IT DOES NO'F. CONSTITUTE ASSUMPTION EIY THE
DEPARTMENT OR :[TB EMPLOYEES OF LIABILITY FOR THE FAILURE OR INADEQUACY OF THE
SEWAGE DISPOSAL.. SYSTEM„
TREVOR JIRICEI( 04/25/95
ENV:I:RONMEN'1"AL. SPECIALIST DATE
THIS PERMIT IS NOT TRANSFERABLE LE AND SHALL BECOME VOID IF SYSTEM CONSTRUCTION HAS
NOT COMMENCED WITHIN ONE YEAR OF ITS ISSUANCE„ BEFORE ISSUING FINAL APPROVAL OF
THIS PERMIT" THE WE.I._) COUNTY HEALTH DEPARTMENT RESERVES THE. RIGHT TO IMPOSE ADDI—
TIONAL TERMS AND CONDITIONS REQUIRED TO MEET OUR REGULATIONS ON A CONTINUING BA—
SIS. FINAL PERMIT APPROVAL IS CONTINGENT UPON THE: FINAL INSPECTION OF' THE COM—
PLETED SYSTEM BY THE WELD COUNTY HEALTH DEPARTMENT.
SYSTEM INSTALLER -•--- +,19/ 1= IN AL INSPECT' DATE 57 9r
SYSTEM ENGINEER . __ _ _.,—OPP 4CJVAL
TYPE (J' SYSTEM INSTALLED ED LNVII lJNML N I AL
THE :ISSUANCE OF THIS PERMIT DOES NOT IMPLY COMPLIANCE WIT1-I OTHER STATE « COUNTY
OR LOCAL. REGULATORY OR BUILDING REQUIREMENTS, NOR SHALL I I" ACT TO CERTIFY THAT
-THE.•:: SUBJECT SYSTEM WILL. OPERATE IN COMPLIANCE WITH APPLICABLE STATE, COUNTY ANT.?
LOCAL REGULATIONS ADOPTED F -'E RSUAN'1' TO ARTICLE. is },. TITLE 25, CRS 1973. AS AMENDED,
EXCEPT FOR THE PURPOSE OF ESTABLISHING FINAL APPROVAL OF AN INSTALLED SYSTEM FOR
'ISSUANCE F; OF A LOCAL OCCUPANCY PANCY PERMIT PURSUANT TO CRS 1973 25-10-111 E.2)
flF' FRTKIA1 ITANFEn r nr-'v--•I,.Ir.kn
Ixlf•`l.d'i1 Mx14, ir'r /l
N
isri
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lg
i
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000
ond
V
se
Y'�
Colotodo Soil AND PERCOLATION TESTS, INC.
?'4'ys-''ti -6:d�-FLry-'=:,r.�.'",I`3'+r`�i'l*Sao`�+rfr�;x,f'Y.1aSst.VbVIWiriy,+';,...t:01-M1Pillbr.1,t`°'f`r0A-1.f`5.'E-Tr��E.,;4',r��•r.
SOIL TESTS • FOUNDATION DESIGNS • PERCOLATION TESTS • SUBDIVISIONS
SUBSURFACE INVESTIGATION
AND
PERCOLATION TEST RESULTS
ON
j` I
J APB +Q
� 51
A TRACT OF LAND LOCATED IN THE NORTH WEST 1/4
OF SECTION 25, TOWNSHIP 1 NORTH, RANGE 65 WEST OF
WELD COUNTY, COLORADO
FOR
Opp i t Gc-v rJ
(---oo 7(c,
GERALD W. SPRINGER
4895 EASLEY ROAD
GOLDEN, COLORADO 80403
278-1047
REPORT NUMBER 95-205
APRIL 10, 1995
fP..�Y,S,Y_ ..----=--; ,9 ,9,9
y4t.' h •A'
#5 PHELPS DRIVE • CASTLE ROCK, COLORADO 80104 • (303) 688-9475
S
TABLE OF CONTENTS
AGREEMENT OF PURPOSE AND DISCLAIMER
GENERAL
CONCLUSIONS AND FOUNDATION RECOMMENDATIONS
SITE CONDITIONS
FIELD AND LABORATORY INVESTIGATION
DESIGN AND CONSTRUCTION DETAILS
SLAB ON GRADE CONSTRUCTION
SURFACE DRAINAGE
SUBSURFACE DRAINAGE BASEMENT CONSTRUCTION
REINFORCING
CONSTRUCTION DETAILS
PERCOLATION TEST RESULTS
LOCATION MAP
LOGS OF TEST HOLES
SWELL CONSOLIDATION TESTS
DECORATIVE GRAVEL OR BARK
DETAILS OF FOUNDATION DRAIN
CONTINUOUS FOOTINGS
SUMMARY OF LABORATORY TESTING
EQUIVALENT FLUID PRESSURE
PAGE 1
PAGE 1
PAGE 1
PAGE 2
PAGE 2
PAGE 3
PAGE 4
PAGE 6
PAGE 6
PAGE 6
PAGE 7
FIGURE 1
FIGURE 2
FIGURE 3
FIGURE 4
FIGURE 5
TABLE 1
TABLE 2
AGREEIVIENT OF PURPOSE AND DISCLATh'IER:
The parties specifically agree and contract that the purpose of this soil investigation
is to test, analyze, and report on the condition of the soils encountered only as these test
pertain to the suitable design and construction of an appropriate foundation for the proposed
building and/or residences to determine the load bearing capacities of the, soil.
THE PARTIES SPECIFICALLY AGREE THAT COLORADO SOIL AND PERCOLATION
TESTS INC. HAS NOT BEEN RETAINED NOR WILL THEY RENDER AN OPINION
CONCERNING ANY ENVIRONMENTAL ISSUES. HAZARDOUS WASTE OR ANY OTHER
KNOWN OR
NOWN CONDITIONS THAT MAY BE PRESENT ON THIS SITE, FULL
ENVIRONMENTAL TESTS AND kNALY$CS CAN BE COMPLETED FOR AN ADDIT'TQ AL
FEE AND EXECUTION QF A SEPARATE CONTRACT,
GENERAL:
This report presents the results of data obtained during the subsoil investigation of A
TRACT OF LAND LOCATED IN THE NORTH WEST 1/4 OF SECTION 25, TOWNSHIP
I NORTH, RANGE 65 WEST OF WELD COUNTY, COLORADO.
