HomeMy WebLinkAboutpitkin.eh.246524302002 (2014)Document Layout
(From Most Recent to Oldest Permit)
Permit
Application
Log Sheet/Notes & Photos
Communications
As -built Design
Engineer Design
Soil Information
Water Permit & Information
Second System on property
Third System etc.
Floor Plans
Please see Building and Land Use Approvals Files for additional information.
8/22/2014 11 Pitkn County Mail - 2014- 27, Trapper Ln
r -k A N
.Vit N'f Bonnie Shiles<bonnie.waechtler@pitkincounty.com>
2014 - 27, Trapper Ln
1 message
Linda Kimmel <Iinda.kimmel@pitkin911.org> Thu, Aug 21, 2014 at 4:10 PM
To: adele.l.lujan@usps.gov, William Mast <William.Mast@co.pitkin.co.us>, AnnMarie Prince
<AnnMade.Prince@co.pitkin.co.us>, Bonnie Shiles <Bonnie.Waechtler@co.pitkin.co.us>, Brian Nichols
<brian.nichols@aspenfire.com>, Brian Pawl <Brian.Pawl @pitkincounty.com>, Brian Pettet
<Brian.Pettet@co.pitkin.co.us>, Brittany Rosselot<brittany.rosselot@pitkin911.org>, Bruce Romero
<Bruce.Romero@pitkin911.org>, Cory Garske <Cory.Gars ke@cityofaspen. com>, Dawn Sager
<dawn_sager@cable.comcast. com>, debra.pattison@pitkincounty.com, Debby Payne
<Debby.Pay ne@pitkincounty.com>, gavette@carbondalefire.org, Ginny Bultman <Ginny.Bultman@pitkin911.org>,
APCCC email <dispatch@pitkin911.org>, Janice Vos <Janice.Vos@co.pitkin.co.us>, Jan Schubert
<jan.schubert@pitkin911.org>, Jeff Rice <Jeff.Rice@cityofaspen. com>, Jim Wilson <jimw@basalLnet>, Joanna
Schaffner <Joanna.Schaffner@co.pitkin.co. us>, Kathy Rogo <Kathy.Rogo@cityofaspen. com>,
karen.k.heier@usps.gov, Kurt Dahl <Kurt.Dahl@co.pitkin.co.us>, Lea Vasten - Meredith PO
<Leatrice.E.Vasten@usps.gov>, Lee Ledesma <Lee.Ledesma@cityofaspen.com>, Linda Manning
<Linda.Manning@cityofaspen.com>, Lori Quinlan <lori.quinlan@pitkin911.org>, Mary Lackner
<Mary.Lackner@cityofaspen.com>, Qwest Addressing <Omaha.AMC@gwest.com>, Ray Gendron
<Ray.Gendron@co.pitkin.co.us>, Sam Irmen <Sam.lrmen@cityofaspen.com>, Scott Thompson
<sthompson@basaltfire.org>, Susan Pearson<Susan.Pearson@co.pitkin.co.us>, USPS Carbondale
<carrie.katsis@usps.gov>, USPS Old Snomass <Debra.K.Reams @usps.go\/>, Vicki Monge
<Vicki.Monge@co.pitkin.co.us>, Fran Soroka <Fran.Soroka@co.pitkin.co.us>, Gary Tennenbaum
<Gary.Tennenbaum@co.pitkin.co.us>, dion.r.helmick@usps.gov, Reza.E.Tehrani@usps.gov
The Addressinq Division has assigned a new street name and 3 new address numbers on the newly named
street. Intersectinq E Sopris Creek Rd at armrox MM 2.5, the new street name is Trapper Ln. Two existing
homes are on this street, and 1 CDU to be built. The Lat/Long for the origin of Trapper Ln is 39.337975
-107.056333 , .
See below for PIN, owner, former and new addresses.
PIN/246524302002
Owner/ Bob & Sue Pietrzak, LLC
Former address= 2053 E Sopris Creek Rd
New address = 93 Trapper Ln
New address for CDU to be built = 141 Trapper Ln
l
Former address = 2051 E Sopris Creek Rd
New address = 182 Trapper Ln
Linda Kimmel, Emergency Dispatcher II
Addressing Division
Pitkin County Regional Emergency Dispatch
.® 2014 - 27, East Sopris Creek Rd.pdf
144K
https://mail.google.corrVmail/WO/?ui=2&ilr-661115d810&mn pt&search=inbox&th=147fa9fO9f5e6ldO&std1 147fa9fO9f5e6ldO 1/2
Ik186
Sticky Note
New address: 141 Trapper
Ln
PARCEL:246524302002
OWNER:PIETRZAK, BOB &
SUE LLC Ght-�-
.2055
s,
,=2053
91x
Ik186
Sticky Note
Old Address :2051 E Sopris
Creek Rd
New address:182 Trapper Ln
PARCEL:246524302002
OWNER:PIETRZAK, BOB & SUE
LLC Ma i n
Ik186
Sticky Note
Old address : 2053 E Sopris
Creek Rd
New address: 93 Trapper Ln
PARCEL:246524302002
OWNER:PIETRZAK, BOB & SUE
LLC /-- a ren r o
� � 1TKIN
COUNT
WASTEWATER TREATWNT SYSTEM (OWTS)
CONSTRUCTION PERMIT
76 Service Center Rd. Aspen, CO - 81611
Phone: 970.920.5070 Fax: 970.920.5374
Permit#: 00432013.POWT Parcel ID#:
2465-243-02-002
Permit Issued: ®NEW CDU []REPAIR ❑REMODEL/ADDITION ❑TANK ONLY []FIELD ONLY ❑AMENDMENT
Owner(s): Bob and Sue Pietrzak, LLC
Property Address:
Legal Description:
Size of Lot: 46.5 Acres
Size of Building: ft, Sq. Ft.
