HomeMy WebLinkAbout20210747.tiffORIGINAL PERMIT APPLICANT(S)
URO A RUIZ
APPROVED WELL LOCATION
Water Division: 1 Water DiStriCt:
Designated Eosin: Nr4
Management District: NiA
County: WELD
Parcel Name:
N;,4
Physical Address: N/A
E 1/4 SW 1/4 Section 17 Township _D N Range 66_0 W Sixth P_M_
UTM COORDINATES (Metem, ire: 13. NAD83)
Easting: 5165'68.9 Northing: 444231CI.3
ISSUANCE OF THIS PE R IAIT DOES NOT CONFER A -WATER RIGHT
CO NDMO NS OF APPRCIVAL
1) This well shall be used in such a way as to caus.e no material injury to existing water rights. The issuance of this 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) Construction details for this existing well have not been provided to this office', therefore, it is not known if the construe don of
this well is in compliance with the Water Well Construction Rules, 2 CCR 402-2. The issuance of this permit does not relieve the
well owner of responsibility or Liability in the event contamination of the groundwater source results from the construction or
use of this welt, nor does the State Engineer assume any responsibility or liability should contamination occur.
3) This well is recorded and permit approved in accordance with CRS 37-92-602(5j for historic use as indicated herein and
described in CRS 37-92-#02(1){b), being a welt producing 15 GPM. and used for ordinary household purposes inside 1 single family
dwelling(sj, fire protection, the watering of domestic animals and poultry, and the irrigation of net more than 1 acre of ham
gardens and Lawns,
4) The date of first beneficial use, arc claimed by the applicant, December 31, 1949.
Issued By
Date Issued'. 713112O03
Expiration Date; NIA
PER, IT HISTORY
{L3- -2019 PERMIT CANCELED (CANCELLED UPON ISSUANCE OF PERMIT NO. 312836)
03-10-2010 CHANGE IN OWNER NAMEWILING ADDRESS
Printed 03-22.2079
FOr questions about this permit call 303.$6#x.3567 Or $0 www_water.state_co.us Rafe 1 of 1
ORIGINAL PERMIT APPLICANT(S)
URO A RUIZ
AUTFIDRIZED AGENT
LAWRENCE JONES CUSTER ICS LLP (TRICK,
CURRAN A.)
PERMIT TO REPLACE EXISTING WELL
APPROVED WELL LOCATION
Water Division: 1 Water DiStriCt:
Designated Basin: Nr4
Management District: WA
County: WELD
Parcel Name: 1309-17-3 RE -3843
Lot: A
Physical ,address: 13291 WGR 20 FORT I_UPTON, GO 80821
E 1/4 SW 1/4 Section 17 Township 2.0 N Range 86.0 W Sixth P.M.
UTM COORDINATES ( ten Zane: 13, NAD83)
Easting: 516569.0 Northing: 4442510.0
Block: Filyrti :
ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT
CO NDITIO h#S CIF APPROVAL
1) This well shall be used in s.uch a way as to cause no material injury to existing water rights. The issuance of this permit does not
ensure that no injury gill occur to another vested water right or preclude another owner of a vested water right from seeking
relief in a civil court action
2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless approval of a
variance has been granted by the State Board of Examiners of Water Well Construction and Pump Installation Contractors in
accordance with Rule 18.
3) Approved pursuant to CRS 37-92-602(3)(b)(I ) and policy of the Mate Engineer under the following conditions, for a 9,45 -acre
parcel known as Lot A Recorded Exemption 1309-17-3 RE -3843.. Weld County,
4) Approved for the change in source of an existing well, permit no. 252117. The old well must be plugged in accordance with Rule
16 of the Water Well Construction Rules within ninety-one (91) days of completion of the new well, The enclosed Well
,abandonment Report form must be completed and submitted to affirm that the old well was plugged.
5) The use of ground water from this well is limited to ordinary household purposes inside three (3) single family dwellings, the
watering of of up to 15 of the user's own domestic animals, and the irrigation of not more than 16,400 square feet of home
gardens and lawns,
6) The pumping rate of this well shall not exceed 15 GPM.
7) The annual withdrawal of ground water from this well shall not exceed 1.91 acre-foot.
