HomeMy WebLinkAbout20142863.tiff EXHIBIT F
EVIDENCE OF ADEQUATE WATER SUPPLY
Bottled water will be provided during construction by the contractor. After construction, potable water
will be provided by a water well on the parcel in the S/2NE/4. A permit for a well will be filed with the
State of Colorado Department of Water Resources (DWR) concurrently with the USR application. A
preliminary consultation has been conducted and the DWR and the agency advised that they can issue an
Exempt Commercial Well for said parcel, for office use/sanitary purposes, for 1/3`d of an acre foot of
water per year, approximately 4-6 weeks after submittal to the DWR. The permit ft will be provided to
Weld County staff immediately upon receipt.
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EXHIBIT C
EVIDENCE OF ADEQUATE SEWAGE DISPOSAL
Temporary sewage disposal units (portable toilets)will be provided by the contractor during
construction. After construction, one portable toilet will be on-site for truck drivers who are onsite less
than 2 hours.
After construction, the Facility will also have proposed septic. UET is proposing two restrooms, housed
in two separate(but adjacent) structures (the MCC/computer and the office/storage), used by
approximately 9 total employees (working in shifts)daily. Engineered designs and permits will be
submitted to the Department of Health as required. A septic leach field is shown on the plat drawings.
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Form No. -OFFICE OF THE STATE ENGINEER
sws:55 COLORADO DIVISION OF WATER RESOURCES
818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203
(303)866-3581
AUTH
WELL PERMIT NUMBER 283108 -
APPLICANT DIV. 1 WD 1 DES. BASIN MD
APPROVED WELL LOCATION
WELD COUNTY
SE 1/4 SE 1/4 Section 34
UNITED WATER & SANITATION DISTRICT Township 5 N Range 63 W Sixth P.M.
C/O HYDROKINETICS INC DISTANCES FROM SECTION LINES
12975 WEST 24TH PLACE 500 Ft. from South Section Line
GOLDEN, CO 80401- 500 Ft. from East Section Line
(303) 237-8865 UTM COORDINATES (Meters,Zone:13,NAD83)
PERMIT TO CONSTRUCT A WELL Easting: Northing:
ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT
CONDITIONS OF APPROVAL
1) This well shall be used in such a way as to cause no material injury to existing water rights. The issuance of this permit
does not ensure that no injury will occur to another vested water right or preclude another owner of a vested water right from
seeking relief in a civil court action.
2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless approval
of a variance has been granted by the State Board of Examiners of Water Well Construction and Pump Installation
Contractors in accordance with Rule 18.
3) Approved pursuant to CRS 37-92-602(3)(b)(I)for uses as described in CRS 37-92-602(1)(f). Use of this well is limited to
monitoring water levels and/or water quality sampling.
4) This well must be equipped with a locking cap or seal to prevent well contamination or possible hazards as an open well.
The well must be kept capped and locked at all times except during sampling or measuring.
5) Records of water level measurements and water quality analyses shall be maintained by the well owner and submitted to
the Division of Water Resources upon request.
6) Upon conclusion of the monitoring program the well owner shall plug this well in accordance with Rule 16 of the Water
Well Construction Rules. A Well Abandonment Report must be completed and submitted to the Division of Water
Resources within 60 days of plugging.
7) The owner shall mark the well in a conspicuous place with the well permit number and name of aquifer as appropriate,
and shall take necessary means and precautions to preserve these markings.
8) This well must be constructed by or under the supervision of a licensed well driller or other authorized individual according
to the Water Well Construction Rules. If non-standard construction is anticipated, a variance request must be submitted in
accordance with Rule 18 and approved prior to well construction.
9) A Well Construction and Test Report(Form GWS-31), including lithologic log must be submitted by the individual
authorized to construct the well. For non-standard construction, the report must include an as-built drawing showing
details such as depth, casing, perforated zones, and a description of the grouting type and interval.
10) This well shall be constructed not more than 200 feet from the location specified on this permit.
11) Issuance of this permit does not guarantee that this well can be converted to a production well under a future permit. The
ability of this well to be converted to a production well is limited by all governing statutes, rules, regul ' , orders, and/or
decrees.
