HomeMy WebLinkAbout20193300.tiffScanning Cover Sheet
for
Septic Permits
Permit #
Permit Type:
Situs Street Address
Situs City, State, Zip
G19890266
Health / EHS History / EHS Conversion History
1245CR19
Sec/Town/Range: 28-41 N -67W Application Status: Frnaled
Application Date: 03/11/1996
Parcel # (12 digits)
Owner Full Name:
Owner Address:
Contact Name:
Contact Address:
146928400002-R1200196
VESSELS OIL & GAS
1245 WCR 19
BRIGHTON,CO 60601
Owner Phone #: 303 8596534
Contact Phone#
Information above has been Verified in Accela by employee noted below
X
Proces
November 04, 2008
Date
Report ID: EHS00024v003
Print Date -Time: 11/4/2008 3 22:23PM
Page 1 of 1
-. ti
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}-ESP/'.'6P.
INDIVIDUAL :. F I s ::. DISPOSAL SYSTEM PERMIT r' O . a ..., J:7 G r; %? .i
OWNER VESSELS OIL C.ti G A:'
WELD COUNTY HEALTH DEPARTMENT
i.:: !V:i:11; +i... Gi-i I::RV'.4'.[:;I.::S
1516 HOSPITAL ROAD, GRE!, i.._L.`', CO B0631
REPAIR PERMIT
ADDRESS 124 4d 1, 19 PH ( ZO) 659-6531
BRIGHTON CO 0060
ADDRESS OF PROPOSED S'YS'TEM I24: WEN 19
BRIGHTON CO 80601
LEGAL DESCRIPTION OE SITE: ;W4SW4 SF:: Cs 23 T ErI P 1 f i`.! [:•: t a 7 ' y
I..ID ?.I.1' I }.I.'..rI\: LOT i .L:;I_.00Ic ) FILING ;'
i.J,S'I:E TYPE: :: COMMERCIAL E:Ik F :I: [ I :
SERVICES: PERSONS 5 BATHROOMS 1_50 I_. l:r'T' SIZE 25,50 ACRES
DE:D [:r[:ME () I:3F>GS'I:::Mir: I..1. I::'I...L.JN1:':l:NG:: NO. WATER ,`)tJI:I::I...Y i'WI::I...I...
APPLICATION Fur $100,00
RI:::i::II) !:3Y [::[:rr'rE:Y, DI:ANNIi:
DATE 10/:31/09
SIGNED BY RAYMOND O. ':;r.l s (JN
DATE 10/1/P9
PERCOLATION RATE 23,0 MIN. PER INCH - LIMITING Ztri4!IE: IEE FEET
ST:i:l:I... T. -.PI::: SUITABLE PERCENT GROUND SLOPE OZ DIRECTION
REQUIRES ENGINEER DESIGN YES
FROM THE APPLICATION 41":LO 'INFORMATION N(}.1.:I:i N1 SUPPLIED AND THE ON — SITE SOIL PERCOLATION DATA
.... `I E SPEC Y..., ,...., iii N3 kE::: I F::(1ITF�;E:C�:
THE ::. FOLLOWING , Lr 1'j �.. .. 'I . I IINSTALLATION -ICATIONS i I I .. !.� t , �.`; j.:}
;s 1::: l:' -T- :E: I: TANK 4000 GALLONS i A. ,S 1.1 I E T J. E.E EV TRENCH SQ . FT,
..
ADSORPTION
:1:4! ADDITION, N •ri••k:ES I::r:{.;:M:I:'r TS SUBJECT ..1IE:i:.f. ..t'Ci !
CONDITIONS:
i 2 .. 1A?.. AND
THIS J::.J:!'i3I:l:-T- :I:.S' GRAN-T'EI? TEMPORARILY TO ALLOW CONSTRUCTION TO COMMENCE, THIS PERMIT
;i:T
NAY BE REVOKED OR SUSPENDED BY THE ,Jf:L..i:] COUNTY HEN_111 DEPARTMENT FOR REASONS SET
F''[:il''.''rI'•I :I:r! THE:: WELD COUNTY :1:ND:FV:I:DUAI... SEWAGE DTSPDAL.SYSTEM REGULATIONS ATTCIN; :CNT.:t u1j:I'. J[::
FAILURE -TO fl::::: -T ANY TERM OR CONDITION IMPOSED THEREON DURING R TEMPORARY OR FINAL
APPROVAL, T"I••lE: ISSUANCE O1.' THIS PERMIT DOES NOT CONSTITUTE ; s'z` ui'[P T':i:ON BY rf-EI::: -
DEPARTMENT OR ITS EMPLOYEES OF LIABILITY FOR THE FAILURE OR INADEQUACY (:GI' Jill
SEWAGE DISPOSAL .S'Y,S' l I::: i h
-DC. iPNINIU WEE POTTER
R
DC —
THIS PERMIT IS I'loi. TRANSFERABLE AND SHAL_E... BECOME vo:LD IF `Y„'.rE:`'i CONSTRUCTION 1-IrS
NOT COMMENCED I:::0 WITHIN ONE YEAR OF ITS ISSUANCE, BEFORE l: ISSUING FINAL L. APPROW)L O
THIN l'' PERMIT I E,EI::: WELD COUNTY HEALTH DEPARTMENT RESERVES T-I"il::: RIGHT TO IMPOSE ADDI-