8) Production is limited to the Laramie -Fox Hills aquifer which is located approximately 365 feet below land surface and extends
to a depth of approximately 670 feet. In accordance with Rule 10.4.8 of the WaterWell Construction Rules, plain steel casing
must be installed and grouted from the top of the permitted production zone up to at least ton feet above the base of the
surface casing, or to the depth required by Rule 10,5,2.1, if no surface casing is installed, (NOTE: If coals and/or carbonaceous
shales are encountered in the borehole, plain casirtig and gout should be installed through these intervals to exclude poor
duality water from entering the well.)
9) The return flow from the use of this well must be through an individual waste water disposal system of the type so that not less
than 2% of the total amount of water withdrawn is returned to the same stream system in which the well is located,
10) This well shall be constructed not more than 200 feet from the location specified on this permit.
11) Pursuant to Construction Rule 6.2.2.1 (2 CC R 402-2), licensed or private drillers and pump installers must provide advanced
notification (at least 24 hours) to the Mate Engineer prior to each of the following for this well. well construction, the initial
installation of the pump, and initial installation of a cistern connected to the water well supply system. Ary change in the
anticipated date of construction/installation must be re -noticed (at least 24 hours prior to revised anticipated date).
Information regarding the notification process and a link to the electronic notification form can be found on the following
webpage: http://water.Mate.co.usigroundwater/B0E/Pages/Variances aivers.aspx
Printed 04-06.20'19 FOr questions about this permit call 303.$6#x.3567 Or $0 LO www_water.state_co.us
Rafe 1 of
WELL PERMIT NUMBER 312836 -
RECEIPT NUMBER 3688776
DOTE: The ability of this well to withdraw' its authorized amount of water from this non-renevwable aquifer may be less than the
100 years upon which the amount of water in the aquifer 15 allocated, due to anticipated water level declines.
MOTE: To ensure a maximum productive life of this well) perforated casing should be set through the entire producing interval
of the approved zone or aquifer indicated above.
DOTE; This permit will expire on the expiration date unless the well is constructed by that date, .A Well Construction and Yield
Estimate Report (G -31) must be submitted to the Division of Water Resources to verify the well has been constructed. An
exterrsion of the expiration date may be mailable. Contact the DWR for additional information or refer to the extension request
form (6W5-64) available at http:1 hoevw.wator.state.co. us
Issued By .JOANNA WILLIAVIS
Date Issued: 31M2019
Expiration [ate; 31M2021
Printed 04-06.2079
FOr questions about this permit call 303.$6#x.3567 Or $0 LO www_water.state_co.us Rafe of �
Scanning Cover Sheet
for
Septic Permits
Permit #
Permit Type:
Situs Street Address
Situs City, State, Zip
SP -0300196
Health / Residential / Repair
13291 CR 20
Sec/Town/Range : 17 -02N -66W
Parcel # (12 digits) 130917300001-R3181804
Owner Full Name:
Owner Address:
Contact Name:
Contact Address:
MAYER GLEN
13291 CR 20
FORT LUPTON,CO 80621
Application Status: Finaled
Application Date: 05/29/2003
Owner Phone #: 970.857.2551
COLLINS CONSTRUCTION & TRUCKING LLC
13187 CR 17
PLATTEVILLE,CO,80651
Contact Phone# 970.785.6323
Information above has been Verified in Accela by employee noted below
X \Y/CQC441 CC:UV-Q-1-
Processed by:
May 14, 2008
Date
Report ID: EHS00024v003 Page 1 of 1
Print Date -Time: 5/14/2008 11:31:34AM
WELD COUNTY DEPARTMENT OF P4CTBLIC HEALTH AND ENVIRONMENT
Permit #:
Owner:
Applicant:
Permit Type: RREP C=Commercial, R=Residential + NEW, REPair, VauLT
Parcel #: 1309-17-0-00-027
Location: 13291 CR 20 FT LUPTON
Legal Description: 16135A THAT PT SW4 1 7 2 66 E OF RR & S &
W OF N LN PLATT IL
Installer: 1.1,0 `1 (As Conk r -u n
1555 NORTH 17TH AVENUE
GREELEY, CO 80631
PHONE (970) 304-6415 FAX (970) 304-6411
SP -0300196
MAYER GLEN
COLLINS CONSTRUCTION & TRUCKING LLC
Sec/Twn/Rng: 17 02 66
Finaled
Status: ISSUED
Applied: 05/29/2003
Issued: 0610 /2003
Finaled: 11° 3
Description: HOUSE
Commercial: N
Residential: Y
# of Persons: 2 Basement Plumbing:
# of Bedrooms: 3 Bathrooms - Full: 2 3/4: 0 1/2: 0
Water Public: N
Water Private: Y
Water Source:
Cistern: N Well: Y Well Permit #:
Acres: 49
Percolation Rate: 7.7 Limiting Zone: 8 ft 0 in Description:
% Ground Slope: 0 Dir: Soil Suitable: (Y/N) Y
Engineer Design Required: (Y/N) N In 100 Year Flood Plain: (Y/1) N
Minimum Installation Chambers
Septic Tank: 1000 gallons Absorption Trench: 522 square feet
or Absorption Bed: 711 square feet
Actual Installation
Septic Tank: 1 opa gallons Absorption Trench: square feet
Absorption Bed: 741 square feet
Design Type:,
.PS
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 CRS 1973 25-10-111 (2).