CONCLUSION AND FOUNDATION RECOMMENDATIONS:
A satisfactory type of foundation system will be continuous concrete footings bearing
on the undisturbed natural soil. These footings shall be designed for a maximum soil bearing
pressure of 1,500 pounds per square foot, dead load plus one-half live load, for all depths of
the excavated area. All loose and disturbed soil shall be removed before placing of the
concrete for the footings. The bottom of the footings shall be a minimum of three feet (3')
below final grade for frost protection. One can expect some settlement with this type of soil
1
•
condition, but with this- type of lightly loaded foundation system, it should be within
allowable limits. Refer to Table 2 for equivalent fluid pressure criteria.
SffE CONDITIONS:
At the present time this site is vacant. It is our understanding that a single family
residence with a basement and garage is planned far construction on this site.
FIELD AND LABORATORY INVESTIGATION:
Two (2) exploratory test holes were drilled on April 6, 1995 at the location on the site
as shown in Figure 1. These test holes were drilled with a four inch (4") diameter power
auger.
At specific intervals, the drilling tools were removed from the test holes and soil
samples were obtained with a two inch (2") inside diameter spoon sampling tube. The
depths at which soil samples were taken are shown on the Logs of Test Holes, Figure 2.
All soil samples were carefully inspected and classified, in the.field and laboratory.
The samples were subjected to visual inspection and laboratory testing in order to evaluate
the physical and mechanical properties of the materials encountered. The natural moisture
content and the natural dry density was obtained from relatively undisturbed drive samples
of typical materials. encountered. Swell -Consolidation tests were also performed on typical
samples of soil, see Figure 3. These tests indicate the behavior of the soil upon various
loading and wetted conditions.
The following guide is used to determine the degree of severity of soil expansion and
is referenced in Figure 3 of this report.
2
SWELL POTENTIAL
AT 1,000 LBS.
CLASSIFICATION
0 to %a°%
Non-exp. / Very Low
%, to 1'!,°%
Low
Di to V.4%
Moderate
3 h to 6%
High
6 to 8%
Very High
Greater than 8%
Critical
In general, both test holes consist of a sandy clay to the five foot (5') depth, and a
clayey sand found from. five foot (5') depth to the fourteen foot (14') depth, and a sandstone
encountered below the fourteen foot (14') depth. Both holes were drilled to a depth of twenty
feet (20'). No free water was encountered during the drilling operation.
DESIGN AND CONSTRUCTION DETAILS SLAB ON GRADE CONSTRUCTION:
The natural soils are suitable for the support of exterior concrete slabs, garage slabs,
and basement slabs. However, when clayey soils have an increase in the moisture content
and become wetted, they will expand in volume and swell, thus raising and cracking the
concrete slabs. When sandy soils have an increase in the moisture, content, they may
consolidate in volume and shrink thus lowering and cracking the concrete slabs. The builder
and future owners should be aware of and understand that there is a definite risk of future
damage with any . slab on grade construction.
If the builder and future owners are willing to accept the definite risk of some damage
due to concrete floor slab movement, the following recommended details should be carefully
followed during construction of the interior floor slabs. Experience with similar soil
3
it
conditions has shown that these details will help prevent wetting of the soils under the slabs
and will minimize damage when wetting of the soil does occur.
1. Do not place a gravel layer beneath the concrete slab. The slab should be placed
directly on the undisturbed natural soils, or well compacted fill soil.
2. Separate the slab from all load bearing members and utility lines of at least one inch
(1") to allow for independent movement of the slab. Provide a positive control or slip
joint at the construction joint between the slab and foundation walls.
3. Provide frequent scoring of the slabs to provide control joints for possible cracking of
the slab. Control joints should be placed to provide approximate. slab areas of 200
square feet.
4. The soils that will support the concrete slabs should be kept moist during construction
by occasional sprinkling of water and especially a day or so prior to pouring of the
slab. This procedure will help maintain the moisture content of the underlying soil.
5. In the event the builder or future owner desires to provide decorative gravel or bark
around the house, we have attached Figure 4 to illustrate one acceptable method of,
installation. The method will prevent ponding of water near the foundation and
provide for proper drainage away from the house.
SURFACE DRAINAGE:
The backfill soil around the house should be moistened and well compacted to prevent
future settling. Minimal and controlled puddling of the backfill soils is considered acceptable
by this office. The builder is reminded that some "warranty companies" prohibit "water
puddling" of the backfill soil. The backfill material should be free of trash, frozen soil and
4
large rocks. Limited and controlled puddling may be used on pier foundations and spread
footings if done prior to pouring interior slabs; however, do not puddle backfill material on
pad foundations. The future owner should be advised to fill in any settled area to eliminate
ponding of water near the house and to provide adequate slope for proper drainage away
from the house and off the site .at all times.
The finished grade or ground surface near the foundation walls should have adequate
slope to provide proper drainage away from the house and off of the site. A minimum slope
of ten percent (10%) for at least the first five feet (5') out from the house is recommended.
Roof downspouts and sill cocks should discharge onto long concrete splashblocks,
minimum of five feet (5') long, or into metal gutter extensions to deposit runoff water further
out from the house and beyond the limits of backfill soil near the foundation walls.
The future owners should be cautioned and advised against the installation of a lawn
sprinkler system within five feet (5') of the foundation walls. If a sprinkler system is
installed, the sprinkler heads should be placed so that water spray from the heads under full
pressure does not fall within five feet (5') of the foundation walls. Lawn irrigation should
be controlled to prevent excess wetting of the subsurface soils. Lawn, flowers, shrubs, and
other plantings within five feet (5') of the foundation walls should be hand watered and this
watering should be minimized. If a drip irrigation system is used, one should limit the
amount of water to sustain the plantings. One is also advised that any irrigation lines can
leak and/or break and release excessive amounts of water near foundations and can cause
damage to slabs and foundation walls,
5
•
SUBSURFACE DRAINAGE AND BASEMENT CONSTRUCTION:
No free water was encountered during the drilling of the test holes. Due to the
consolidation factor of the soil when it becomes wet , we require that a foundation drainage
system should be connected to an adequate outfall or into a sump area with a pump for
proper discharge of water. See Figure 5 for a suggested method of installing the foundation
drainage system. Ground water should not affect construction or be a deterrent to the
construction of the house with a basement.