TIONAL TERMS rAlr'II) CONDITIONS REQUIRED TO MEET OUR REGULATIONS ON A CONTINUING DA —
FINAL PERMIT All"'I"'IRCO'vAE.. IS CONTINGENT UPON THE F'•:I:Ni`•II... INSPECTION O DE THE COM—
PLETED SYSTEM BY THE WELD COUNTY HEALTH DEPARTMENT, N l-,. ,
SYSTEM ,' r ___FINAL INAI... E:fit:sPi:=:l:.f..... , 1 _d
SYSTEM ENGINEER Ilr:i :l,` ..............................._. ! __APPROVAL ....:.. ..... ,._ , .,... . ... .... r
E::: ! L' :I: I T:t i� i•i I:: I I T" A I_. SPECIALIST
TYPE OF SYSTEM INSTALLED
I'I/29rfisi`rl
E N V T I O I`! iM E_: r .T A L.. ,s' F'' I:: [::, :I: (1 L..:i: F •r DATE
TI.II::: ISSUANCE OF THIN PERMIT .i)llf;::ati NOT :LMI'I_.Y COMPLIANCE IALLT i OTHER STATE, COUNTY
OR I...00A1... REGULATORY OR BUILDING REQUIREMENTS, NOR S'HALE... :I:T ACT -TO CERTIFY THAT
.1 1'.I I::. SUBJECT SYSTEM WILL OPERATE :I: N COMPLIANCE WITH A h' F I... a: T:: I" 1 ::: i_. i::: STATE, COUNTY A i l l)
LOCAL l... REGULATIONS ADOPTED I::.I:::C UAN..1. TO ARTICLE 10, T .i- T 1,1;: 25, CRS 197, AS AI-1i:':N})f::x5
IE'":I:;l;:•1::.•r' FOR THE PURPOSE OF I \'i'r"}1:31...:1::'II:I NG I':i:W*APPROVAL OF AN INSTALLED SYSTEM I='i:Ii
ISSUANCE UAi (::I : OF A L(r(:iAI... OCCUPANCY PERMIT PURSUANT TO CNN 197 25-10-111 (2),
ORIGINAL !AL.. APPLICANT; T:OE::,Y....Iii[::flr:)
[.J,:, I'f I)-- I:::H,S MAY, 'r'; .)
t
rAe
r55'c�r
ALPHA ENGYNEER/NG
CIVIL ENGINEERING
LAND
DEVELOPMENT
PROPERTY SURVEYS
RECEIVED
SANITATION DIVISION
KC 08 198E
VIM 01111 ( REAM MEAT.
December 5, 1989
Weld County Health Department
1516 Hospital Road
Greeley, CO 80631
RE: Septic System for The Office Building of Vessels Oil &
Gas Co. Ft. Lupton Facility, 1245 Weld County Road 19.
Dear Sir.
I inspected the above septic system and found it to be
built according to the approved Alpha Engineering plans. Plan
file no. is 26-1N7-04.
Sincerely,
Cecil R. Crowe
PE & LS 12330
BIT 5TH sr. -- R O. BOX 392 FORT LuPT0N, COLORADO 8062/
Ph: DENVER (3051573 573-5/86 FORr L UPrON 1303) 857- 2508
i..l ,.. F 1 ;f E=, F'
r
INDIVIDUAL ,:: I::. W GF D I, S i" O S Ii••3 1_. SYSTEM PERMIT NO, l ,- G-96266
OWNER�� r; ti M i -. . r ..
ll:... ..r :.i__.3 .�.I.._ K .xF�:.:.
WELD t::t.il.fi'-f T.,i' !' i:.:(i{_.'1 I -I DEPARTMENT
Y'
ENVIRONMENTAL HEALTH SERVICES
1516 #-ll.Jl-'.L"f Al... ROAD, l.xRr..l:'i..l::.`f , CO 80631
REP6IR PERM -IT
nDDRESS i245 .i .: I•S'. f PH ( Q . J 659-6564
1:RIGHI i_li•.! CO 8060i
f
A1YDRESg iil:: ::'ROC7& fl:0 , :•'"i Et•i 121 l:;R
GU','20601
LEGAL I DE • : I: -T' E: ;: 2R ..t' U:! P 'I F, i' a t::; 6'•F
,.. ,-. -- I s.: tir ,': E.1.k� �J .I. �'d I. � � I, I, ' iti i--, I E I a i l�s i�l i_�' i,; r: FILING 0
USE 1:.. .T Yr R I::. t:', O M M is � I,<C I: A I._ OFFICE
SERVICEE: PERSONS 5 JA€HROOMS 1.50 LOT EIHE 2150 ACRES
BEDROOM .. : BASEMENT I. .17 ',j .. i WATER t .,.' 1::: AWN I I i'
'. �� 'i_._ f T_.. i•.t:. i l_ k F•i I , .I•'. ,4{.. ,- � "i �, I::_
I'a r P I.- 1. 1 r i 1 .I I.. N I - I::: f::: :i. o (� 10
RECI
DATE 10/1/29
..4 sNED BY RAYMOND it i -k-'•i.N
r- : 0/1/S9
r t. l i
i '...Is.� �L_i=a :1:.,1= I+ r I E: ha f:?! PER Lssi4,.l"! i a.li �: i :J:i`I r .:..1„1111:1:. I::I:::E:. I
C�
Q I, L ,' ENGINEER DESIGN
......
. - ; �' .. PERCENT GROUND ,..L..L.1[-=r::: _X �..I:f�,f:c:'r:€. t:f},.I .,..�.,....