Detached Accessory Unit:
Size of Accessory Unit:
®YES []NO
1000
Sq. Ft.
Designed By:
-All Service Septic
Project#:
C1052 Dated: 91M13
Phone #:
970-309-0484
Mailing Address:
PO Box 2844, Glenwood Springs
Fax #:
303-216-2796
Email Address:
Carla.0stbero0ornail.com
Perc Rate: .85 LTAR
Minimum Tank Capacity: 843
Profile Hole Depth: 8 feet Depth to Groundwater or Bedrock: ➢ 8 feet
Ions Minimum Absorption Area: 715 ft2 w/ 10% reductiori
This OWTS Construction Permit is approved on the condition of compliance with the engineer design as submitted with the application and the specifications
cited above. Changes must be approved by this Department and the engineer prior to construction.
This system will consist of 1000 gallon, 2 -compartment septic tank with an effluent filter in the outlet. Tank risers much be
accessible from grade. The tank will then gravity flow to a distribution box which will evenly distribute effluent to 2 beds.
Distribution box must be accessible from grade. The each bed will consist of 3 rows of 12 Infiltrator Quick -4 chambers. Al
least 6' of undisturbed soil will be left between beds. Observation ports will be installed at the end of each bed.
This Permit must be kept on-site during installation. The engineer must do a final inspection of the installation and submit an "as -built" letter to this
Department within 30 days of the final inspection, unless a longer period of time has been agreed upon, in writing. This Department must also be called for
the final inspection with a minimum of 48 hours notice.
Minimum horizontal distances between components of the system and physical features shall conform to the requirements of the Pitkin County OWTS
Regulation.
This Permit is conditioned upon the property owner(s) providing for regular inspection, cleaning, and maintenance of the system by qualified personnel, in
accordance with the manufacturer's recommendations and the requirements of the Pitkin County OWTS Regulation. Issuance of this OWTS Construction
Permit does not constitute a guarantee, warranty, or representation by the Department that the system will operate properly or will not fail. Issuance of this
permit does not imply compliance with Pitkin County building and/or land use regulations, nor guarantee issuance of building and/or land use permits.
THIS PERMIT IS EXPRESSLY CONDITIONED UPON COMPLIANCE WITH ALL REQUIREMENTS OF THE PITKIN
COUNTY OWTS REGULATION, INCLUDING BUT NOT LIMITED TO THOSE CONDITIONS SPECIFIED ABOVE.
Plans and specifications for the proposed OWTS have been reviewed and are considered satisfactory. Permission is hereby
given to the property owner(s) to perform the work indicated in accordance with the Pitkin County OWTS Regulation. This
Permit will expire 1 year from the date of issuance unless construction on the system has commenced. An "as -built" drawing
must be submitted and approved by EH before final approval of the system will be issued.
Issued By: Bryan Daugherty, REHS
Installer:
SgJo.�tn_ 'V -
Date: 11/1/13 Expires:
11/1/14
Authorized by:
Final roval Issued't3y� \ ` — 11 Date: -y /� /' New Expiration Date: ❑
cam„o.. I�4vc hY 'i l4"L6/I
D*NSITE WASTEWATER TREATNOT SYSTEM (OWTS)
MEHINK CONSTRUCTION PERMIT -APPLICATION
76 Service Center Rd Aspen, CO 81611
Phone 970.920 5070 Fax: 970.920.5374
Parcel IDR (available from the Pitkin County Assessor's Office
/ /•
0 ��
970.920-5160 or at www.oitkinuseasor.oral:
t
Purpose of Permit. NEW ❑ REPAIR DUE TO FAILURE
❑ REMODEL/ADDITION ❑ TANK ONLY ❑ FIELD ONLY
Cost of System Repair or RemodellAddition (approximate).
co X16 1Z
' ZN 4 '
Business Phone:
Property Address.
- CA: -JEW P.
- r W K.Ce - K
Lot Block Filing:
Subdivision 11
Property Owners• Email Address.
z7fiF � LC. o • Car AA,
Owner's Mailing Address. City, State. Zip.
EK 2
Home Phone B 7;��
Z0 tz A 3 o
'Contact information must be provided for the owner signing this application
Primary Contact Person/Applicant (if not owner)-
Com any:
S -
o t
t
ContactiApplicanl Mallin Address.
City. State. Zip.
0 2
co X16 1Z
Cell hone:
Business Phone:
ol. S
Fax Number.
Email Address.
Water Source:
XPRNATE WELL F] SURFACE WATER
L�
Building Permit s (if applicable)"
Lot Size (in acres)
46. S
Size of Building (square feet)
10 0
Number of Potential Bedrooms.
3
Detached ❑ YES El NO Accessory Unit?
Size of Accessory Unit (square feet).
Number of Potential Bedrooms In or Fixture List for the Accessory Unit'.
Water Source:
XPRNATE WELL F] SURFACE WATER
❑SPRING ❑ COMMUNITY/PUBLIC WATE0. SYSTEM
Name of Community/Public Water System (if applicable).
Engineering Firm: Job Number. Phone Number. Fax Number.
a1u.yEawrs G 1bS2 9�o.618.5'o3Z 3o3.21L-Z+ 16
Mailing Address City. State. Zip
0-,n 241 r4 C _W woo,7 SL,o S(6o Z
PLEASE READ BEFORE SIGNING:
I certify that the above Information is complete and accurate and that I have provided complete and accurate information in all of the documents
included In my application package. I acknowledge that EHINR may revoke any permit I am issued It my application is found to contain any
Inaccurate, false, or misleading Information. 1 understand that no construction may be undertaken on an OWTS until an OWTS Construction Permit is
Issued.