5-
. 1�
APPROVED
4-
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State Engineer By
Receipt No. 3644999 DATE ISSUED 05-03-2010 EXPIRATI N D TE 5-03-2012
25
COLORADO DIVISION OF WATER RESOURCES • Office Use Only Form GWS-46(07/2009) '
DEPARTMENT OF NATURAL RESOURCES
1313 SHERMAN ST., RM 818,DENVER CO 80203 RECE ED
phone—info:(303)866-3587 main:(303)866-3581
Fax:(303)866-3589 http://www.water.state.co.us MAR
u!�'nn
MONITORING/OBSERVATION 7` tJ
Water Well Permit Application WATER RES0u1RtLES
STATE
Review instructions on reverse side prior to completing form. COLO
The form must be completed in black or blue ink or typed.
1.Well Owner Information 6. Use Of Well
Name of well owner
United Water and Sanitation District Use of this well is limited to monitoring water levels
and/or water quality sampling
Mailing address 7. Well Data (proposed)
5460 S.Quebec St.,Suite 110 Total depth Aquifer
City State Zip code -y 110 feet Alluvium
Greenwood Village CO 80111 8. Consultant information (if applicable)
Telephone C E-Mail(Optional) . Name of contact person
(303)773 1005 Pat OBrien
2. Type Of Application (check applicable boxes) Company name
ElUse'existing well ElReplacement for existing monitoring well: Hydrokinetics Inc
®Construct new well Maling address
Permit no.:
❑Other: 12975 West 24th Place
3. Refer To (if applicable) City State _ Zip Code
Monitoring hoe acknowledgment Wet name or 4 Golden CO 80401
MH- l Bridge Telephone h
4. Location Of Proposed Well (Important! See Instructions) (303)237-8865
County 9. Proposed Well Driller License#(optional):
Weld SE 1/4 of the SE 114 10. Signature Of Well Owner Or Authorized Agent
Section Township N or S Range E or W Prinopal Meridian The mak ng of false statements herein constitutes perjury in the Second
degree,which is punishable as a class 1 misdemeanor pursuant to C.R.S.
34 5 ® 0 63 ❑® 6
24-4-104(13)(a). I have read the statements herein, know the contents
thereof and state tha ey are true to my knowledge.
Distance of well from section Ines(section lines are typically not property fines) Sign here(Must be on I Date
5(() Ft.from ONE'S 500 Ft.from® E 0 W
3/I6/#0
For replacement wells only-distance and erection from old well to new well __ t n e 8 tit! ,,// —` f
v~�� �I� <
feet direction .4/4,4-f
Well location address Include City, Zip) W D,4 /,U /.7,,,„,s-,-_,,,, ' -'( State, ❑Check if well address is same as Item 1. Office Use Only
Optional: GPS well location information in UTM format USGS map game DWR map no. I Surface elev.
You must check GPS unit for required settings as follows:
Format must be UTM !�� /f .Receipt area only
❑Zone 12 or El Zone 13 aryl (lft�J �
Easting t
Units must be Meters
i
Datum must be NAD83
Northing
Unit must be set to true north
Was GPS unit checked for above? O YES Remember to set Datum to NAD83
Trans plumber;3644009
5. Property Owner Information 3/29/2010 4'11:31 PM
Name of property owner Geoff Davis(21)
Total Trart8 Mitt$1170.0t1
Same CHECK
Check Number: 1889
Mailing address
oo
Check Am0th1t $
City State Zip Code
Telephone 4 DIV_1 _ WD J_ BA MD
( )
Form No. urrll.t ur INC b I /A I C CINUIINCtK
GWS-25 COLORADO DIVISION OF WATER RESOURCES
818 Centennial Bldg , 1313 Sherman St., Denver,Colorado 80203
(303) 866-3581 LIC
WELL PERMIT NUMBER 295200 - -
APPLICANT DIV. 1 WD64 DES. BASIN MD
APPROVED WELL LOCATION
WELD COUNTY
SE 1/4 NE 1/4 Section 2
UET MIDSTREAM LLC Township 9 N Range 59 W Sixth P.M.
225 UNION BLVD SUITE 200 DISTANCES FROM SECTION LINES
LAKEWOOD, CO 80228- 2515 Ft. from North Section Line
450 Ft. from East Section Line
(303) 634-7420 UTM COORDINATES (Meters,Zone:13.NAD83)
PERMIT TO CONSTRUCT A WELL Easting: Northing
ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT
CONDITIONS OF APPROVAL
1) This well shall be used in such a way as to cause no material injury to existing water rights. The issuance of this permit
does not ensure that no injury will occur to another vested water right or preclude another owner of a vested water right from
seeking relief in a civil court action.