;:: S-. a = ON —SITE
I -• I::. EyePERCOLATION i• i ] I l i f I1 1 1... I. I r :I: i:f h' '. `..:..... � ..... t::l' I a r- � �:� _::
'.'ti'. " r" r.:. :-' -• � 1 -. ..i•' .. i.�ii"II'1 i ° E �i ' L- i.L,.f�J I•ii�i.1 THE 1`-.•... 1 � .�. DATA
r..i
THE FOLLOWING F'{a.E`1.1 I' rr.i I I :I.NI ,. J~ri._!c'•i I .F1Te'!.'ePEi.+If',:..3,r.._t:•R rTOs'!.'r i-,' R ,'REQUI I_.'.I. -
,`.-: I::. I- T L C ii N K -- � GALLONS, AS ..11' . I ' ` i .i... t . TRENCH ........... ..`, {; ! . i" i ..
I. B,°•:.tol'';:I''`'i'.I.Dl'••! BED L . 3Q: FT,
IN Si}:i•E}.i•J I-i-I!'•I l7{ I i---I:I`I` I I 1i.ti,Il::�, YI Ii THE .Eli I,1�J L-I.r�',I '^II<'; 11-Ii-i+�[11_- TERMSI,•ilF
1.1..1.1. ,. i,; f,., l,�, � i .#... 'F ' i s l' L f`f l -a ... ,...... .. ,.. I.. I.. , I... ` I F i I I ' L I.., ,_ . i - - .. ., ........ I ... i.. COMMENCE,
• � i .! ...... l.1 ...E.JI=V.: •':EiL; r .i. i. I, i �! THIS ' ::.I•':i I. I
MY :'.I::: REVOKED I::.F. DR ,`.';E;,`}I I:::,•!f: I.:D !. 15'11::: Wl.-:I. ST l:rl)ti iT Y Ili::r''a# "t!! A71..1::.=11, i HN'w L01; !_'! nI;;t.fN::; •.'L
F O ; i l"I :i.M 'I KE:: bll:::i...Fa t:;1?i.11•i i'i :l:i'dAi:l:V :I:Atl.il^•II... ':'L'::WAt:il' DISPOSAL SYSTEM i4iWl::•fi.11_.r[.1'.JA:`} INCLUDING
FAILURE ..1;J I'il:.l^:"r ANY 15---1.41 i.1l": +..=I:fi'�It9 ....I..`4i I.!i1' I..,,....r� .THEREON DURING TEMPORARY ,.. i" ai
• ., I :I: I -,. E.I I -.. ,� .'�s �`: i..-.. : i,.. €"7I'•' . � I;;� �I :�'i' (.? I•�: FINAL
THE
. 1l'.•� 11 I..I ., 1 i ... PERMIT ". z, '` DOE
l :... ;. NOT
CONSTITUTE '
APPROVAL, � � � . L.. I a'i L !— i'� i i I. I ,e.) r.:. i ..J .,I.. ASSUMPTION ,:, i.' i � I��' .T. I.4.! f:� t:r •� THE
i ::
I ! _ ITS r, i a, h 'i .. �.i z. ' 11 FAILURE l.i . INADEQUACY l 1-;� i F A i_ i i.- THE
DEPARTMENT I '� �--. ! L.... Si' . .,..!. I `I .. I , ... �r::i !. k I';, . J I'i ;, �;; .. Y .. I l•:.
SEWAGE i::t:,a•f:'I'I.si•iI.� SYSTEM, 25!/qCi11
3Q ENVIRONMENTAL i'i::{::..r=1 L.. i:..i.
6
:1r'?i.!':.
THIS PERMIT IS NOT T1;1;5.34'1::'F::!AN,,,1':: AND .':>'k•li"I!...s... BECOME iµ 1:5:Xa 1:F SYSTEM I T"'Oi'•,;'..i• [`fJE., .I:(:lE:! HAS
NOT COMMENCED WITHIN ONE YEAR or I: f S ISSUANCE, BEFORE t:iI L ISSUING [.i:i N FINAL w-,lf'plti :!VF. I- OF
THIS PERMIT .5..1'55::: WELD D Cu IF.! 1 Y f'{i:::,',!...AI-I DI I-'fii l M!:i:i`-ri RESERVES 'I --II::: RIGHT TO :l:r"rf"'k;:lSl:: t''11:;D:1i....
.i 7_iVdr;If. i`LkM 6111 :ii.,,t` i I'r'-. I-LilN.;4 'I: 'Lis.' ..'G'i::.x1 TO MEET 1..1 - R REGULATIONS OH A CONTINUING BA—
SIS, FINAL PERMIT APPROVAL I:.#; ["i,'slj\l'j':I:NGI:i.F l UPON THE FINAL ;f.. INSPECTION OF THE t::'t:Hii,,,.
5''1..1: _I,.. D SYSTEM {.i=7 THE WEED I:II.+;-. i Y I!I::t=11... I I-5 D1:::F'l I f'`kf:i': 1
{ 97":.. 1.-:.!.N �: __....(..IP .. [.-. I...,i-}141 I i.,,. " : st ,.,H_0 '..c.• ., a .....: s' .., 19i'r4
Flt5i
Property address
Legal description &a _ `r� - - --
Property Owner:.
Yfl-County Health Department
Percolation Test and Solis Data Form
Name
VE s c,'- 1A -S CO. D "•G
Address / 2- a., p l c Q L5
Phone
Note:
• Percolation Test Form, Site Plan and Grain Size Distribution Curve of the Sample mast
be submitted with this form.