Owner Signa a (Requir Date- �1
�0
Appli nt Signal Date:
b. 21S • 13
"2FI
SE ONLY
IHR Stab. Fee & Receipt S. Dale
Prddri County Environmental Health Department
Contact Log Sheet
Name:
ParcelAciclress.
Person SiJoken To._ 6-p4iments /Adon to be Taken-
...... Initials Time
os i4� ",irA loseP'% A I ; LRJ.
. rIk<, a te . ")o
r'
0
33 Four Wheel Drive Rd
ALLCarbondale, CO 81633
!!0.3093359
lic h p
November 23, 2013
Gavin Brooke
Land + Shelter
aavina,landandshelter.com
2 71a3_r,z_CnL4
C�63
Onsite Wastewater Treatment System (OWTS) Installation Observations
Peitrzak 3 -Bedroom Caretaker Dwelling Unit (CDU)
2053 E. Sopris Creek Road
Pitkin County, Colorado
OWTS Construction Permit 0041.2013.powt
Gavin,
Project No. C 1052
ALL SERVICE septic, LLC observed the installation of the onsite wastewater treatment system
(OWTS) on November 13 and 21, 2013 for the subject property. Savage Excavation installed the
system. The house was not yet constructed at the time of the installation observations; therefore, no
measurements have been provided on the record drawing.
The installation included a new 1000 -gallon, two-compartment Valley Precast concrete septic tank
with an effluent filter on the outlet tee in the second compartment. A handle extension will be added
to the filter for better accessibility from grade. This filter must be cleaned annually or more
frequently, if needed.
Effluent gravity flows to a distribution box, accessible from grade, and then to two gravelless
chamber beds. Each bed consists of three rows of 12 `Quick 4' Infiltrator® chambers for a total of 72
chambers and 711 square feet of infiltrative area. 6 -feet of undisturbed soil were present between the
beds.
The absorption area and distribution piping are near the Riding Arena and driveway. Care should be
taken to assure the absorption area is protected from horse and vehicle traffic. Additionally, Schedule
40 pipe was used for all distribution piping.
The OWTS was generally installed according to specifications. This observation is not a guarantee
of workmanship and/or parts and materials. ALL SERVICE septic, LLC should be notified if
changes are made to the OWTS in the future. Any additional OWTS construction must be according
to the county regulations.
LIMITS:
Observations are limited to components that are visible at the time of the inspection. The installer
must have documented and demonstrated knowledge of the requirements and regulations of the
county in which they are working. The quality of the installation is dependent of the expertise of the
installer, soil type, and weather conditions.
y
Please call with questions.
Sincerely,
ALL SERVICE septic, LLC
eah(&df&AS
Carla Ostberg, MPH, REHS
0 0
A
Richard H
View of septic tank looking toward future house location
Inlet tee
Outlet tee with effluent filter
Distribution box, accessible from grade (recommended blue board covering
instead of distribution box lid for easier accessibility to piping in the future and some protection from
freezing).
N
0
Two beds containing 3 rows of 12 `Quick 4' Infiltrator® chambers
Backfill over beds
MI
Covered beds (notice observation ports)
4-i
N
0' 10' 20'
Scale: I"= 20'-0"
k�
l h/
I /
� k
I
'00ALlON, TWO
CO PARTMENT
CON RETE SEPTICS O
TANKWITH EFFLUENT
FILTERS x
I I
� I
I �x
/
'8/40 4' DIAMETER PIPE —
JIM
/DISTRIBUTION BpXT�
GRADE
prB a 33 Few 970.309.5 910 81fi23�
PIPE WITH
2%
,
I
1 I
I
;I
`-'QUICK4' CHAMBER BEDS.
TWO BEDS EACH WITH 3
ROWS OF 12 CHAMBERS=
SEWER PIPE 72 CHAMBERS
RECORD DRAN7N
Flathush Farms, Lot 2
2053 E. Swns Creek Read
Pitkin County, Carorada
Project Number. C1052
-----------
_- X `----
ur ------
�� 'UT
UT
X 1 ri
4nd °Vies
71LE /179
_RVATION POR
\
1
V \
\
1
\
\
\
\
1
1.
I
� 1
.90rp
FF: 6840.
Date: 11123/13
Designed By: CBO record
Checked By: RHP
0 0
s
'0':
0 Box 2844
rrrjjnMnj�V�1 septic Glenwood Springs, CO 81602
SLIT I I
Fax 303 21652796 '
Ph 970-618-5033
September 4, 2013
Gavin Brooke
Land + Shelter
ag vina,landandshelter.com
Project No. C1052
Subsurface Investigation and Onsite Wastewater Treatment System Design
Peitrzak 3 -Bedroom Caretaker Dwelling Unit (CDU)
Flatbush Farms, Lot 2
2053 E. Sopris Creek Road
Pitkin County, Colorado
Gavin,
ALL SERVICE septic, LLC performed a subsurface investigation and an onsite wastewater treatment
system (OWTS) design for the subject residence. The property is located outside of Basalt, in an area
where OWTSs and wells are necessary.
SITE CONDITIONS
A main house exists to the north of the proposed CDU and is served by a separate OWTS. A
proposed 3- bedroom CDU is proposed near the Riding Arena. A private well provides water to the
property and is located to the east of the proposed CDU, greater than 100 -feet from the proposed
absorption area. East Sopris Creek runs through the property and will be greater than 50 -feet from
the proposed absorption area.
SUBSURFACE
The subsurface was investigated by digging one 8 -foot profile pit and taking a soil sample from
approximately 3 -feet below grade. A gradation analysis and hydrometer analysis was run by HP
Geotech and results are detailed in a report dated August 22, 2013, Job No 113 064Q.