This permit is non transferable and non refundable. The Weld County Department of Public Health and Environment reserves the
right to impose additional terms and conditions required to meet our regulations on a continuing basis. Final permit approval was
contingent upon the final inspection of the completed system by the Weld County Departme • f Public Health and Environment.
En iro tal Health Specialist
Form: S_FINAL
WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
1555 NORTH 17TH AVENUE
GREELEY, COLORADO 80631
PHONE (970) 304-6415 FAX (970) 304-6411
Permit #:
Owner:
Applicant:
Permit Type:
Parcel #:
Location:
Legal Desc:
W OF N LN PLATTEVIL
SP -0300196 Sec/Twn/Rng: 17 02 66
MAYER GLEN
COLLINS CONSTRUCTION & TRUCKING LLC
RREP C=Commercial, R=Residential + NEW, REPair, VauLT
1309-17.0-00-027
13291 CR 20 FT LUPTON
16135A THAT PT SW4 1
7266EOFRR&S&
PERMIT
Applied: 05/29/2003
Expires: 05/28/2004
Description: HOUSE
Commercial: N
Residential: Y Acres: 49
# of Persons: 2 Basement Plumbing:
# of Bedrooms �3Bathrooms - Full: 2 3/4: 0 1/2: 0
Water Public: N Water Source:
Water Private: Y Cistern: N
Well Permit Number:
Percolation Rate 1-1r- Limiting Zone >ct ft in Description
% Ground Slope Direction Soil Suitable (Y/N)
Engineer Design Required (Y/N)' In 100 Year Flood Plain (YI/N) l
From the application information supplied and the on -site soil percolation data the following minimum installation specifications are
required:
Septic Tank t000 gallons, Absorption Trench 5ZZ square feet
or
Absorption Bed
i
911
square feet
Ti_ambers
n addition, this permit,is subject to the following additional terms and conditions:
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 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 failure or inadequacy of the sewage
disposal system.
This permit 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. This permit eaires one year fro n.
the sonlication date.
1\A -Al U (DIE 4
Form: $ _PERM ETR Environmental Health Specialist Date
FOR OFFICE USE ONLY
ISDS APPLICATION FLOW SHEET
Owner:
M a err f H en
Location:- 13aq C. 2 -4 1=LIP
Date B
Permit #: 5?-03Oa q (D
Legal Description: ' I i e=agdP
Comments
Parcel Number Received
:Yeke
rns
Information Form Complete
�`
Authorization Form Received
Map Drawing Received
---
Flood Plain? Yes/No
Site Inspection Date
Engineer Design? Yes/No
Date Engineer Design Received
Customer Notfied? Yes/No
Date Staff Approval Sent
Date Staff Approval Reed
Pero Data Entered in Computer
Date of BON Approval
Eng Approval Letter Sent
(Letter, Permit, BOH Review)
Date of Final Inspection
fri I_ p3
-�
..,e,.....0
Eng Final Inspection Letter Recd
�"'
Variances Needed? Yes/No
Sent Variance Staff Approval
Recd Variance Staff Approval
Variance BOH Approval .