• For all Lots <5 acres the site plan must include the entire lot. Test locations rust
be accurately tied to lot corners or other permanent markers.
Saturation and Swelling
• Smeared surfaces removed: < Yes No
• Sand or gravel added: _K_Yes No
• Date and time presoak water added:
• Amount of presoak water added (gallons):
/O
• Date and time percolation test is started:
_ .5- , ,0- 7, J g997 8,'2- 4 -An
• Did water remain in hole after the overnight swelling
Hole 1 Yes _X_No
Hole 2 Yes }c No
Hole 3 Yes _ >C No
Percolation Rate Measurement
Percolation Rare (minfin.)
Hole 1
Hole 2
Hole 3
Average 2.3
Groundwater: 4.70,1 e.,
• Encountered @ feet.
• Estimated depth to maximum seasonal
water table if not encountered in
profile:
= Is area believed to be subject to seasonal
fluctuations which could result in a
seasonal water table within W of surface?
Yes No
Slope determination In absorption area:__?? % to
the _ A" (direction)
Bedrock: h p .nom .- .. a
• Encountered @ feet.
• Estimated depth if not encountered in
profile:
• Type of bedrock: Sandstone
Claystone S tstwne
Other
• Is bedrock fractured or weathered?
Yes __No
• Is bedrock believed to -be permeable?
(Pere rate <60 min./in.)
Yes No
ti
TCHD S-101 1/88
- 'ofile Hole Infortnalion (Cont.)
(Soils must be classified using Unified System ASTIvi D2487)
0
Profile Hole Log
f
2
3
5
8
7
8
9
.10
Certification
I certify that the above information is correct and complete to the best of my knowledge and that all tests
were performed in accordance with the provisions of Tri-County Health Department Regulation I-ii8 by
myself udder m supe ion.
Original Signature
Company Name
O'cK c7
. .. Pre; .
Address
Date
4 •• 42"
�h'6 •ir
• •
t..
:2330):)
• :
fJll!!
f fi COL.. ktiti.
fhryiiri!!I}i'.iititi��
Original Seal
TRI-COUNTY HEALTH DEPARTMENT
Percolation Test Result Form
Hole
No.
Hole Length of Water Depth
Depth Interval @ Stan
(in.) (min.) of Interval
Water Depth
@ End
of Interval
fint
7"
Drop In
Water Level
4 .
Percolation
Rate @ Final
Interval
(min./in.)
2
36
3O
30
30
30
3o
39
3a
3O
3o 1.
/,‘1
2.7-O
l,s
'$73
1,91P
1,4-5
1,Iz-
1r� �
1+ 44-
/2.5
/4-/Z7_
p, o6
,4w;, 2 3mf ,4 4pi
'Feld Notes shall be recorded on this form or in this format; typed copies of field records may
be submitted on this form.
'A lour hour test must be conducted unless (a) water remains in the hole after the presoak in
which case one 30 mire. interval is sufficient, (b) the first 6' of water seeps away in 30
minutes in which case a one -hour test of 6 - 10 minute time intervals may be used, (c) the test
is being conducted in sand in which case a one -hour test of 6 - 10 minute lime intervals may
be used, (d) three successive water level drops do not vary by more than 1/16 inch in which
case a two hour test may be conducted.
TCHD S-100 1/88
Director, Health Protection
Applicant
WILDc.
COLORADO
STAFF APPROVAL OF ENGINEER -DESIGNED SYSTEM
DEPARTMENT OF HEALTH
1516 HOSPITAL ROAD
GREELEY, COLORADO 80631
ADMINISTRATION {303) 353-0586
HEALTH PROTECTION {303) 353-0635
COMMUNITY HEALTH (303) 353-0639
The engineer -designed Individual Sewage Disposal System =proposed for the
property located at 2
and designed by
approved subject to
the following conditions:
I. RANt tor+ rs Q . , L c *L
is hereby
, applicant for I.S.D.S. Permit No._-,9Q.C.6
under the provision of the Weld County Individual Sewage Disposal System
Regulations, do hereby understand and agree that after approval by the
Director of Health Protection Services, I may proceed with the construction of
my engineer -designed sewage disposal system prior to approval by the Weld
County Board of Health, but that the Board of Health reserves the right to
disapprove any or all parts of the system design when it considers my
application. I understand and agree that I proceed at my own risk and that I
may be required by the Board to remove any or all of the system installed
prior to Board of Health consideration of my application.
t
Date, Date
COLORADO
Approved: A copy of the
Form and your I.S.D.S.
TEN MUST BE INSPECTED
THE DESIGNING ENGINEER
OPERATION. THE ENGINEER
THAT THE SYSTEM HAS
SPECIFICAITONS,
DEPARTMENT OF HEALTH
1516 HOSPITAL ROAD
GREELEY, COLORADO 80631
ADMINISTRATION (303) 353-0586
HEALTH PROTECTION (303) 353-0635
COMMUNITY HEALTH (303) 353.0639
November 28, 1989
Vessels Oil 6, Gas
1245 WCR 19
Brighton, Colorado 80601
Dear Sir:
This is to inform you that your engineer designed septic system has been
reviewed by the Weld County Board of Health and approved as submitted,
This is Permit #G-890266 located at the office,
Geld County Board of Health I.S.D.5_ Review
Permit are enclosed. PLEASE NOTE THAT THE
SYS BY A REPRESE1!TAT �1 F TH EPARTMEEVT_ AN J Y
. BEFORE THE SYSTEM CAN BE APPROVED FOR
LUST CERTIFY T9 THIS DEPARTMENT. IN WRITING.