The materials encountered in the profile pit consisted of 4 -inches of topsoil, underlain by dark brown,
dense, moist sandy loam to 3.0 -feet, underlain by medium brown, dense, moist sandy loam to a
maximum depth explored of 8.0 -feet. No bedrock or groundwater was encountered. A pipe was
placed in the pit to monitor for groundwater. Irrigation typically occurs in the fields up -gradient of
the proposed absorption area; however, no irrigation was taking place at the time of the subsurface
investigation. The gradation performed by HP Geotech shows the soil consists of 10% gravel, 63%
sand, 16% silt, and 11 % clay. The USDA soil type is classified as Sandy Loam. A long term
acceptance rate (LTAR) of 0.85 gal/sq. ft will be used to design the OWTS.
0
August 12, 2013
• Page 2
DESIGN SPECIFICATIONS
The OWTS design is based on 3 -bedrooms. An average daily wastewater flow of 450 GPD will be
used. The installation must include a 1000 -gallon, two-compartment septic tank with an effluent filter
on the outlet tee. Effluent will gravity flow through a 4 -inch diameter pipe to a distribution box. The
distribution box, accessible from grade, will distribute effluent to two gravelless chamber beds. Each
bed will have three rows of 12 `Quick 4' Infiltrator chambers for a total of 72 `Quick 4' chambers.
There should be 6 -feet of undisturbed soil between each bed.
The absorption area and distribution piping will be near the Riding Arena and driveway. Care should
be taken to assure the absorption area is protected from horse and vehicle traffic. Additionally, we
recommend using Schedule 40 pipe from the tank to the distribution box. This pipe should be well -
bedded and blue board insulation may be placed on top to assure additional protection from
compaction and freezing in the area where it crosses the driveway and where it may be subject to
horse traffic.
The component manufacturers are typical of applications used by contractors and engineers in this
area. Alternatives may be considered or recommended by contacting our office. Construction must
be according to Pitkin County Onsite Wastewater Treatment System Regulations, the OWTS
Construction Permit provided by Pitkin County Environmental Health Department, and this design.
REVEGETATION REQUIREMENTS
An adequate layer of good quality topsoil capable of supporting revegetation shall be placed over the
entire disturbed are of the OWTS installation. A mixture of native grass seed that has good soil
stabilizing characteristics (but without taproots), provides a maximum transpiration rate, and competes
well with successional species. No trees or shrubs, or any vegetation requiring regular irritation shall be
plated over the area Until vegetation is reestablished, erosion and sediment control measures shall be
implemented and maintained on site. The owner of the OWTS shall be responsible for maintaining
proper vegetation cover.
9
9
• Page 3
OPERATION INFORMATION AND MAINTENANCE
The property owner shall be responsible for the operation and maintenance of each OWTS servicing the
property. The property owner is responsible for maintaining service contracts for manufactured units,
alternating absorption systems, and any other components needing maintenance.
Geo -fabrics or plastics should not be used over the absorption area. No heavy equipment, machinery, or
materials should be placed on backfilled absorption area. Livestock should not graze on the absorption
area. Plumbing fixtures should be checked to ensure that no additional water is being discharged to
OWTS. For example, a running toilet or leaky faucet can discharge hundreds of gallons of water a day
and harm an absorption area.
The homeowner should pump the septic tank every two years, or as needed gauged by measurement of
solids in the tank. Garbage disposal use should be minimized and non -biodegradable materials should
not be placed into the OWTS. Grease should not be placed in household drains. Loading from a water
softener should not be discharged into the OWTS. No hazardous wastes should be directed into the
OWTS. Mechanical room drains should not discharge into the OWTS. The OWTS is engineered for
domestic waste only.
ADDITIONAL CONSTRUCTION NOTES
If design includes a pump, air release valves and weep holes should be installed to allow pump lines
to drain to minimize risk of freezing. Excavation equipment must not drive in excavation of the
absorption area due to the potential to compact soil. Extensions should be placed on all septic tank
components to allow access to them from existing grade.
INSTALLATION OBSERVATIONS
ALL SERVICE septic, LLC must view the OWTS during construction. The OWTS observation
should be performed before backfill, after placement of OWTS components. Septic tanks, distribution
devices, pumps, dosing siphons, and other plumbing, as applicable, must also be observed. ALL
SERVICE septic, LLC should be notified 48 hours in advance to observe the installation.
LIMITS:
The design is based on information submitted. If soil conditions encountered are different from
conditions described in report, ALL SERVICE septic, LLC should be notified. All OWTS
construction must be according to the county regulations. Requirements not specified in this report
must follow applicable county regulations. The installer should have documented and demonstrated
knowledge of the requirements and regulations of the county in which they are working.
N
. .,
0
Please call with questions.
Sincerely,
ALL SERVICE septic, LLC
•
Carla Ostberg, MPH, REHS
Reviewed
Richard H
0
Page 4
0 0
OWTS DESIGN CALCULATIONS - for Pitkin
USING LTAR
Owner's Name Parcel ID # -
Hoose Size ft.) 8Pd or 100 gpd)
Bed
Number of Bedrooms in Main House
Number of Offices, Libraries, Studies, Similar -sized Rooms in Main House
Number of Bedrooms in Detached Caretaker unit
Number of Offices, Studies, Similar -sized Rooms in Caretaker Unit
(if the caretaker unit is ATTACHED, heat as if part of main house.)