Variance BOH Approval Sent
(Variance, BON Review)
Additional Comments:
MAENVIRONMENTAL HEALTH SERVICESLSEPTICTLOWSHEEr
1! -
WELD COUNTY DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT
1555 NORTH 17TH AVENUE, GREELEY, CO $0631 PHONE: (970) 304-6415 FAX: (970) 304-6411
WEBSITE: WWW.CO.WELD.CO.US
Permit Number: SP -0300196
05-29-2003 Amount: $375.00 Payment Method: Check
Owner Name: MAYER GLEN
Applicant Name: COLLINS CONSTRUCTION &.TRUCKING LLC
Parcel Number: 130917000027
Location: 13291 CR 20 FT LUPTON
Account Code Description
2560-41400-4221-4203 New Septic Permit
2560-41400-4221-4203 Repair Septic Permit
2560-41400-4221-4203 Vault Permit
Description: HOUSE
Commercial: (Y/N) N
Residential: (Y/N) Y Acres: 49
Number of Persons: 2 Basement Plumbing: (Y/N)
Number of Bedrooms: 3 Bathrooms: Full - 2 3/4: 0 1/2: 0
APPLICATION / RECEIPT
Initials: MS
Receipt Number: HAP -03198
Notation: 2227
Amount
$0.00
$375.00
50.00
Water Public: (Y/N) N Water Supply:
Water Private: (Y/N) Y Cistern: (Y/N) N Well: (Y/N) Y Well Permit Number:
TERMS AND CONDITIONS
A permit fee, as set by separate ordinance of the Board of Weld County Commissioners, shall be required of applicants for new
individual sewage disposal systems (ISDS), payable at time of application. Permit fees are non-refundable: permit
applications are non -transferable. If both a building permit and an ISDS are issued for the same property and
construction is not commenced prior to the expiration date of the building permit, the ISDS permit shall expire at the same time as
the building permit. If an ISDS permit is issued for a property that does not require a building permit, the ISDS permit shall 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 certifies that the proposed system will not be located within 404 feet of a community sewage system. The
undersigned certifies that all statements made, information and reports submitted herewith are, or will be, represented to be true
and correct to the best of his/her knowledge and are designed to be relied on by the WCDPHE for evaluation for purposes of
issuing the permit applied for herein. Applicant further understands that falsification or misrepresentation may result in the denial
of the application or revocation of any permit granted, and in legal action of perjury as provided by law.
Owner/Applicant
Form: RT HAPP
Date
MAY -28-2003 WED 04:31 PM ENVIRON HEALTH SERVICES 9703046411 P. 01
Y
SEPTIC INFORMATION FORM
COLORADO
PARCEL NO • / % (12 DIGIT NUMBER)
Gam, LL u a 1 14ir•!.J rittim THE ASSESSOR'S OFFICE AT (970) 353-3845 EXT 3650
PROPERTY OWNER .G LFn/ /71.4
MAILING ADDRESS: /3 a. 97 GR rig() CITY _ rT. L UPTD T C_e) ZIP .c•D‘a /
HOME PHONE: [92a) 9-57 ,4_S5 I WORK PHONE (__ _ FAX [
To obtain an I.S.D.S. permit, one must file an "application for Individual Sewage
Disposal System" at the Weld County Environmental Health Services office and
pay the application fee. A "repair" fee shall be charged for the expansion,
replacement, or repair of an existing system. The following information must be
provided on the septic information form.
APPLICANT NAME: n OA) /714 YE 2 - if;i4A0S G®ai l-k-"UeT/.dia TiQ /l�6 LGa
MAILING ADDRESS: /2' CITY147 ST go zip Edacl
HOME PHONE: 90 ) WORK PHONE EM- ) lj9-,5fs":V-FAX (94) d7�7
/`RT or 4pagi- i „Sre./7 zgTaF/e/.1-S. N-1,, 7
LEGAL DESCRIPTION PT PT SEC TWN--aZ-- RNG BARES "X?