BEEN INSTALLED ACCORDING TO HI,S/HER
Should you have any questions regarding your septic system, please
this office at your earliest convenience at 353-0635.
Sincerely,
tab d 74-7:eVu 49 -a -et gC17/Fni-d2z-
Wes Potter, Director
Environmental Protection Services
WP331/cs
cc: Engineer
I.S.D.S. File
Weld County Department of Planning
contact
WELD COUNTY BOARD OF HEALTH
Engineer Designed System Review
.APPI,_ I C'AJNIT' :_u_e52.)(15 at. ,(4,05
acs No: WI,e(p
LEGAL DESCRIPTION: PT L} 5 f T itf
SUBDIVISION:
LOT
BLOCK
FILING
SITE ADDRESS: L( [
FACILITY:
PERC RATE:
l.��l'L�n•�efiCd['x
SOIL: cyjiAkin
SLOPE: 4f: .. TAMXTLNG ZONE: > $
ENG1KEER DESIGN (3.5)
ENG€NEER: Cf
ESTIMATED. FLOW: ==•Jg
PRIMARY TREATMENT:
DISPOSAL METHOD:
REQUEST FOR VARIANCE:
ACRES: •
WAVER SUPPLY: AMC..
EXPERIMENTAL DESI-GN ( 3.14)
e
G.P.O.
CAPACITY :1T1[X
SIZE: Lillg
-STAFF COMMENTS:_
STAFF - RECOMMENDATION: _
REVIEWED BY BOARD.
0.0.HH. DECISION:
YI RONME{ITAL HEALTH SPECIALIST:
- APPROVED
Da1e•Pdters Chairman
Weld County Board of Health
•
• DENIED
TABLED
F; '- _. 1I_fi I .I oI`? FOR .i.-':.fi.l. c'.L1..` A_. •• fJf'i.rla. DISPOSAL, I y NO, G-89266
OWNER :E1'•, V r::.:' I::.I._..r ult..,
WELD COUNTY HEALTH x;'I:::Pf'rl( ?•Hi:::i'r.Y.
ENVIRONMENTAL
1 f HEALTH `
gFRVICEE
i516 1 i I -I I.Z i} I-' I 1r (. i.,. R(.J I'�i i) , (.� L,,.I:, e., 1::. 1
FEPATR APPLICATION
A s, .JI"; I::. L: 1245 :OCR I PH ...1. ..i 1 659-65,1
BRIGHTON CO ;: .r1r>;
ADRES or PROP(...:. ;MTEM 1245
k:J: I;; H O r! r:.
LEGAL_ S)C:: CR:1'f'''I:1:(:)i' OF EW4
U.; i::: "(YE i:. ' CI::IMMEi.R(:ra. F1i... OFFICE
}I:::" -;V .#, I.; : l y'I:-iL,`t7l' ,} - .i_iA"I'I,.ircOO1°I: i.50
;')
Lo 0060i
L.. O i rl P L.. O (i i'
>{I
LOT SIZE 21:,0 ACREE
is{1:DEs:(:)l'::ik=f,`.;` C 1'f)i'T::i-'li:_N•'I• PLUMLING NO 1,4ATER 'LIPi'I...`:' E''L I::i._i...
f=:i'E'`i_.:!.[Ai,J.;. f11:,1.: I(';=`>,<I..F'(:•:E::,' ..I.I.I{•.f.i. THE (';(:�`rii'i_.I::. I I:�'i�•11::; :' > I; .fi,. ..f.i f `ti f'4F='F�l._, r;A i :i:i) i :I: 'f')'iJi_i;i_..( .l,I.•ri,.6r•.ri_.
UPON FURTHER MANDATORY h.O I"'ll::iD ., i:�i`: 'L. I r:. E AN } I:I :E'l: Gti"1 .-' i'I,: .i°.if,'i.. BE _ REQUIRED ...,.._: ,... I r.: _. s_ ,.. -.. � z� r € i1...
i r a'. ,.. 11 � HEALTH E.. ,. �, .. i� .. .. -- - 1 �FURNISHED --r ,: ... .. - � � y � ! I p ,., �I THE
E::. k... a� ,.. LJ , I • I r , ...� .� i ) �' i••I I�� 11'' ::. ' I . • .., f'1 E� i } e: !•-1''- i:• i THE 1:: F'! h' I" i..... l.: f'I }' I
.I -r, HEALTH DEPARTMENT
... E_:. THE ...
WELD
1...:7"sl1`� IE.. !F � ...i F..,. .. I .;., ,• EVALUATION i E•'"i--��;i,.....E. ...I I
u.::-i-.J., ,.,,..r;- E ..ii.,, .•11::.. h i'li::.11 h•3,)I�: I�la1 I''l.l�01::...� (ai.. THE L..�r•11._i,Jt�k�.f}.)�`': OF � : r�'I"' —•f"1
AHD
T i.. '. ..: E.. ...I• ..IjI... .. '�i r' ' i.} ..�`..�J.':. jfi.,... J ,i ',}, ,{. .' ,'---.1. } _ ..,
r-i1?i� THE L':. I :.r 1.l ill �i i�� � I.., I..I.. € i�. I r I J � :_1(.�i • I l,..I�f'�,: f—ti�::. I.., 1.1 i`-:A; i i�`��`. ��1:r �.1 i_. I...f i,...