2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless approval
of a variance has been granted by the State Board of Examiners of Water Well Construction and Pump Installation
Contractors in accordance with Rule 18.
3) Approved pursuant to CRS 37-92-602(3)(6)(1) and the policy of the State Engineer for appropriation of ground water
tributary to the South Platte River system.
4) The use of ground water from this well is limited to drinking and sanitary facilities as described in CRS 37-92-602(1)(c),
for a commercial business. Water from this well shall not be used for lawn or landscape irrigation or for any other purpose
outside the business building structure.
5) The pumping rate of this well shall not exceed 15 GPM.
6) The annual amount of ground water to be diverted by this well shall not exceed 1/3 acre-foot(108,600 gallons).
7) Approved as the only well on a tract of land of 40.00 acre(s) described as the SE1/4 of the NE1/4 of Section 2,Township 9
North, Range 59 West of the 6th P.M., Weld County.
8) The return flow from the use of this well must be through an individual waste water disposal system of the
non-evaporative type where the water is returned to the same stream system in which the well is located.
9) A totalizing flow meter must be installed on this well and maintained in good working order. Permanent records of all
diversions must be maintained by the well owner(recorded at least annually) and submitted to the Division Engineer upon
request.
10) This well shall be constructed not more than 200 feet from the location specified on this permit.
•
APPROVED J / , J
SMJ y/// ( y/
_ _ . . _ _ State Engineer __ _. __. . By........r .... ,.� .,. ..,..,.
Form No. Urrlut Ur Hit bilk ! t tNtal Vttt(
GWS-25 COLORADO DIVISION OF WATER RESOURCES
818 Centennial Bldg , 1313 Sherman St, Denver, Colorado 80203
(303)866-3581 LIC
WELL PERMIT NUMBER 295200 - -
DIV. 1 WD64 DES. BASIN MD
APPLICANT
APPROVED WELL LOCATION
WELD COUNTY
SE 1/4 NE 1/4 Section 2
UET MIDSTREAM LLC Township 9 N Range 59 W Sixth P.M.
225 UNION BLVD SUITE 200 DISTANCES FROM SECTION LINES
LAKEWOOD, CO 80228- 2515 Ft. from North Section Line
450 Ft. from East Section Line
(303) 634-7420 UTM COORDINATES (Meters.Zone.13.NAD83)
PERMIT TO CONSTRUCT A WELL Easting: Northing
ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT
CONDITIONS OF APPROVAL
1) This well shall be used in such a way as to cause no material injury to existing water rights. The issuance of this permit
does not ensure that no injury will occur to another vested water right or preclude another owner of a vested water right from
seeking relief in a civil court action.
2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless approval
of a variance has been granted by the State Board of Examiners of Water Well Construction and Pump Installation
Contractors in accordance with Rule 18.
3) Approved pursuant to CRS 37-92-602(3)(b)(I) and the policy of the State Engineer for appropriation of ground water
tributary to the South Platte River system.
4) The use of ground water from this well is limited to drinking and sanitary facilities as described in CRS 37-92-602(1)(c),
for a commercial business. Water from this well shall not be used for lawn or landscape irrigation or for any other purpose
outside the business building structure
5) The pumping rate of this well shall not exceed 15 GPM.
6) The annual amount of ground water to be diverted by this well shall not exceed 1/3 acre-foot (108,600 gallons).
7) Approved as the only well on a tract of land of 40.00 acre(s) described as the SE1/4 of the NE1/4 of Section 2, Township 9
North, Range 59 West of the 6th P.M., Weld County.
8) The return flow from the use of this well must be through an individual waste water disposal system of the
non-evaporative type where the water is returned to the same stream system in which the well is located.
9) A totalizing flow meter must be installed on this well and maintained in good working order. Permanent records of all
diversions must be maintained by the well owner(recorded at least annually) and submitted to the Division Engineer upon
request.
10) This well shall be constructed not more than 200 feet from the location specified on this permit.
APPROVED
SMJ
State Engineer — .-- .-- - -- By ... .....