SUBDIVISION LOT BLOCK FILING
DESCRIPTION OF BUILDING (EX: HOUSE, MOBILE HOME. MODULAR. SHOP, OFFICE) Ae,s-F _
SITE ADDRESS / 3 q t Gk, a n ;7.- 1 Uil7T411, C'p .'d 6a /
DIRECTIONS TO SITE Ye / 11 �, Ci}sT d F e s- fau l/ del 12.b �.n
NEW PERMIT REPAIR PERMIT VAULT PERMIT
$ 375 S 375 $ 150
IF OBTAINING A REPAIR PERMIT, PLEASE LIST PREVIOUS OWNERS OF THE PROPERTY:
FLOOD PLAIN YES !dff)"
RESIDENTIAL CMP/ NO
• NUMBER OF PERSONS g.
NUMBER OF BEDROOMS
WATER SUPPLY: PUBLIC
CENSUS TRACT
COMMERICAL YES 0
BASEMENT PLUMBING YES / NO
BATHROOMS: FULL
NAME LU 644
PRIVATE S NO CISTERN YES/ WELL 6:9/NO WELL PERMIT #
PERC HOLES MARKED FOR INSPECTION BY SPECIALIST NO
MAY -28-2003 WED 04:31 Pit ENVIRON HEALTH SERVICES 9703046411
P, 02
COLORADO
DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT
1555 N. 17th Avenge
Greeley, CO 80631
1NEBSITE: www,co.weld.cc
ADMINISTRATION: (970) 304-6410
FAX: (970) 304.84'12
PUBLIC HEALTH EDUCATION & NURSING: (970) 304-8428
FAX: (970) 304.8416
ENVIRONMENTAL HEALTH SERVICES: (970) 3046415
FAX: (970) 304-6.411
AUTHORIZATION FORM
RE: 0 PERMIT APPLICATION [] I.S.D.S, EVALUATION
0 SALE OF PROPERTY n WATER SAMPLE
I G'a resent ILEA) 17)I7E J‹ for the property
(Agent/Ap licant} (Owner)
—
located at / 3a V f �- L e E-06.2/
LEGAL DESCRIPTION: SECTWN RNG
SUBDIVISION NAME: LOTBLK�„�
I can be contacted at the following phone #'s: Home *0- 9,*2
Work 9'70 - a 9
Fax # 97e -WS-- 76 7
The property owner can be contacted at the following phone #'s
Home !`'70 -
Work
Fax #
Correspondence mailed to (only one): j.___�Agent/Appiicant
Property Owner
DATE J �( a 3
OWNER'S SIGNATURE _
MO -28-2003 WED 04,32 PM ENVIROH HEALTH SERVICES 9703048411 P. 03
„,
PLEASE DRAW A MAP TO YOITR PROPERTY.
N
Cg
r3a`il
AO (g)
f
May 29, 2003
Collins Construction & Trucking
13187 Weld County Road 71
Platteville, Colorado 80681
Attn: Mr. Bob Collins
Re:
Proposed Septic System
13291 Weld County Road 20
Fort Lupton, Colorado
Terracon Project No. 21035457
Dear Mr. Collins,
lrerracon
1289 First Avenue
Post Office Box 1744
Greeley, Colorado 80632-1744
(970) 351-0460 Fax: (970) 353-8639
On May 22, 2003, a representative of Terracon performed percolation testing for a proposed
septic system that is to be constructed to support an existing three -bedroom residence at
the above referenced address in Fort Lupton, Colorado. Six percolation test holes and one
soil profile test pit were provided by the client. The percolation test holes and the soil profile
test pit penetrated the on -site soils to depths of 30 inches anc,_.-specti,vely.
The on -site soils in the area of the proposed septic system consisted of approximately six .
inches of topsoil underlain by silty sand to a depth of about 4'/z feet. The materials
underlying the surface soils and extending to the maximum depth of exploration of 8 feet
consisted of well graded sand with silt and gravel.
Percolation testing conducted in the area of the proposed soil absorption bed are summarized
as follows:
Percolation Test Results
. ' Test Hale .