-NECEAY 1t:1 :I:I''E(.EG I::: is;'I::ri'I 'i...1.f1r':€(.;I::: 4-J:I. l L'I 1',;.Ei...E:.i' AND RiLULATIONE ADOPTED UNDER f-'`iE'. f-Ci...'l :
"...., ; c.. I"; .:, I'I •'. i ..1.:_ �. THE E::. APPLICANT .•'. I''' 13 I•• , - : ,.1� THAT THE I: r 't 1.1 l s f::
�; I �� I I...t1 Li .i .. 1 NOT I `.. • I -I1.' •� r.E....;, .. r. �..,. S.r l I I,JI.I.I...f..._f. SEWAGE
�.i(,15.�.. ..E...: THE.
,..
r..,. ,. ... � .-.. , i h....: E 1 i.f � i'. i:.•!.. `�'' tl �:,; t',-• -,.
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111r.'�.J1...I•,�.:.' E i:rr?I... I7 1' il::.!"' i::. J.,; y' I I".Ik I .1, L' I.I" I I'it'r 1 ALL �„ 3 E r...... .„,-: n-..,� '�''.! ..--#...4r y --k;
... L, � '. :r i k::. f-'i i_. I``I I 4'ri l e Jr 1:.. , .i ! -s l I_..1 k i i ��l I .i. t.1 i',i AND f ,i r.1 1'; i::.1 `t:I 14 1
f.E,;.ry} .I...i...�1::.�.1 HEREWITH
•!• .q ..•,N.., .I'.: ...il I' ..,, +i ` [ ... 1-,` - __ __ ,,_if _ _- '..[ WILL :.. ..� !'3
SUBMITTED ''::I� ,a..."if, AND I�,,.s:,..l'F�`I'r�1 TO t•�i•.. ':-sh��l'I.�.L..iE:n;' ".�'E' if-li:� iEE'i"'I..LI:.t51.. ��k::.: ,rl'; .i.
REPRE.TUNTED TO E I I'';I.EI-.. AN CDPRECT TO nFT O a= f .-i.1.}c;.11_,I::_� :,I::. AND x:;J,:,1,,..J.::.I- r AND
i !.J e I•• I" I" E .i. .,° v i i�., LL.D
COUNTY -I r.: �.� r.i _ti -EVALUATING .. 4!k >•. � � ,.:. !..._..: HEALTH ,.. k i` .L I'�.
.J I'• .,. 1 1. I r _i 1••' 1" i FOR w HEREIN I I"I ::. ,} f•�� I'i .. .. 1.. � i'C { 1'-; ..' !_! k:'r I". �''.- E �.:- I .. L . � ' :. i" t.- i l J }. E I::. l'+ UNDER .. .
ET
,. xf,., , , Y '', F I. (..["r I .1. l.JI'-? ,.11{ dki.i. I:I::.I' i�'�I::.;::I: ('�..I.('r_F..I_ (:- l,i I'li'`I`f' ' i';'I:: Ii.- ..I. { �J ,.. DENIAL r,,..
,� f i-i1�:.1 THAT k f'fE:: 1 � I •: __ ,.-I THE
r::.
S'li"•i'•i... s.'.rl+=! f .I.I..JI`I i.ii'i REVOCATION OF ANY I--`t:.IFI I. I t:fI1AY } i....( i.ilriSIl::.lr' t.UP--'€.ii1 a'ri i.4) 5'iPi'i....I.C i .I.I.1N AFL)
IN 1..El:rAi... f.:11,!Ti•EN FOP PEE'._JI L`a' AS pa:J'_.)V.I.(._F...(,I BY LAW,
::::. . , 1''IE.JI'.._} J . 1.::.. L1 "'I"`L.,.l.Erf-=11 .LlJ!' I" I''1 f_, 11;1 ,>y '''fi'I tN "JI-.
J: I::: (; ` :t 1 :f . r' ( . I.:{ 1 I I ,' , O I I I~ iii:
DATE 10/1/89 C: rir-1- . i f TO `' :i. (..'cI;, is:
�.
10/1/B1
F:;.
I,:i I^; 1. r ... ` I•i i-..... ••i l" 1" 1.... n { i E 1..1 ! f " :. 3: MAY, 1904
INDIVIDUAL SEWAGE
DISPOSAL SYSTEM EVALUATION
Weld County Health Department
OWNER:
16-6
MAILING ADDRESS: (2gcj L,( t
SITE ADDRESS: 0{..Q
REQUEST NO: 6-7--))
DATE RECEIVED:
RECEIVED BY:
FEE $70.00: LVC L� /W .e
PHONE: 64,({-(Qs3 L
{ t c �, vow
CITY STATE ZIP
LEGAL DESCRIPTION: PT:S L PT: _
SUBDIVISION:
WATER SUPPLY:
rui
CITY STATE
ZIP
SEC: 41 'MN; N RNG : 61 W
LOT:
RESIDENTIAL COMMERCI
BLK: FLG:
TOTAL ACRES: t
PERMIT ON RECORD: NamegeSSRAO riCrIs
Permit No.:[o(o S.O.E.:
System Size: Tank •j gallons Trench: square
Percolation Rate: rr23.O
Engineer Design:
minutes per inch
N Percent Ground Slope:
feet Bed: (o1S square feet
Soil Type: L,
Direction:
The septic system identified above IS /-IS—NOT of sufficient size to accommodate the proposed
structures) served by this system.