REINFORCING:
The concrete foundation walls should be well reinforced at the top and bottom of the
walls to clear span at least a distance of ten feet (IV). This will give the walls, beam
strength, to span or bridge over any soft or loose pockets of soil not found in our exploratory
holes or that may develop during construction. This will also help prevent differential
movements of the foundation system.
CONSTRUCTION DETAILS:
In any soil investigation it is necessary to assume that the subsurface soil conditions
do not vary greatly from the conditions encountered in our field and laboratory testing. Our
experience has been that at times soil conditions do change and variations do occur and may
become apparent to the time of excavation for the foundation system. If soil conditions are
encountered which appear different from the test borings as presented in this report, it is
recommended that this office or a qualified soils engineer be called to inspect the open
excavation. This inspection is not a part of this report and is not included as any part
thereof.
6
+ • '''a
PERCOLATION TEST U TS
On April 13, 1995, percolation tests were conducted on the site known as A 44 ACRE TRACT
OF LAND LOCATED IN. THE NORTHWEST 114 OF SECTION 25, TOWNSHIP 1 NORTH,
RANGE 65 WEST OF WELD COUNTY, COLORADO.
The . percolation tests were performed in accordance with Chapter 25-10-104 (2) 1973 of the
Colorado Revised Statutes as amended, which pertains to individual sewage disposal systems.
The percolation rates of these tests are reported in minutes of time per inch of water drop. The field
percolation rate is the average of all the test holes observed in the proposed leaching area.
SOIL PROFILE HOLE ... 10 FEET DEEP
0,-10' Clayey Sand, moist, brown to light brown
PERCOLATION TEST HOLE #1 ... 48 inches deep
Percolation rate = 30 minutes per inch
PERCOLATION TEST HOLE #2 ... 48 inches deep
Percolation rate = 30 minutes per inch -
PERCOLATION TEST HOLE #3 ... 62 inches deep
Percolation rate = 60 minutes per inch
FIELD. PERCOLATION RATE = 40 minutes per inch
The minimum effective liquid septic tank capacity based upon the number of bedrooms is as
follows:
2 or less bedrooms
3 bedrooms
4 bedrooms
Each Additional Bedroom
750 gallons
1,000 gallons
1,250 gallons
Add 250 gallons
Assuming that the residence will contain both a garbage grinder
machine, the minimum acceptable size for the leach field should
automatic clothes washing
quare feet per bedroom_
A soil sample was taken at a depth of four feet (4') from the soil profile hole and consists of 6%
moisture, 0 % gravel, 77 % sand, and 23% minus 200 material.
LOCATION MAP
4,
4
444
ci
CJ
.4
J
LEGEND:
Foundation Soil Test Hole
a
ant -17y Pete
Soil Profile Hole
O Percolation Test Hole
r
Figure 1
Colorado Soil
Log of Test Holes
20
25
1 2
Sandy Clay, light brown
Clayey Sand, light brown
111 Sandstone, tan
NOTES: 1.i Depth at which soil samples were
taken.
2. 12112 indicates that 12 blows of a 140
pound hammer falling 30 inches is required
to drive a 2 -inch diameter sampler 12 -
inches.
Job Number: 95-205
i
Swell under constant
pressure due to wetting
urnuioiiiuii..rmoo
'ea.'
Ii_11111111111■---„,,,,,,....,
100
500
1,,000
Sample of 5Vidli {, &u
10,000
LOAD (psf)
100,000
from test hole I at depth 3 feet.
Natural Moisture no tent � I X Natural Dry Density { '7 pcf.
Figure 3
,0,
1
W
O
• O
• Z
C 14
• 1.4
d .44
V
M Fd
dad 0
ro
L3
I
LI
Water added
to sample
100
500
1,000
10,000
i
Sample of CdL1P,_LL3 _
Natural Moisture Content H % Natural Dry Density ld
Swell under constant
pressure due to tiretting
100,000
LOAD (psf)
• from test hole -I at depth e} feet.
pcf.
Fi gure 3
w
ii
D
1
Swell under constant
pressure due to wetting
Iiii!!IIIIIMSI
an �I��III 11111
Water added I MEI 11111
to sample
1 111111011111
100
500
1,000
Sample of , d.1k)I1 PJ
10,000
LOAD (psf)
100,000
from test hole I at depth ,1!1 feet.
Natural Moisture Content % Natural Dry Density 9-5 pcf.
Figure
•a
Provide a minimum slope of 10%
in the firs: 5 out from the house
Roof gutter downspout and
extension should extend beyond —)
the gravel or bark area.
Decorative g=avel or
bark area
;Fetal or wood edge with
weep boles or 1/2" space
at bottom :o allow for the
release of water
Ground
surface
4„ l+ 111
Support for
edge sc .p
2 x 4 (2 x 6) Redwood
with 12" spike @ 4' cc
drilled hole
1 x 4 2 4` Redwood
12" cc
Niff 4.0A
i:=
4-�
:�.
Plastic memb r ane
or Landscape Fabric
PREFERRED *C 3OD
DEOORAIPE CRAVm OR BARK
AROUND ?I1 OF HOUSE
Gravel over plastic
or
Landscape Fabric
AL' NA E EDGE S:RZP
I;
Concrete
foundation wall
Figure 4
•� - _
6rPartonn'or:
FOUNDATION
WALL
CONCRETE SLAB
r •
3"OR
Q' DIAMETER PERFORATED
PLASTIC PIPE
x
INOTc DO NOT EXCAVATE TRENCH
� VERTICAL TO THE FOOTING
THE SLOPE TO THE BOTTOM OF
THE DRAIN PIPE SHALL EXTEND
OUT AT A 45' ANGLE WITH THE
BOTTOM OF THE FOOTING
.11
WATERPROOFING
BACKFILL AREA
POLYETHELENE MEMBRANE
CONCRETE FOOTING
Details of peripheral drain system
Continuous Footing Foundation System
P T D ATI1T INTO SUIT. ..! OL'- .T, 1/4 PER FOOT
BUILDING PAPER ON
TOP OF GRAVEL
MINIMUM DEPTH OF CLEAN'
GRAVEL. r INCHES (MIN.