1313 Sherman St., Ste 821, Denver, Colorado oUZUJ
(303) 866-3581 Fax (303) 866-3589
INFORMATION FOR WELL PERMITS APPROVED PURSUANT TO CRS 37-92-602
(HOUSEHOLD, DOMESTIC, LIVESTOCK AND EXEMPT COMMERCIAL USES)
Carefully read the conditions of approval on your well permit. The conditions and the information on this
information sheet must be complied with in order for the permit to remain valid.
THE PERMIT EXPIRATION DATE IS TWO YEARS FROM THE DATE ISSUED. The well must be constructed and
evidence of it's construct,on must be received by this o`_ice in the form of a Wel ConstrL.chhon and Test report from
the well construction contactor confirming that the we' was constructed prior to expiration of the well permit. The
well perm': number is located in the upper right hand corner of the pe-m't, and the expiration date is located in the
iower right hand corner. he expiration date of the permit may be extended one year at a time at the d:smetion of
the Stare Cnglneer for good cause shown If an extension of time is necessary to construct the well, a written
request for the extension of time must be received by this office prior to the expiration date of the well
permit. In the request, you must provide the well permit number, your name and mailing address and the
reasons why the well has not been constructed and approximately when it will he constructed,
Wale' well construction and pump installation contractors are spec'fically licensed in Colorado to perform these
specc.alized tasks. It is illegal for contractors who de not hold these licenses to construct wars and/or install pumping
equipment in or on wells. The wel' nius: be constructed and the pump insta',ed by contractors with current
!icense(s) issued by the Stave of Colorado unless exempted as described on the reverse side. Please ask to see
they license(s). Backhoe Operators anci Licensed Plumbers may or may not hold the respective Weli Construction
and/or Pump Installation licenses. Please he aware of this when you contract to construct the wok and install
pumping equipment The well construction report including a test of the well yield must be submitted to the office of
the State Engineer within sixty (60) days of completion of the work or within seven clays after expiration of the
,permit whichever is earlier. The pump installeton report including a pumping system test must be submitted within
sixty (60) days of cemp'e`ion o' the work. The contractor(s) must provide you with a copy of the work report(s) filed
with the State Engineer. the Well Construction and Test Report; Form Number GWS-31 and the Pump Installation
and Test Report Form Number GWS-32 are available from the Division of Water Resources offices. Additional
information regarding well construction, pump installation, requlhed testing and we'1 plunging and sealing regulations
are found on the reverse side of this shoot.
You have been provided with at least two copies of the well permit. Keep a copy for your records. There is
also a copy for the pump instal'.ation cont'acter. Copes have been sent to the driller if you indicated a dri'ler
['cense number on the application, or two addifonel copies have been enclosed. You may make addtional
copies for the well construction contractor if you select one different from the one indicated in your application.
The original permit is on file in the Denver office Records Section. Copies nay be obtained for a fee et 50 cents per
page. Statutes require that any change of mailing address or ownership be reported to the State Ermines-. Form
nun-ibe- GWS-11 is used both by new owners to report ownersh.p changes and current owners to report address
changes.
If you nave q'uesfons, contact toe Denver Office, or toe Division Off co in the area where your well is located.
[Division 1 Division 2 Division 3 D.dslon 4
810 9� St 2 F,00r 310 E Abriendo Ave Ste B ' 301 Murphy Drive jc kit;8-
Greelcy. CO 80531 Pueblo CO 51004 i Alamose, CO 81101 iviuntrose, CO 81401
(970) 352-8712 (719) 542-3358 (710) 589-6683 I (970) 249-6622
Fax (970) 392-1816 _ Fax (719) 544-0800 Fax (719) 589-5685 _ Fax (970) 249-8728
•
Division 5 Division 6 i Division 7 Denver Office
Direct mail to Box 396 DI ect mai' to Box 773450 160 Rock Point Dr., Ste E ' 1313 Sherman St Ste 821
Glenwood Spas CO 81602 505 Anglers Dr Suite 101 Durango, CO 8130` Delver CO 83203
50633 U S Hwy 6 8 24 Steamboat Spgs CO (970) 247-1845 (303) 866-358'
Clenv.:ood Spgs , CO 8100' 80477 Fax (970) 259-0044 Fax (303) 866-3589
(970; 945-5665 (970) 879-0272
FEx ;970) 945-8741 Call first Fax (970) 879-1070
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