CURRENT FLOW
Description:
Persons:
Bedrooms:
Bathrooms:
Basement Plumbing:M0
0
The ex
acc•
1
i 'ng Sept'
ADDITIONS
Description: (LZ 4
O
syste s IRED to h
PROPOSED TOTAL
Desc rgiion",
3.
e the f • ow eratio m.•e
date ■r- 'reposed alterations to the structure(s) serve
ggsxx 0-1A_ -itit utLeduzvit 0 (.-L Lve4i41 VtL 5(0"
Neither the County of Weld nor any of its agents or employees undertake or assume any liability to
the owner of the above property, to any purchaser of the above property or to any lending agency
making a loan on the above property or in the report.
This inspection was conducted for the purpose of determining compliance with current regulations
and for detecting health hazards observable at the time of inspection. This does not constitute
a warranty that the system is without flaw or that it will continue to function in the future.
Inspections requested during periods of snow cover and high soil saturation may be of questionable
value to potential buyers due to adverse conditions. Evaluations based on Statements of Existing
(S.O.E.) relies on information the property owner provides,, under oath, indicating current status
of the system and representing to the best of his/her knowledge the system is not failing to
function properly.
/�-'c r&'dc
}E JS FORM MuS7 BE
',UNMITTEQ PPiOR TO'4"
PHE E•XP+RATION OF THE
ERMIT, TYPO OR
RINT IN BLACK INC.
'COPY OP ACCEPTED
STATEMENT MAILED
ON REQUEST. •
FOR OFFICE USE ONLY
Div- Cty. -
STATE OF COLORADO
COUNTY OF
LOCATION OF WELL
6Z -
THE AFFIANT(S) Vessels Gas Processing, Ltd._ County Weld
whose mailing
address is 600 South Cherry Street, Suite 1220 !'1E IA ot,h, SE 14, Se4+ien _28---.
City Denver CO 80222 Twp 1 N , RAp 67 (4 , 6 P.M
pT T1I (i;r I Yu DR s73M,53-- Yi1
being duly sworn upon oath, deposes and says that he (they) is (are) the owner(s) of the well described hereon; the well is
• •
COLORADO DIVISION OF WATER RESOURCES
300 Columbine Bldg., 1845 Sherman St.
Denver, Colorado 80203
X. STATEMENT OF BENEFICIAL USE OF GROUND WATER
AMENDMENT OF EXISTING RECORD
PERMIT NUMBER 018674`F
} 55.
APT 1 71986
Krim Emmen
+STATE. ENGINEER
COL&
located as described above, at distances of 1346
feet from the south section line and 311
(Asst, uA sbvint
feet from the
east section line; water from this well was first applied to a beneficial use for the purpose(s) described herein on the 3rd
(EAST 0H WESTI
day of December
l9 74; the maximum sustained pumping rate of the well is 19 gallons per minute, the pumping
rate claimed hereby is 19 gallons per milR.ite; the total depth of the well is 793 feet; the overage annual amount
of water to be diverted is 3 . acre-feet; for which claim is hereby made for industrial
purpose(s); the legal description of the land on which the water from this well is used is
described as Parcel B on the attached Land Parcel Survey which totals
0 acres and which is illustrated on the map on the reverse side of this form; that this well was completed in compliance
with the permit approved therefor; this statement of benefit ► LLf- of ground water is Filed in compliance with law; he (they) has
(have) read the 51 ptorrents made hereon, knoyf; and that the same are true of his (their) :knowledge.
Signoture(s).�
� Michael S. Boland
sub scr chop+ grn,
to beef iui ire;!on ,1s` day of
y�
a or $6 -'T
. '+� 4 P l..9 1v C. Rau, 00'" .'�lferry, Denver, CO 8022
Al� G BY THE STATE ENGINEER OF COLORADO
PUURgt2 4P9144"11-4tOLLOWING CONDITIONS:
1)A S.IC 5.11;`._E5'.`,T}lE ?'ttOOF OF BENEFICIAL USE WAS T1711.1 1•1ED.
NO O13t ECTIONS WERE RECEIVED THE PROOF TS ACCEPTED AND THE
WELL PERMIT REMAINS TN FORCE AND EFFECT.
?)THAT THOSE CONDITIONS OF APPROVAL AS STATED ON THE ?TELL
PERMIT ARE CO"T?LIED WITH.
April
L131,09
19 86
r,.
AU6 15'986
DATE STATE EI'Gi
FOR OFFICE USE ONLY
Ceort Cosa No.
•
W,il Use
Diet. Basin Man, Dis.
Prier. Mo, Day Yr.
a. /Fa:74)44_0 lwS� BY
R`. _
• •
Well drilled by Kenneth Rutt Lic, Na.
9
Pump Installed by Spain Well Service Lic. No 715
Meter Serial No. 3627084$
LL, ® Flow Meter I] Electric Meter ❑ Fuel Meter
Owner of land on which
water is being used Vessels Gas Processinj,. Ltd. - - -
THE LOCATION OF THE WELL MUST BE SHOWN AND THE AREA ON WHICH THE WATER IS USED
MUST BE SHADED OR GROSS -HATCHED ON THE DIAGRAM BELOW.
This diagram represents nine (9) wections. Use the CENTER SQUARE
(one Section) to indicate the location of the well, if possible_
NORTH
+ -
f
+
1
- ~w --
1-
-I-- -
- -I- -
-
•
+ _
1- -__.