Depth
iriches
• Sail
•
Classlficatcon
Percolatlan�Rate �:
(rnlnuteslinch} ; �
1
30
SM
6
2
30
SM
a
3
30
SM
6
4
30
SM
8
5
30
SM
11
6
30
SM
7
Average
8
Arizona ■ Arkansas ■ California ■ Colorado III Georgia ■ Idaho ■ Illinois ■ lowa IN Kansas ■ Kentucky ■ Minnesota ■ Missouri
Montana ■ Nebraska ■ Nevada ■ New Mexico ■ Oklahoma IN Tennessee ■ Texas ■ Utah ■ Wisconsin ■ Wyoming
Consulting Engineers & Scientists Since 1965
www.terracon.com
Proposed Septic System
13291 Weld County Road 20
Fort Lupton, Colorado
Terracon Project No. 21035057
Page No. 2
Terracon
Field test results indicate the soils in the area of the proposed septic system have good
percolation characteristics.
Septic System Construction
Based on field test results, it is our opinion that a standard septic system and leach field (soil
absorption bed) is feasible for construction on the site. The system should be designed in
accordance with applicable state and county requirements and should be located at the
minimum distances from all pertinent ground features described in Weld County regulations.
An average percolation rate of 8 minutes per inch is recommended for design purposes.
No groundwater or bedrock was encountered in the soil profile test pit located at the proposed
soil absorption bed. Accordingly, the leach field may be constructed to a depth of 4 feet from
existing site grade.
Additional design criteria for septic system construction are as follows:
• Based upon the residence containing 3 bedrooms, the proposed soil
absorption bed should include a minimum of 645 square feet of area in plan
view.
• A minimum 1,000 -gallon capacity septic tank should be used in the design
and construction.
• Distribution lines within the soil absorption bed should consist of 3- or 4 -inch
diameter perforated plastic or similar pipe approved in governing regulations.
Distribution lines should be placed the full length of the proposed absorption
bed or trench and should not exceed 100 -feet in length. Distribution lines
should be spaced at a maximum of 6 feet on center with the perimeter lines
placed within 3 feet of all sides in the absorption bed.
• Absorption beds should be backfilled with a minimum 12 -inch thickness of
clean graded graves ranging in size from 3/4 to 2-1/2 inches in diameter. The
gravel should extend a minimum of 6 -inches below and 2 inches above the
distribution pipes.
• The gravel bed should be completely covered with untreated building paper
prior to final soil cover. Final soil cover should be a minimum of 12 inches in
thickness and suitable for vegetative growth. The surface of the soil cover
4.
Proposed Septic System
13291 Weld County Road 20
Fort Lupton, Colorado
Terracon Project No. 21035057
Page No. 3
Terracon
should be graded for positive surface drainage and to reduce the possibility of
surface water infiltration.
• A gravelless soil absorption bed, or infiltrator system, may also be considered
as an alternative to the standard type gravel system outlined above.
Terracon understands Weld County allows for a 50% reduction of the leach
field size for infiltrator systems. Accordingly, the infiltrator system should
consist of a minimum of 21 chambers with infiltrator rows spaced at 3 1/2 feet
on center.
General Comments
Terracon should be retained to review the final design plans and specifications so
comments can be made regarding interpretation and implementation of our geotechnical
recommendations in the design and specifications. Terracon also should be retained to
provide testing and observation during the construction phase of the project.
The analysis and recommendations presented in this letter are based upon the data
obtained from the test holes at the indicated locations and from other information discussed
in this letter. This letter does not reflect variations that may occur between test holes,
across the site, or due to the modifying effects of weather. The nature and extent of such
variations may not become evident until, during, or after construction. If variations appear,
we should be immediately notified so that further evaluation and supplemental
recommendations can be provided.
The scope of services for this project does not include either specifically or by implication
any environmental or biological (e.g., mold, fungi, bacteria) assessment of the site or
identification or prevention of pollutants, hazardous materials or conditions. if the owner is
concerned about the potential for such contamination or pollution, other studies should be
undertaken.
This letter has been prepared for the exclusive use of our client for specific application to the
project discussed and has been prepared in accordance with generally accepted geotechnical
engineering practices. No warranties, either express or implied, are intended or made. Site
safety and excavation support requirements are the responsibility of others. In the event that
changes in the nature, design, or location of the project as outlined in this report are planned,
the conclusions and recommendations contained in this report shall not be considered valid
Proposed Septic System
13291 Weld County Road 20
Fort Lupton, Colorado
Terracon Project No. 21035057
Page No. 4
Terracon
unless Terracon reviews the changes and either verifies or modifies the conclusions of this
report in writing.