SIZE 1 INCH
Figure 5
SUMMARY OF LABORATORY. TESTING
JOB NUMBER 95-205
HOLE
NO.
DEPTH
(FEET)
NATURAL
MOISTURE %
NATURAL
DRY
DENSITY
PASSING
200 SIEVE
I
140 POUND
HAMMER
BLOWS
SOIL
DESCRIPTION
1
3
14
97
69
8/12
Sandy Clay
1
8
11
109
37 '
12/12
Clayey Sand
1
18
2
95-
6
20/4
Sandstone
to
I
EQUW'VALErT QUID PRESSURE
RANKINE FORMULA
Typical Values of Unit Weight & Equivalent Fluid Pressure
FRICTION
• SOIL ANGLE
CLASSIFICATION IN -
DEGREES
DENSITY OR
CONSISTENCY
LtNIT
WEIGHT
OF SOIL
ACTIVE CASE
EQUIVALENT
FLUID
PRESSURE
Coarse Sand or Sand 45 Compact
140
24
and Gravel 38 Firm
120
29
32 Loose
90
28
Medium Sand 40 Compact
)
I30
28
34 Firm
110
3i
30 Loose
90
30
Fine Sand 34 Compact
130
37
30 Firm
100
33
28 Loose
85
31
Fine, Silty, Sand, 32
Compact
130
40
And Sandy Silt
30
Firm
100
33
26
Loose
85
31
Fine, Uniform Silt
30
Compact
135
45
28 Firm
110
38
26 Loose
85 .
33
Clay - Silt
20 Medium
120
59
Soft
90
44
Silty Clay
15 Medium
12D
71
Soft .
90
53
Clay
10 Medium
120
84
Soft
90
63
Clay
0 .
Medium
120
120
Soft
90
90
This table assumes that the on site soil will be used in the backfill operation of
this home. It is unknown to this office the degree of soil compaction
that the builder will provide during the backfill operation.
Table 2
UI.41La1(VAL—(.F'F'L.tLHN I : i:.:(: PY—WC;HU WLHU~-EH5 MANY.
H SP1O6F'
INDIVIDUAL SEWAGE DISPOSAL. SYSTEM PERMIT NO. C-95OO76
WELD COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH SERVICES
1517 16TH AVENUE COURT, GREELEY. CO 80631
353-0635 EXT.2225
NEW PERMIT
OWNER SPRINGER. GERALD/MARILYN ADDRESS 4895 EASLEY RD PH (30._,) 278--•1047
GOLDEN CO 5040.3
ADDRESS OF PROPOSED SYSTEM ROUTE 47/BETWEEN RD 4 & 6
HUDSON CO 80642
LEGAL DESCRIPTION OF SITE: SEC 25 TWF' i RNG 65
SUBDIVISION: LOT 0 BLOCK 0 FILING 0
USE TYPE: RESIDENTIAL HOUSE
SERVICES; PERSONS 2 BATHROOMS 1.75 LOT SIZE 44.01 ACRES
BEDROOMS 3 BASEMENT PLUMBING NO WATER SUPPLY PWE.I.-L.
AP'P'LICATION FEE $150.00
REC'D BY
DATE 03/06/95
SIGNED BY GERALD W. SPRINGER
DATE 03/06/95
D
F'E FC:GI-.A"I WE TON RAT _Lei0 MIN PER INCH LI'! 1I I ING ZONE ? F f_I. "F _.._,._
SOIL I E PERCENT GROUND SLOPE I DIRECTION
REGUIRE;S ENGINEER DESIGN _ IN 100 YEAR FLOOD PLAIN ZONE ..•.__._•
FROM THE APPLICATION INFORMATION SUPPLIED AND THE ON -SITE SOIL PERCOLATION DATA
THE FOLLOWING MINIMUM INSTALLATION SPECIFICATIONS ARE REQUIRED:
SEPTIC TANK -0 GALLONS. ABSORPTION TRENCH _ __„_, SO. FT.
OR
ABSORPTION BED {_J 0-50. FT.
IN D:[TITI sN, TH PE I �I IS '•UFJ; E{ 1-L THE 1 OLL OWING ADDITIONAL TERMS AND___.....
��yJJ++{ff 10 d
THIS PERMIT IS GRANTED TEMPORARILY TO ALLOW CONSTRUCTION TO COMMENCE. THIS PERMIT
MAY BE REVOKED OR SUSPENDED BY THE WELD COUNTY HEALTH DEPARTMENT FOR REASONS SET
FORTH IN THE WELD COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM REGULATIONS INCLUDING
FAILURE TO MEET ANY TERM DR CONDITION IMPOSED THEREON DURING TEMPORARY OR FINAL
APPROVAL. THE ISSUANCE OF THIS PERMIT DOES NOT CONSTITUTE ASSUMPTION BY THE
DEF'ARTN IT R ITS EMPLOYEES OF LIABILITY FOR THE FAILURE OR IN'r1j'=DIJACY OFF THE:
SEWAGE L SYSTEM.
`"" STEM.
5PECIALI ENVIr•;IJNME._.TA....�_._.,...-__.....-__.._._T5_-.---1-'--
I.,. T DATE
THIS ERMI:-r NOT TRANSFERABLE AND SHALL BECOME VOID IF SYSTEM CONSTRUCTION HAS
NOT COMMENCED WITHIN ONE YEAR OF ITS ISSUANCE. BEFORE ISSUING FINAL APPROVAL OF
THIS PERMIT THE WELD COUNTY HEALTH DEPARTMENT RESERVES THE RIGHT TO IMPOSE ADDI-
TIONAL TERMS AND CONDITIONS REQUIRED) TO MEET OUR REGULATIONS ON A CONTINUING BA-
SIS. FINAL PERMIT APPROVAL IS CONTINGENT UPON THE FINAL INSPECTION OF THE COM-
PLETED SYSTEM BY THE WELD COUNTY HEALTH DEPARTMENT.