Average Daily Waste Flow 450
State Review Required? no
LTAR -(1)
Design Flow (Q) = # potential bedrooms X 2 people/bedroom X gpd X 1.5
Q= 675
Minimum tank capacity 843.75 gallons
Absorption Area (=B20 X 1.0/B17) A = Q x 1.0 loading/LTAR
A = 794 sq. ft. of absorption area required
A= 794 sq. ft. of absorption area required
Abs. Area w/ loading factor (B25)
Trench
Bed
Quick4 Trench
Quick4 Bed
Pipe and Gravel
715
794
72
so
Dosing
635
695
64
64
Chambers
j5�
715
56
72
Max Allowable
397
556
40
56
Secondary Treatment
Abs Area w/ out loading factor (B28)
Trench
Bed
Pipe and Gravel
715
797
72
w
Dosing
M3
025
64
64
Chambers
556
715
56
72
Max Allowable
397
,55566
40
56
100
SETBACK FROM WELL
# of feet =
50
SETBACK FROM POND, STREAM OR IRRIGATION DITCH
# of feet =
25
SETBACK FROM DRY GULCH
# of feet =
1)
If 'v/r/'l4/illll!llpll
! ewTso►RIs / r � � , 11 a ;r i / / / l l r r l
l"it l!/i lV
rr(lll \I
/r/ /r/i� /%r �/ r % _/t, i i� �r/rr5�ii�l /r 1j111\1\Il
/ i / //,r / j / / �•. ///; ri / ' / / 111111
/a \\///., / \/i / , \ 111 I
10T 18[PIID ow/ / / / i �� / i� 'lr/' )111111
EABEaKxF. LOGO"
it
1 a III '
/II• � 11 I I
�/ t / I 1 1 �I EAST SOPRIS CREEK
�� 1rr I l Al i ;�� tt1 I III I
Pl
if
111 1l / i i % 1` l l / i / I Ia �'FIRINCivA I i I ; 1\ '; I II 111\ \\ \\\
/ t6—�/1 1 I / / I I it DWEWNGLOTi,
tv
/ 1 1 1 ! I / / 1
l/ 11 !Ii I i liI\ I i
It / I'• i III
It
-- j / / t/ / r/ r // t I \\\/ ! 11 , / 1 \\ `\ \ \ \\ \\\` \\ •\ \\ `\ `\,
PARTIAL SITE PLAN -
1" equals ONE HUNDRED RFT! /eat i / / f 1 / 1 \ ,•1 \ \ \ `• \ \ \ \ \ \ —^ —
It I
Fy
IIIIIf
I
" 1 I
/ ! i ��\ I i \ ��� \\ \� .,•,\\ \ •\ \\ \I '�� 1\ \I 11 11 \ Il�r /
uylxNIt
I! r i i 1 I . \V •,A \ 1; A 1V I 1 III All
1 I I I 11 1/ 1/I �I
—
I,
I I I II \ 1 I 1 i 1 i l r C o��� ---- 1 i i I I.
\`
II 11 11 II\ \ 1 \I 1 111 11 11 11/ / I 1 eek ��
1 I II I 1\ \\ I l i I IIII 111 i i i 1 I cr::. •...,./ / I ,/ i ii1 1i
I 11 \ \ 1 1 1 1 1 I I I I I I PROPOSED
I 1 AI A I
DR
xl 1 / IVE A� 13asy q\ II 11 11 I I'll/
I 1 1 ALL S,. SEPIIC \ 1 \ I I
ORAWINGSANDSPECS1 I \ `\. `�\ PRIM
i
ISxOwe soFD1$MRBAmgN I '\\\ — \ \\ \ 1 1 ,/ �/q/ J/\Aca
FENCING AND EXISTING FENCING' I / I \
/ BE USED FOR DEDNIATION
I I I CO��pI�sss�ExTEx�s.l
AUSEEMa SEPTIC ,1�. \I
DRAVnxas
111/1 /r/II
ALLSEBWQ9EPBOXOC ER's
/
I
/ / / I I 1 I I I I 1 1 1 1 1 1 1 1 \ 1 \ </,. _/ \ /• /1
// \\/
l ! i I I I 1 1 1 1 1 1 1 1 1 I I I\\\♦/ •/ / 1 j/ ,�,/ %�' \ —
i\V` \\ \ -
/ / 1SITE
ualeTWEMYA
Veeqra
// xaml
Land+Shelter
wmVuawww
i�mwn
iEwmN r wwAw
Drns PEPJffT
Dam:
Revisions:
B lozsta
As
N
8
mOm
_ N
tlI
m
N
a
S
wv
M
? w4E
N �
,A ♦ J
\ O
� to —
asas � soPe ereeL aws
eov. mstsxl
SRF PLAN
11 a xwn0w..
A2.0
Fr: rwwoxnq_�w.aa
\
\
13
\
/ i / //,r / j / / �•. ///; ri / ' / / 111111
/a \\///., / \/i / , \ 111 I
10T 18[PIID ow/ / / / i �� / i� 'lr/' )111111
EABEaKxF. LOGO"
it
1 a III '
/II• � 11 I I
�/ t / I 1 1 �I EAST SOPRIS CREEK
�� 1rr I l Al i ;�� tt1 I III I
Pl
if
111 1l / i i % 1` l l / i / I Ia �'FIRINCivA I i I ; 1\ '; I II 111\ \\ \\\
/ t6—�/1 1 I / / I I it DWEWNGLOTi,
tv
/ 1 1 1 ! I / / 1
l/ 11 !Ii I i liI\ I i
It / I'• i III
It
-- j / / t/ / r/ r // t I \\\/ ! 11 , / 1 \\ `\ \ \ \\ \\\` \\ •\ \\ `\ `\,
PARTIAL SITE PLAN -
1" equals ONE HUNDRED RFT! /eat i / / f 1 / 1 \ ,•1 \ \ \ `• \ \ \ \ \ \ —^ —
It I
Fy
IIIIIf
I
" 1 I
/ ! i ��\ I i \ ��� \\ \� .,•,\\ \ •\ \\ \I '�� 1\ \I 11 11 \ Il�r /
uylxNIt
I! r i i 1 I . \V •,A \ 1; A 1V I 1 III All
1 I I I 11 1/ 1/I �I
—
I,
I I I II \ 1 I 1 i 1 i l r C o��� ---- 1 i i I I.