If you have any questions, or if we can be of further assistance to you, please do not
hesitate to contact us at (970) 351-0460.
Sincerely,
TERRACON
Andrei Bedoya, E.I.
Staff Engineer
Copies to: Addressee (3)
"4":;c1,4.9 .............
... , S y
. 38512
.. +��(J c� -c
-.k "�ilid('�.�.....
Ty G. Alexander, P.E.'',a,`, ,,,
Office Manager
WCR 20
P-3
P-4
Test
Pit
P-� 1 n . \Y11 sko
LEGEND
e PERCOLATION TE5T HOLCS
'Notes Drawing bred on usformatiors gathered during ate melt.
Not untended for ceestnrction.
FIGURE I: SITE PLAN
PROPOSED SEPTIC SYSTEM
13291 WELD COUNTY ROAD 20
FORT LUPTON, COLORADO
1
Project Heir TGA
Deolgeed By:
Chocked Br TCA
Approved By: TGA
lrorracon
fY89 FIRar Metz
GRIELey, Ca moo 80681
Project No. 21035057
Scale: 1' = 60'
Dote: 5-29-03
Drawn By: AB
CName: 21035057.dwg
Figure No. 1
LOG OF TEST PIT NO. 1
Page 1 of 1
CLIENT
Mr. Bob Collins
SITE 13291 Weld County Road 20
Fort Lupton, Colorado
PROJECT
Proposed Septic System
GRAPHIC LOG
DESCRIPTION
USCS SYMBOL
SAMPLES TESTS
w
0_
c
CC
w
a
U
w
CC
0
G Q-
tu —
zz
zz
uj o
cc
V)
TOPSOIL
a.5
TOPSOIL
SILTY SAND, moist, brown (SM)
4.5
ti WELL GRADED SAND with SILT and
ti GRAVEL, moist, light brown (SW-SM)
3-
1
l
l
l
l
ti
1
1
Lg
BOTTOM OF TEST PIT
y
5 —
The stratification lines represent the approximate boundary lines
between soil and rock types: in -situ. the transition may be gradual_
WATER LEVEL OBSERVATIONS, ft
WL
None'
WL 17
lrerracon
BORING STARTED
BORING COMPLETED
RIG FOREMAN
WL I 'At time of site visit.
I JOB # . 21035057
Scanning Cover Sheet
for
Septic Permits
Permit #
Permit Type:
SE -0300063
Health / Residential / Statement of Existing
Situs Street Address 13291 CR 20
Situs City, State, Zip
Sec/Town/Range: 17 -02N -66W
Parcel # (12 digits) 130917300001-R3181804
Owner Full Name:
Owner Address:
Contact Name:
Contact Address:
MAYER GLEN
13291 CR 20
FORT LUPTON,CO 80621
Application Status: RECORDED
Application Date: 05/30/2003
Owner Phone #: 970.857.2551
COLLINS CONSTRUCTION & TRUCKING LLC
13187 CR 17
P LATT EV I L L E, C O, 80651
Contact Phone# 970.785.6323
Information above has been Verified in Accela by em►oloyee noted below
X
Processed by:
May 14, 2008
Date
Report ID: EH500024W003 Page 1 of 1
Print Date -Time: 5/14/2008 11:32:48AM
L . Y
f
WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
1555 NORTH 17TH AVENUE
GREELEY, COLORADO 80631
PHONE (970) 304-6415 FAX (970) 304-6411
STATEMENT OF EXISTING SEPTIC PERMIT
Permit #:
Owner:
Applicant:
Parcel #:
Location:
Legal Desc:
W OF N LN PLATTEVIL
SE -0300063
MAYER GLEN
COLLINS CONSTRUCTION & TRUCKING LLC
1309-17-0-00-027
13291 CR 20 FT LUPTON
16135A THAT PT SW4 1 7 2 66 E OF RR & S &
Sec/Twn/Rng: 17 02 66 PERMIT
Applied: 05/30/2003
Description: HOUSE
Commercial: N Residential: Y
# of Persons: 2
# of Bedrooms: 3
Water Public: N
Water Private: Y
Septic Tank: UNKN
Absorption Trench: 0
Absorption Bed: UNIKN
Acres: 49
Basement Plumbing: Y
Bathrooms - (Full): 1 (3/4): 1 (1/2): 0
Water Source:
Cistern: N Well: Y Well Permit Number:
Tank Material: CONCRETE
Year Installed: UNKN
sq. ft.
sq. ft.