4 --
NORITIi SECTION
I-
+
LIt,IE
I
-f-
-- -I-
-I- -
WEST SECT
i
-
- !..
k
W + —
I
-I-
.#11
I
ION LINE
-_ - -
hi
Y7
+ -,.
(U
I -
+11
I
4 I
I
I
SOU H SEC1
+ I + _
ION L I E
+-
E
+ 4
I
+ _I
THE
SCALE OF THE
I
DIAGRAM IS
'l Mile
TWO INCHES E
-1.-[
UALS ONE -MILE
+ ---
-- ,- `
g...-± ± -'4
-^_
WATER EQUIVALENTS TABLE (Rounded Figures)
An acre-foot covers 1 acre of lend 1 foot deep,
1 cubic foot per second (cfs) .. 449 gallons per minute (gpm).
1 acre -Feet . , . 43,550 cubic feet , . , 325,400 gallons.
1,000 gpm pumped continuously for one day produces 4,42 acre-feet
100 gpm pumped continuously for one year produces 160 acre-feet.
9-
F
W Ra-2B• 72
THIS r^C1nm ML T I L• suBMIri
- WITHIN-kr) DAYS OF Cc MPLeTI0M
,OF THE wgRh,c bE9k.zIREDHERE
'ON_TYPE ORPTtINTIN et_AC:K
111EK,
c
COLORADO DIVISION OF WATER RESOURCES
300 Columbine Bldq., 1845 Sherman St.
Denver, Colorado 80203
WELL COMPLETION AND PUMP INSTALLATION REPORT
PERMIT NUMBER 0let574--F
Vessels Gas Processing Ltd., Leeeee
WELL OWNER _David `- Fr work, Owner NE. % of the
2nd. ' Floor 180 Gook St
ADDRESS Denverls+.. &21)6 T. B, 67 -1d
Lrr.�
DATE COMPLETED Oct. 11. 1974
From To
WELL LOG
BE
RECEIVED
0CT 2 3 '74
wRIO
TJTI�eG t
Ei
e a
34 of Sec. 28
, 19 _— HOLE DIAMETER
7 7/8 in. from 0 to 578 ft
Type and Color of Material
Water
Loc.
0 25 Overburden
25 53 Weathered shale
53 70 6he.1e & Sand atks.
70 110 Shale
110 115 Oba1
115 287 Shale
2d7 289 Grey rook
289 309 Shale
309 311 Cfroy rook
311 357 Shale
3557 359 coal
359 436 shale
436 440 Coal
440 4.142 Shale
t142 446 Goal
446 479 shale
479 481 Co a l
481 487 Shale
487 488 goal
8 003 Shale
503 505 ❑o al
%5 522 Shale
522 537 Shale
x,,37 .552 Br. rock 11 •, Shale
5- 559 0oa1
559 560 Br. rock
560 570 Bile. Shale
570 572 Coal
572 607 Sand
607 614 Shale
614 64+0 Sand
Goo 647 Shale
645 705 Sand
705 725 Sandy shale
725 722 Shale
729 772 3 and
772 779 Shale
779 790 Sand
790 793 Shale.
TOTAL DEPTH 7951
Use additional pages necessary to complete log.
5 5/8 in. from 578 to 795. It,
in. from
DRILLING METHOD
to - ft,
Rotarlr
, 6 P.M.
CASING RECORD: Plain Casing
Size , 6 & kind atae1 from
Size & kind
from
Size . & kind from
0 1O' 578
Perforated Casing
to
to
ft.
ft.
ft.
Size 4 I & kind -t eel from 570 to 793 ft.
Size & kind
from
Size - _..__ & kind --- from
GROUTING RECORD
Material Cement
Intervals
0....578
Placement Method ollibur#az�
to ft,
to
GRAVEL PACK: Size
Interval _ _
ft.
TEST DATA
Date Tested Oct. 11, 1974 19
Static Water Level Prior to Test .--.-.-•-27S--_ .., _ , ft,
Type of Test Pump 8e.lar 4 $jrreit=t
Length of Test
Sustained Yield (Metered) 23 OPT[
Final Pumping Water Level 760
MAW INSTALLATION REPORT
Pump Make
Type
Powered by ._. HP .
Pump Serial No.
Motor Serial No.
Date Installed
Pump Intake Depth
Remarks -- _--
WELL TEST DATA WITH PERMANENT PUMP
Date Tested
Static Water Level Prior to Test
Length of Test Hours
Sustained yield (Metered)
Pumping Water Level
Remarks
GPM
TOTAL DEPTH
0
1.1
—
I—
I
i
s .I WATER
> is > V TABLE
.tea � al+
w
z
CONE or
DEPRE S SioN
CONTRACTORS STATEMENT
The undersigned, being duly sworn upon oath, deposes and says that he is the contractor of the well or
pump installation descry d hereon, that he has react the statement made hereon; knows the content
thereof, and that the e'is true of hi Own awl
Signature
License No.
State•of Colorsldo, County of C—vt l -v SS
:`Subserthe' d and S1„ orn to before me this Laday of -._, i9"7
1 '41'1ti ion Expires Auk. 1 B;1 U 78
My' Commission ;x0-04:
Notary Public . _-
FORM TO BE MADE OUT IN QUAORUPLICATE: WHITE FORM mull be an original copy on bo#h sides and eternal
WHITE AND GREEN copies must ba filed with the Slate Engineer, PINK COPY b for the Owner and YELLOW COPY is for the Drille
r.
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