\`
II 11 11 II\ \ 1 \I 1 111 11 11 11/ / I 1 eek ��
1 I II I 1\ \\ I l i I IIII 111 i i i 1 I cr::. •...,./ / I ,/ i ii1 1i
I 11 \ \ 1 1 1 1 1 I I I I I I PROPOSED
I 1 AI A I
DR
xl 1 / IVE A� 13asy q\ II 11 11 I I'll/
I 1 1 ALL S,. SEPIIC \ 1 \ I I
ORAWINGSANDSPECS1 I \ `\. `�\ PRIM
i
ISxOwe soFD1$MRBAmgN I '\\\ — \ \\ \ 1 1 ,/ �/q/ J/\Aca
FENCING AND EXISTING FENCING' I / I \
/ BE USED FOR DEDNIATION
I I I CO��pI�sss�ExTEx�s.l
AUSEEMa SEPTIC ,1�. \I
DRAVnxas
111/1 /r/II
ALLSEBWQ9EPBOXOC ER's
/
I
/ / / I I 1 I I I I 1 1 1 1 1 1 1 1 \ 1 \ </,. _/ \ /• /1
// \\/
l ! i I I I 1 1 1 1 1 1 1 1 1 I I I\\\♦/ •/ / 1 j/ ,�,/ %�' \ —
i\V` \\ \ -
/ / 1SITE
ualeTWEMYA
Veeqra
// xaml
Land+Shelter
wmVuawww
i�mwn
iEwmN r wwAw
Drns PEPJffT
Dam:
Revisions:
B lozsta
As
N
8
mOm
_ N
tlI
m
N
a
S
wv
M
? w4E
N �
,A ♦ J
\ O
� to —
asas � soPe ereeL aws
eov. mstsxl
SRF PLAN
11 a xwn0w..
A2.0
Fr: rwwoxnq_�w.aa
N
Scale: Not to Scale
rl SITE PLAN
NOT M
Q I
P.O. Box 2844
Flatbush Farms, Lot 2 Date: 09/04/13
' I L
Septi Glenwood Springs, Colorado 81602 2053 E. Sopris Creek Road \ A / �) . O
Phone 970.618.5033 Pitkin County, Colorado Designed By: CBO �/ �/ I
SfflYICf Fax 303.216.2796 Checked Project Number. C1052 Drawn BvBP
ANG Sheet 1 of 4
N
01 10, I i I ! r / / ! / �� 1
Scale: 1" = 20'-0"
11 f J( t i l
4rS I
I 1100MGALLON,iTWO
CO PARTMENT,
CON RETE SEPTIC rrr O
l TANKLNITH`iEFFLUENT
'I F ILT� Rf
f
OOD BEDDING BELOW
IPE AND BLUE BOARD
INSULATION ABOVE PIPE
TRAFFIC AND FR EZING
DIG> TDRIEBUTION B%X T�
�
PROPO ED
3 -BED OOM NICE
CE
I
4" DIA TER SDR -35
ER PIPE WITH
CLEANOUT
t6LOPE 2% TO TA 1
4"
Fal
EJ
Ur_
UT�
Y-__-_--_ il? 9vr
I � 9rope/ i FF: 6840.
P C
@SEF��/ Q� POR%
❑ %E. I.
I
r
/ "SR 35 SEWER PIPE
'QUICK -4' CHAMBER BEDS.
TWO BEDS EACH WITH 3
ROWS OF 12 CHAMBERS =
72 CHAMBERS
1
n PROPOSED OWTS
L tie 30-0-0
C�
P.O.HujiGlenwood
Box 2844 Flatbush Farms, Lot 2 Date: 09/04/13
Springs, Colorado 81602 2053 E. Sophs Creek Road W2.0 /f, /� .O
R10Phone 970.618.5033 Pitkin County, Colorado Designed By: CBO �/
Fax 303.216.2796 Checked By: RHP
Project Number: C1052 Drawn BY: ANG Sheet 2 of 4
4" PVC HEADERS
(1%F.. r
DISTF
BOX,
TO G
4" EFF
INLET
TYPICAL PLAN VIEW - N.T.S.
INFILTRATOR(R) QUICK4(TM) CUT SHEET
0z
12" (EF48"
FECTIVE LENGTH)
fl A
34" a ®IIII®IIIIIIII
�MO�
m�►I
BED MAY BE ANGLED TO FIT TOPOGRAPHY AND TO MINIMIZE REMOVAL OF EXISTING VEGETATION.
LIMITATIONS - THESE PLANS MUST BE USED IN CONJUNCTION WITH LETTER AND SOILS DATA FORM
PROVIDED. THE DESIGN IS BASED UPON INFORMATION SUBMITTED. IF SOIL CONDITIONS ENCOUNTERED
ARE DIFFERENT FROM CONDITIONS DESCRIBED IN REPORT, ALL SERVICE SEPTIC L.L.C. SHOULD BE
NOTIFIED. ALL OWS CONSTRUCTION MUST BE ACCORDING TO COUNTY REGULATIONS. THE INSTALLER
SHOULD HAVE DEMONSTRATED KNOWLEDGE OF THE REQUIREMENTS AND REGULATIONS OF THE
COUNTY IN WHICH THEY ARE WORKING. THE COUNTY AND ALL SERVICE SEPTIC L.L.C.MUST VIEW
INSTALLATION.