HSP1O6F'
AF'F'L._ICAtICN 'FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM NO. G -95O0)76
WELD COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH SERVICES
1517 16TH AVENUE COURT, GREELEY, CO 80637.
353-0635 EXT 2225
NEW APPLICATION
OWNER SPRINGER. GERALD/MARILYN ADDRESS 4895 EASLEY RD PH (303) 278--1047
GOLDEN CO S0403
ADDRESS OF PROPOSED SYSTEM ROUTE 47/BETWEEN RD 4 & 6
HUDSON CO 80642
LEGAL DESCRIPTION OF SITE: SEC 25 TWP 1 RNG 65
SUBDIVISION: LOT 0 BLOCK 0 FILING 0
USE TYPE; RESIDENTIAL HOUSE
SERVICES: PERSONS 2 BATHROOMS 1.75 LOT SIZE 44.01 ACRES
BEDR❑OMS 3 BASEMENT PLUMBING NO WATER SUPPLY PWELL
APPLICANT ACKNOWLEDGES THAT THE COMPLETENE'S'S OF THIS APPLICATION IS CONDITIONAL
UPON FURTHER MANDATORY AND ADDITIONAL TESTS AND REPORTS AS MAY BE REQUIRED BY THE
WELD COUNTY HEALTH DEPARTMENT TO PE MADE AND FURNISHED BY THE APPLICANT OR BY THE
WELD COUNTY HEALTH DEPARTMENT FOR PURPOSES OF THE EVALUATION OF THE AP'P'LICATION;,
AND 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
100, TITLE 25, CRS 1973, AS AMENDED. THE APPLICANT CERTIFIES THAT THE PROPOSED
SYSTEM WILL NOT BE LOCATED WITHIN 400 FEET OF A COMMUNITY SEWAGE SYSTEM. THE
UNDERSIGNED HEREBY CERTIFIES THAT ALL STATEMENTS MADE, INFORMATION AND REPORTS
SUBMITTED HEREWITH AND REQUIRED T❑ BE SUBMITTED BY THE APPLICANT ARE, OR WILL BE,
REPRESENTED TO BE TRUE AND CORRECT TO THE BEST ❑F MY KNOWLEDGE AND BELIEF, AND
ARE DESIGNED TO BE RELIED ON BY THE WELD COUNTY HEALTH DEPARTMENT IN EVALUATING
THE SAME FOR PURPOSES OF ISSUING THE PERMIT APPLIED FOR HEREIN. I FURTHER UNDER-
STAND THAT ANY FALSIFICATION OR MISREPRESENTATION MAY RESULT IN THE DENIAL OF THE
APPLICATION OR REVOCATION OF ANY PERMIT GRANTED BASED UPON SAID APPLICATION AND
IN LEGAL ACTION FOR PERJURY AS PROVIDED BY LAW.
APPLICATION FEE ;150„00
REC'D BY
DATE 03/06/95
GERALD W. SPRINGER
OWNER/AGENT SIGNATURE DATE
C:1RIGINAL—.AF'F'I_ICANTe COPY-- JCHD WCH17.,..ERS MAY. 1954
HSP1O6F'
APPLICATION FUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM NO. G--950070
WELD COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH SERVICES
1517 16TH AVENUE COURT. GREELEY. CO 80671
Z53-0635 EXT.2225
NEW APPLICATION
OWNER SPRINGER. GERALD/MARILYN ADDRESS 4895 EASLEY RD PH (70:_3) 278-104
GOLDEN CO 20403
ADDRESS OF PROPOSED SYSTEM ROUTE 47/BETWEEN RD 4 & 6
HUDSON CO 2064?
LEGAL DESCRIPTION OF SITE: SEC 25 TWP 1 RNG 65
SUBDIVISION: LOT 0 BLOCK 0 FILING 0
USE TYPE: RESIDENTIAL HOUSE
SERVICES: PERSONS 2 BATHROOMS 1.75 LOT SIZE 44.01 ACRES
BEDROOMS BASEMENT PLUMBING NO WATER SUPPLY PWELL
APPLICANT ACKNOWLEDGES THAT THE COMPLETENESS OF THIS APPLICATION IS CONDITIONAL.
UPON FURTHER MANDATORY AND ADDITIONAL TESTS AND REPORTS AS MAY BED REQUIRED BY THE
WELD COUNTY HEALTH DEPARTMENT TO BE MADE AND FURNISHED BY THE APPLICANT OR BY TH
WELD COUNTY HEALTH DEPARTMENT FOR PURPOSES OF THE EVALUATION OF THE AF'PLIC ATIONE
AND 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 1973, AS AMENDED. THE APPLICANT CERTIFIES THAT THE PROPOSED
SYSTEM WILL NOT BE LOCATED WITHIN 400 FEET OF A COMMUNITY SEWAGE SYSTEM. THE:
UNDERSIGNED HEREBY CERTIFIES THAT ALL STATEMENTS MADE, INFORMATION AND REPORTS
SUBMITTED HEREWITH AND REQUIRED TO BE SUBMITTED BY THE APPLICANT ARE, OR WILL E_+f.=::.
REPRESENTED TO BE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. AND
ARE DESIGNED TO BE RELIED ON BY THE WELD COUNTY HEALTH DEPARTMENT IN EVALUATING
THE SAME FOR PURPOSES OF ISSUING THE PERMIT APPLIED FOR HEREIN. I FURTHER UNDER-
STAND THAT ANY FALSIFICATION OR MISREPRESENTATION MAY RESULT IN THE DENIAL OF THE
APPLICATION OR REVOCATION OP ANY PERMIT GRANTED BASED UPON SAID APPLICATION AND
IN LEGAL ACTION FOR PERJURY AS PROVIDED BY LAW.