NOTICE
The property owner/agent has certified by Notary Seal that the above described septic system is in fact installed as described, and
exists at this time on the parcel identified above by the parcel number and/or legal description, and further states that the system
IS / 1S NOT in good working order and to the best of his/her knowledge IS / IS NOT failing to function properly.
The property owner/agent further understands that any falsification or misrepresentation may result in the revocation of any permit
granted based upon this information hereby submitted and in legal action for perjury as provided by law.
The Statement of Existing Record relies on information the property owner or his/her representative provides, under oath, indicating
current status of the system and representing to the best of his/her knowledge that the system IS / IS NOT failing to function properly.
Issuance of the Statement of Existing Permit for any system does not constitute assumption that the site was evaluated or inspected
during any phase of construction by this Department to meet regulations.
Environmental Health Specialist
Date
Form: S_EXIST
illik
COLORADO
WELD COUNTY DEPARTMENT OF PUBLIC SOE# 5 - 043 000(a3
HEALTH AND ENVIRONMENT ORG PERMIT #
- 1555 N. 17TH AVENUE REPAIR # 9?-% T# I
GREELEY,. COLORADO 80631 LOAN #
PHONE: (970) 304-6415 ISDS #
FAX: (970) 304-6411
STATEMENT OF EXISTING FOR SEPTIC SYSTEM
(PLEASE FILL OUT IN BLACK INK ONLY)
PARCEL NO. 1.30 7/ 7Gi1ooa 7
PROPERTY OWNER "�E /i/
MAILING ADDRESS /.0 `7/ CD,Q,-
PHONE NO. (92O) PS -.7
City
State Zip
DESCRIPTION OF BUILDING (ex. house, mobile/modular home; shop, office) }rid F
9./ • -771. 444-,ty ,Po6.21
SITE/LOCATION ADDRESS
City - State Zip
LEGAL DESCRIPTION PT PT SECTION /7 TOWNSHIP 2 RANGE 64,
SUBDIVISION LOT BLOCK FILING
CENCUS TRACT 19 ♦0 LOT SIZE/ACRES h�9
COMMERCIAL YES a
NUMBER OF PERSONS r;
BEDROOMS j3
WATER SUPPLY - PUBLIC
PRIVAT
RESIDENTIAL (/ NO
BASEMENT PLUMBING YE NO
OOMS :FULL / - 3/4_,,,�
YES / r NAME
WELL (SIDNO CISTERN YES 1O WELL/CISTERN#
SYSTEM SIZE: Septic tank material is constructed of �'tcr and has UhkbOt..n gallons capacity.
FIELD: Trench square feet or Bed U„ i9noe. , , square feet YEAR INSTALLED Gin fC l,�ww
You are required to draw a diagram of the system on the reverse side of this form in black ink only and indicate
location, length, width, and distance from the dwelling.
The undersigned property owner hereby certifies that the above described septic system is in fact installed, as
described, and exists at this time on the parcel of ground identified by the above legal d 'ption and further states
that the system is6 n —o -Pin good working order and to the best of his/her knowledge is/ not ailing to function properly
I further understand that any falsification or misrepresentation may result in revocation of any permit granted based
upon this information hereby submitted and in legal action for perjury as provided by law.
S --3o -c, 3.
DATE OWNER SIGNATURE "
Subscried and sworn to before me this d day ofLc.l, , 20 a ,
By _-1/_,/
Witness my hand and official seal.
�3 0 �G,3.
DATE
STATEMENT OF EXISTING INS
OF'Cp1.
mmission ex
ires/ /o
TARY PUB c
D BY\f\AAir(
ENVIRONMENTAL HEALTH SPECIALIST DATE
PI/4 ielliN Of) 137/9e
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