CROSS SECTION OF TYPICAL CHAMBER -TRENCHES
4" SDR 35 PVC
OBSERVATION/VENT
PIPE WITH CAP
4.5'
EXTENT OF
EXCAVATION
(MUST BE MINUS 3 -INCH MATERIAL)
S� E FOR
SURFACE
BED MUST BE LEVEL. USE ONSITE SOILS TO BRING
GRADE UP FOR LEVEL INSTALLATION. SOIL MUST BE
FREE OF COBBLES (MINUS 3 -INCH MATERIAL, AND MUST
BE COMPACTED WITH VIBRATORY MACHINERY.
BACKFILL SLOPE MUST EXTEND AT 3:1
n_BED DETAILS
J 1(�
PIPE (TYP.)
3S
-K(TM)
INFILTRATOR(R)
QUICK4(TM)
CHAMBER, 3'X4'
Q I I
P.O. Box 2844
Flatbush Farms, Lot 2 Date: 09/04/13
I I L L
SQP}} Glenwood Springs, Colorado 81602 2053 E. Sopris Creek Road Designed By: CBO W3.0
I� Phone 970.618.5033 Pitkin County, Colorado
SERVICE Fax 303.216.2796 Project Number. C1052 Drawn B BANG P Sheet 3 of 4
n CLEANOUT DETAIL
BOX AND COVER BROUGHT TO GRADE
CONCRETE LID
FINSHED GRADE
J�
0000\
OUTLETS TILET
DISTRIBUTION BOX BAFFLE
n D -BOX DETAIL
J�
DESIGN
3 -BEDROOM RESIDENCE
(75 GAL/PERSON/DAY x 2 PERSONS/BEDROOM x 3 BEDROOMS)
AVERAGE DAILY FLOW = 450 GALLONS
DESIGN FLOW = Q = 1.5 x 450 = 675 GALLONS
TANK:
450 x 30 HOUR RETENTION TIME = 843 GALLONS
USE 1000 -GALLON, TWO-COMPARTMENT TANK
ABSORPTION AREA:
LONG TERM ACCEPTANCE RATE (LTAR) = 0.85 GAL/ SQ FT
CALCULATED ABSORPTION AREA = Q/LTAR = 794 SF
10% REDUCTION, CHAMBER BED
TOTAL AREA REQUIRED =715 SF
2 GRAVELLESS CHAMBER BEDS, 3 ROWS OF CHAMBERS IN EACH BED
12'QUICK 4' CHAMBER IN EACH ROW
6' OF UNDISTURBED SOIL BETWEEN BEDS
TOTAL FOOTPRINT = 24'X 48'
Septic Tank with the Addition of an Effluent Filter -1000 Gallon, 2 -Comp.
Top of tee to come to
1" from top of tank I
Inlet Tee � r
ORENCO BRAND NAME
NOT ENFORCED
Concrete Risers\
I'S ope Ground
Away From Risers
Liquid Level
z- J
rl TANK DETAIL
V
Fitter Cartridge Handle
(field cut to desired height)
Tank Adapter (cast or bolted)
Vent Orifice
Effluent Discharge
Modulating Discharge Orifices
Vault Inlet Pons
Filter Cartridge
Effluent Filter
Q I IFlatbush Farms, Lot 2 Date: 09/04/13
Il `L P.O. Bax 2844
Glenwood Springs, Colorado 81602 2053 E. Sopris Creek Road W4.0 A / A4 " O
SfBYICE Phone 970.618.5033 Pitkin County, Colorado Designed By: CBO �/
Fax 303.216.2796 Checked By: P
Project Number. C1052 Drawn Bv: ANG Sheet 4 of 4
SLIP-ON PVC CAP
DO NOT GLUE
FINISHED
GRADE
EFFLUENT LINE - 4"
SCHEDULE 40 OR 4" SDR
SEWER LINE -
35 P.V.C.
4"SCHEDULE
40 P.V.C.
INSULATED COPPER TRACER
rWIRE MAY BE INSTALLED TO
1 LOCATE LINE IN FUTURE
n CLEANOUT DETAIL
BOX AND COVER BROUGHT TO GRADE
CONCRETE LID
FINSHED GRADE
J�
0000\
OUTLETS TILET
DISTRIBUTION BOX BAFFLE
n D -BOX DETAIL
J�
DESIGN
3 -BEDROOM RESIDENCE
(75 GAL/PERSON/DAY x 2 PERSONS/BEDROOM x 3 BEDROOMS)
AVERAGE DAILY FLOW = 450 GALLONS
DESIGN FLOW = Q = 1.5 x 450 = 675 GALLONS
TANK:
450 x 30 HOUR RETENTION TIME = 843 GALLONS
USE 1000 -GALLON, TWO-COMPARTMENT TANK
ABSORPTION AREA:
LONG TERM ACCEPTANCE RATE (LTAR) = 0.85 GAL/ SQ FT
CALCULATED ABSORPTION AREA = Q/LTAR = 794 SF
10% REDUCTION, CHAMBER BED
TOTAL AREA REQUIRED =715 SF
2 GRAVELLESS CHAMBER BEDS, 3 ROWS OF CHAMBERS IN EACH BED
12'QUICK 4' CHAMBER IN EACH ROW
6' OF UNDISTURBED SOIL BETWEEN BEDS
TOTAL FOOTPRINT = 24'X 48'
Septic Tank with the Addition of an Effluent Filter -1000 Gallon, 2 -Comp.