APPLICATION FEE $150.00
RECD BY
DATE 03/06/95
GERALD W. SPRINGER
OWNER/AGENT' SIGNATURE
DATE
1 \-ccc
akb
N\-ALLAN.t
Weld County Envivonmentat Health 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 -1300279
Owner Name: ROLL KELLY
Site Address: 1644 CR 47
HUDSON, CO 80642
App Type: Health\ResidentiallNew\Septic
KAREN GREIN
GREIN EXCAVATING
16600 E 188TH AVE
BRIGHTON, CO 80601
Parcel #: 147325000040-R0125295
Legal Desc: 10840-B PT NW4 25 1 65 LYING S OF N IN BOX ELDER LATERAL
DESC AS BEG S2031 6' OF N4 COR SEC WLY ALG N LN LATERAL
S72D32'W 49.19' S85D59'W 95.43' N67D58'W 108.48' N55D15'W 189.3'
N73D41'W 50.72' N86D30'W 726.25' N77D23'W 82.98' N85D23'W 72.52'
S72D24'W 136.15' S52055'W 97.96' 541 D30'W 167.45' 565O01W 79.9'
N70D55'W 97.87' N53D44'W 417.15' N64D23'W 59.47' N79D36'W 85.93'
N85D01'W 200.35' N69D31'W 30.02' S0D03'E 929.09' TO S LN NW4
E2505.02' TO SE COR NW4 NOD28'E 631.07' TO POB (.64R 3.6D)
App Specific info:
flnaled
Application Status:
Final Pending
Applied Date:
12/13/2013
issued Date:
12/19/2013
Finaled Date :
ifoi
Location Description
Repair Reason Type
Associated Building Permit
Associated Building Permit Number
Associated Disaster Permit
Applcation Date
Septic Permit Expiration Date
Waive Fees
Number of Persons
Number of Bedrooms
Basement Plumbing
Full Bathrooms
314 Bathrooms
112 Bathrooms
Public Water Supply
Private Water Supply
Private Water Supply Permit Reference Number
Parcel Acres
1644CR47
New
Yes
MFG 14-00001
No
12/13/2013
12/13/2014
No
2
3
No
2
0
0
No
Well
185934
40
Actual Installation:
Septic Tank: ti O IO gallons
Design Type:
Absorption Trench: sq ft
Absorption Bed : sq ft
Chamber Model,
Chambers
Report ID- EHS00033v00B Page 1 of 3
Print Date Time: 4/7/2014 1:57:00PM
Application Number: SP -1300279
Owner Name: ROLL KELLY
Site Address: 1644 CR 47
HUDSON, CO 80642
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 stale, county and local regulations adopted persuant to Article 10, Title 25, CRS as
amended, except for the purpose or establishing final approval of installed system for issuance of a local occupancy permit persuant to CRS 1973
255-10-111 (2).
This permit is npr«-trangferet ks and non-rQ ndnhi _ Th
additional terms and conditions required to
the compleie4Jystem by the Weld County De
X
Environmental Health Specialist
Weld County Department of Public Health and Environment reserves the right to impose
ions on a continuing basis. Final permit approval was contingent upon the final inspection of
blic Health and Environment
1-\
ate
Report ID: EHS00033v006 Page 2 of 3
Print Date Time: 4/7/2014 1:57:00PM
Onsite Wastewater System
As -Built Drawing
Property Address ! L L C ti 1 44upsd l C'o �oG�
Permit# SP- o X74
System Completion Date L )1 i 11 -
Installer Name GI BE 1n (NA -rimbi LLC.
Installer License # O7 ppo by
Installer Address E. t T" .2160 { i bA'} (O p at), I
Installer Phone 3o - .59 - S 95r
1
P
p4,10 KIR
I:
"= 30+
ExISTU!%
FgFM ltkeAKE
fa1LtV� WOW,. ... _...
• Weil
•
5 ar ' _ 50O A mite
5T1IRx b Fq-Lei
N
qe'
r
14p4 A AL! -P4_ iistOC F.Rr+N +O'._CAUCAorf pot,. (0,040,4/' t! sr a s- �gtlt3
i4" 5oi 35_ .5_=�y�rt 17iPE
.ct.z#49•Out AT_ry0asL
105 ,4v.Is1C 4 thi.FwT g$..
? - f pw5 OF at iks !oragloiL5
. BED S.9.4T t
--.---I44si'ec*.).D J PPS
. A -B- �!8'._ µ-T=t'-S"
A•c= 6'-!0" T-3= 'ILA"
A -Fr le' -4' K-4= Ss5"
vd
1109-5`99-£0£
011 'ONLLVAVOX9 NIR O
db0:b0 t' L LO ady
Weld County Environmental Heaith Services Department
1555 N. 17th Avenue
Greeley, CO 80631
Phone: (970) 304-6415
Septic Permit New Fax: (970) 304-6411
Web: weldhealth.org
Application Number: SP -1300279
Owner Name: ROLL KELLY
Site Address: 1644 CR 47
HUDSON, CO 80642
App Type: HealthlResidential\New\Septic
KAREN GREIN
GREIN EXCAVATING
16800 E 168TH AVE
BRIGHTON, CO 80601
Parcel Number: 147325000040-R0125295
Legal Desc: 10840-B PT NW4 25 1 65 LYING S OF N LN BOX ELDER
LATERAL DESC AS BEG S2031.6' OF N4 COR SEC WLY ALG
N LN LATERAL S72D32'W 49.19' S85D59'W 95.43' N67D58'W
108.48' N55D15'W 189.3' N73D41'W 50,72' N86D30'W 726.25'
N77D23'W 82.98' N85D23'W 72.52' 672D24'W 136.15'
852D55'W 97.96' S41D30'W 167,45' $65D01'W 79.9'
N70D55'W 97.87' N53D44'W 417.15' N64D23'W 59.47'
N79D36'W 85.93' N85D01'W 200.35' N69D31'W 30.02' 30003'E
929.09' TO S LN NW4 E2505.02' TO SE COR NW4 NOD28'E
631.07' TO ROB (.64R 3,6D)
EHS SEPTIC GENERAL:
Application Status:
In Review
Applied Date:
12/13/2013
Intake Person:
MSWAIN
Permit Expiration Date:
12/13/2014
1/2 Bathrooms 0
3/4 Bathrooms 0
Application Date 12/13/2013
Associated Disaster Permit No
Basement Plumbing No
Full Bathrooms 2
Location Description 1644 CR 47
Number of Bedrooms 3
Number of Persons 2
Parcel Acres 40
Private Water Supply Well
Private Water Supply Permit Reference Number 185934
Public Water Supply No
Repair Reason Type New
Septic Permit Expiration Date 12/13/2014
Waive Fees No
EHS PERC TEST (SITE) :
Additional Terms and Conditions
Engineer Design Required
Engineer Evaluation Received
Ground Slope
In 100 Year Flood Plain
Limiting Zone Feet
Limiting Zone Qualifier
Percolation Rate Qualifier
Percolation Rate Value
Slope Direction
Soil Type Suitable
Approved based on Engineer evf
No
Yes
.5
No
8
Greater Than
Equal To
55
S
Yes
Print Date - Time: 12/19/2013 11:4617AM Report ID: EHS00064v001 Page 1 of 2
SEPTIC SIZING INFORMATION:
From the application information supplied and the on -site soil percolation data the following
minimum installation specifications are required:
Septic Tank Size (GAL).
1000
Trench Absorption Area SOFT). Bed Absorption Area (SOFT).
1431 1860
Chambers Options
Standard BioDiffusser and Infiltrator Standard H-10
infiltrator Quick 4 Standard or High Capacity
BioDiffuser ARC 36 Standard or High Capacity
Infiltrator Quick 4 EQ36
Infiltrator Quick 4 Plus Low Profile
Infiltrator Quick 4 Plus Standard or High Capacity
ADS ARC 36 Standard
ADS ARC 36 High Capacity
ADS ARC 36 Low Profile
Trench
47
78
62
112
72
74
59
59
59
Bed Maximum in a Row
60
102
80
146
93
96
77
77
76
INSPECTION RESULT:
Description: Site Status: Approved
Comment: Approved based on Engineer evaluation.
Septic tank must be at least 50 feet from any well. Septic field must be at least 100 feet from
any well.
All Weld County regulations are applicable.
All easements shall be verified prior to installation of septic system.
Septic tank and septic field must be at least 50 feet from any unlined ditch.
closest edge of septic field must be a minimum of 50 feet from CR 47.
NOTICE
16
25
20
25
25
25
20
20
20
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 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 failrue or inadequacy of the sewage disposal system Thls permit is non4ransferabto and
non-refundable 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 County Department of Public Health and Environment
x
12/19/2013
Environmental Health Specialist - \ Date
Print Date - Time: 12/19/2013 11:46:17AM Report ID: EHS00064v001
Page 2 of 2
Application Number:
App Type:
Owner Name:
Parcel #:
Legal Desc:
Site Address:
App Specific Info:
Weld County Environmental Health Sarvicss Department
1555 N. 17th Avenue
Greeley, CO 80631
Phone: (970) 304-6415
Fax: (970) 3046411
Web: www.co.weldhealth.org
Septic Permit Application
SP -t 300279
HealthlResidentiallNewlSeptic
KAREN GREIN
GREIN EXCAVATING
16800 E 168TH AVE
BRIGHTON, CO 80601
ROLL KELLY
147325000040-R0125295
10840-B PT NW4 25 1 65 LYING S OF N LN BOX ELDER LATERAL DESC AS BEG S2031.6'
OF N4 COR SEC WLY ALG N LN LATERAL S72D32'W 49.19' 585D59'W 95.43' N67D58'W
108 48' N55D15'W 189.3' N73D41'W 50 72' N86D30'W 726.25' N77D23'W 82.98' N85D23'W
72.52' S72D24'W 136.15' S52D55'W 97 96' S41 D30'W 167.45' $65D01'W 79.9' N70D55'W 97.87'
N53D44'W 417.15' N64D23'W 59.47' N79D36'W 85.93' N85D01'W 200.35' N69O31'W 30.02'
SOD03'E 929 09' TO S LN NW4 E2505 02' TO SE COR NW4 NOD28'E 631.07' TO POB (.64R
3 6D)
1644 CR 47
HUDSON, CO 80642
1/2 Bathrooms
3/4 Bathrooms
Basement Plumbing
Full Bathrooms
Location Description
Number of Bedrooms
Number of Persons
Parcel Acres
Private Water Supply
Public Water Supply
0
No
2
1644 CR 47
3
2
40
Well
No
Report ID: EHS00056v003
Print Date Time: 12/13/2013 9:02:59AM
Page 1 of 2
Weld County Environmental Health Services Department
1555 N. 17th Avenue
Greeley, CO 80631
Phone: (970) 304-6415
Fax: (970) 304-6411
Web: www.co.weldhealth.org
Septic Permit Application
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 (15DS), payable at time of application Permit fees are non-refundable; permit applications are
nontransferable, If both a building permit and an ISDS are issued far Oa same property and construction is not commenced prior to the
expiration date of the budding 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 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 adopted under article 10 title 25, CRS as amended, The applicant certfies
that the proposed system will not be located within 400 feel 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
OwneriApplicant Date
Report ID: EHS00056v003 Page 2 of 2
Print Date Time: 12/13/2013 9:02:59AM
SEPTIC PERMIT INFORMATION FORM
To obtain an LS.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
RESIDENTIAL PERMIT
NEW or REPAIR $750.00
MINOR REPAIR PERMIT
$ I00.00
PARCEL NO.: 14-13 a5 c>ac C1 IA C.)
(i 2 DIGIT NUMBER)
LEGAL DESCRIPTION: SECTION A-1414,) TOWNSHIP I RANGE bS ACRES 40
SUBDIVISION LOT BLOCK FILING
THIS INFORMATION CAN BE OBTAINED FROM THE ASSESSOR'S OFFICE AT (970) 353-3845 EXT 3650
SITE ADDRESS I %,4 LI C 4'7
DIRECTIONS TO SITE
-)sc.k1
PROPERTY OWNER: L.1 f�
MAILING ADDRESS: .5=1 { 1 I1/4- , Ecru:Li , CITY R)Q_W to ST CC, ZIP i 005
HOME PHONE: t)3) _ -1�5 {WORKK PHONE (3og } } P-`9 -r •.3g•5- FAX ( )
EMAIL ADDRESS: r 3r1 {" C'- V * Yr Yj ow►tr S olek
APPLICANT NAME: 6 r: i.,.t ,t54C61/4) 4Ti-4L IL (2.r..J 6I I I
MAILING ADDRESS: I V be E t L I a d J` CITY 1` f-1 ST Co ZIP 56C -so
HOME PHONE: ( ) WORK PHONE (36 ) `1- S `tS FAX ( r$) 1�7 - ''1 r
EMAIL ADDRESS: 9 {-e-;v, r 31iik.:
DESCRIPTION OF BUILDING (EX: HOUSE, MOBILE HOME, MODULAR, SHOP, OFFICE) 61 c (' t t a ✓_
IF OBTAINING A REPAIR PERMIT, WHAT IS BEING REPAIRED?
NUMBER OF PERSONS - IN FLOOD PLAIN AREA? YES dCCY-
NUMBER OF BEDROOMS - 3 PERCOLATION HOLES MUST BE MARKED FOR
INSPECTION OR A $50.00 FEE WILL BE CHARGED
BASEMENT PLUMBING YES leld
BATHROOMS: FULL
PUBLIC WATER SUPPLY YES IQ NAME
CENSUS TRACT
PRIVATE WATER SUPPLY t]C /NO Fl ./CISTERN PERMIT# ic6") `-1
str4
COLORADO
DEPARTMENT op PUBLIC HBALTR86 ENVIROINENT
1555 N. 17" Avanue
Greeley, CO 80631
lAreasfR; ywvrw.en.wor ,4y,�a
ADMINISTRATION: (070) 304-6410
PAX: ((970 304.6412
PUBLIC HEALTH EDUCATION NURSING: (9703044420
ENVIRONMENTAL HEALTH SERVICES; 8703044415
FAX (7O) 304-8411
AUTHORIZATION FORM
YL$; V PttiMIT APPLICATION 0 I.SUD,S. EV.AT.IJATTO i
SALE OP PItQPERTy Q WATER SAMPLE
GI OccV,L.-C
represent.
(Agent6Applt
located al
I:,EGAL UBSGIUPTION: � SPEC
SUBDIVISION NAME:!".1.T1_ LOT I31,IC
1" ' j___ibr the property
weer)
TIAOs Nc f 1.
can be contacted at the following phone 1Ps:
FIOl11C� .' l W 1 0f./ T
Woik.��. - 5.9 �c '7
Fax # 50.3— (D5( -(0C -
The property owner can be contacted at the [I3llowing phone t{'s
t •
Work
Fax it _
Correspondence mailed to (only one); EK Ageet/Applleant
O Properly Owner
DATE /2
WHIM'S $ CNATOR
Weld County Health Department
Percolation Test and Soils Data
12/2/2013
("1"FrirTh' HGH PLAINS ENGIN RING & DESIGN. LLC
721 4th STREET, SUITE D, FORT LUPTON, CO 80621 + PHONE (303)-857-9280 = FAX: (303)-857-9238
FILE NO.
Property Address
Legal Description
Contact Information
13-4203
1644 COUNTY ROAD 47
WELD COUNTY, CO
Name CLAYTON HOMES - PUEBLO
Street 3912 NORTH FREEWAY ROAD
City, State, Zip PUEBLO, CO 81008
Phone [7191545-4266
Saturation and Swelling
Groundwater
Smeared Surfaces
Removed:
YES
Encountered at I
GREATER THAN 8
feet
Estimated
seasonal
encountered
depth to maximum
water table if not
in profile:
and or rave ' ..5. :
•
Date and Time Presoak
Water Added:
11/19/2013
date
iiii
Amount of Presoak
Water Added:
15
gallons
Is area believed
seasonal fluctuations
result in a seasonal
to be subject to
which could
water table within
8' of surface?
Date and Time
Percolation Test
11/20/2013
date
Started:
13:00
time
[� to ' : Determination
in Abso
lion Area
Did Water Remain in Hole After the Overnight Swelling
Period?
0.5
°!o
to the
SOUTH
direction
Hole 1
NO
Hole 2
NO
Bedrock
Hole 3
NO
Encountered 6
[ GREATER THAN 8 'feet
Hole 4
YES
Hole 5
NO
Estimated depth
if not encountered in
profile:
Hole
YES
Percorat on Re a
Measurement
Deep mil
Perc6FaTfon
Rate (minlin)
Hole 1
36
41.67
TVDe of Bedrock:
Hole 2
36
41.67
Hole 3
36
55.56
Is bedrock fractured
or weathered?
Hole 4
36
55.56
o e •
36
55.56
Is bedrock believed
(perc
to be permeable
rate <60 min/in)?
Hole 6
36
55.56
Avers. e
50.93
the closest edge of the septic field salt be a minimum of 50 feet from County Road 47_
V�
sA
Weld County Health Department
Percolation Test and Soils Data
12/2/2013
Note: Soils must be classified using unified system ASTM O2487
EProfile Hole Low
0
---2
—5
--6
- 7
SANDY CLAY (SC)
CLAY WITH LOW PLASTICITY (CL)
8 _
— 9
- -10
SANDY CLAY (SC)
(Icertiflcatlon
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
High Plains Engineering
& Design LLC
721 4th Street, Suite D
Ft. Lupton, CO 80621
303-857-9280
SITE MAP
ejr 1G44 COUNTY ROAD 47
WELD COUNTY, CO
COUNTY ROAD 47
EXISTING
HOUSE
188'
182'
— 61'
104'
143'
180'
127'
O O
O O
O O
LEGEND
o -Percolation Test Hole
X - Percolation Profile Hole
A- Soil Profile Hole
-X--k-Fence
t
EXISTING
BARN
All locations shown above are based on specific information
furnished by others or estimates made In the field by High
Plains Engineering l!, 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 and out of inappropriate easements.
All distances are to be verified prior to excavation.
Hello