Top of tee to come to
1" from top of tank I
Inlet Tee � r
ORENCO BRAND NAME
NOT ENFORCED
Concrete Risers\
I'S ope Ground
Away From Risers
Liquid Level
z- J
rl TANK DETAIL
V
Fitter Cartridge Handle
(field cut to desired height)
Tank Adapter (cast or bolted)
Vent Orifice
Effluent Discharge
Modulating Discharge Orifices
Vault Inlet Pons
Filter Cartridge
Effluent Filter
Q I IFlatbush Farms, Lot 2 Date: 09/04/13
Il `L P.O. Bax 2844
Glenwood Springs, Colorado 81602 2053 E. Sopris Creek Road W4.0 A / A4 " O
SfBYICE Phone 970.618.5033 Pitkin County, Colorado Designed By: CBO �/
Fax 303.216.2796 Checked By: P
Project Number. C1052 Drawn Bv: ANG Sheet 4 of 4
❑ ❑
MAIN LEVEL
PLAN
A3.1
Form No. OFFICE OF THE STATE ENGINEER
GWS -25 COLORADO DIVISION OF WATER RESOURCES
818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203
(303) 8663581
APPLICANT
BOB & SUE PIETRZAK LLC
1796 E SOPRIS CREEK RD
BASALT, CO 81621 -
(970)927-4462
1095
WELL PERMIT NUMBER 160673 A
l DIV. 5 WD 38 DES. BASIN MD
Lot: 2 Block: Filing: Subdiv: FLATBUSH FARM
APPROVED WELL LOCATION
PITKIN COUNTY
SW 1/4 SE 1/4 Section 24
Township 8 S Range 87 W Sixth P.M.
DISTANCES FROM SECTION LINES
Ft. from Section Line
Ft. from Section Line
UTM COORDINATES (Meters.Zone:13.NAD83)
ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT
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)(c) for the relocation of an existing well, permit no. 160673-A. The old well, specifically permit nos.
64972 (canceled), later re -permitted as 160673 and 160673-A (issued December 5, 2007) 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.
4) Approved as the only well on a tract of land of 46 acres desonbed as lot 2, Flatbush Farm division of land, Peskin County. Further identified as
2053 East Sopris Creek Road, Basan, CO 81621.
5) The use of ground water from this well is limited to fife protection, ordinary household purposes inside not more than three (3) single family
dwellings, the watering of poultry, domestic animals and livestock on a farm or ranch and the irrigation of not more than one (1) acre of home
gardens and lawns.
6) The pumping rate of this well shall not exceed 15 GPM.
7) The return flow from the use of this well must be through an individual waste water disposal system of the nonevaporative type where the
water is returned to the same stream system in which the well is located.
8) Pursuant to Rub 6.2.3 of the Water Well Construction Rules, the well construction contractor shall submit the as -built well location on work
reports required by Rule 17.3 within 60 days of completion of the well. The measured location must be accurate to 200 feet of the actual
location. The location information must include a GPS location (UTM coordinates) pursuant to the Division of Water Resources' guidelines.
NOTE: This well was decreed as Parker Well no. 1 in Division 5 Water Court case no. W2048 (permit no. 64972 (canceled)). This well was
decreed for 0.033 cis (15 gallons per minute). The total depth of the original well is decreed as 50 feet. At the date of the entry of this decree
with the court on May 29, 1974, the well owner was: Barbara B. Parker.
NOTE: A move of greater than 200 feet from the decreed location is considered a change of water right. Application should be made to
the Division 5 Water Court for this change of water right.
NOTE* Permit nos. 64972 (canceled), 160673 & 160673-A (issued December 5, 2007) were previously issued for this well.
NOTE: Parcel Identification Number (PIN): 49-2465-243-02-002
NOTE: Assessor Tax Schedule Number R013147
19-7,
APPROVED
DMW '1
State Engineer _ By
r1
,
ri
COLORADO DPASION OF WATER RESOURCES
poy� Foml GWS�q (06/2005)
DEPARTMENT OF NATURAL RESOURCES
� VE R
D
1313 SHERMAN ST., RM 818, DENVER, CO 80203
phone -info:(303) 8563587 main: (303)8863581
JUL{ a'r1
i620p
fax: 303 SW3589 httpJ/www.wWer.slate.co.us
`
JUL 10 '13
RESIDENTIAL Nde: Also we this f,. tD apply for ar.etook ar.nnmgVWTER
RESOURCES
8sTA7
Water Well Permit Application
TER RESOURCES COLLOOINEER
Review Instructions on reverse aide prior to completing form.
TATE ENGINEER
GLENWOOD #/74
The form must be completed In black or blue Ink or typed.
EG6 r j' ,r'037p
1. A!iglkant Information
8. Use Of Well check applicable boxes
N 'pp wot
See instructions to determine uses) for which you may qualify
Bob & Sue Pietrzak LLC
❑ A. Ordinary household use in one single-family dwelling
(no outatle use)
® B. Ordinary household use in 1 to 3 single-family dweiliogs:
nodes octoses
1796 E. Sopris Creek Road
Number of dwellings: 3
carsin
zoom
Basalt
CO
81621
® Home gardenAawn Irrigation, not to exceed one acre:
area irrigated 1 [1 sq. R ® acre
TWephWwa
Ema(apncwl)
(970) 927-4462
bobpietrzak@msn.com
® Domestic animal watering - (noncommercial)
C] C. Livestock watering (on famUrench/rangelpasfure)
2. Type Of Application (check applicable boxes)
❑ Construct new well ❑ Use existing well
7. Well Data (proposed)
I@ Replace existing well ❑ Charge or Increase use
M-11— wq*v err'
N3"Wemrtm ee Wawarn
❑ Change source (aquifer) ❑ Reapplication (expired permit)
❑ Other:
15 glim
3 acrafeel
3. Refer To (if applicable)feet
TdW aepm
100
Alpft
Tributary
WrpWmwa
war W. ossa
160673-A
S. Water Supplier
DeWoaWa Beim pramrrlm a
Nrl mme n a
Is this parcel within boundaries of a water service area? OYES IN NO
M yes, provide name of supplier.
4. Location Of PyroposedWNI
9. Type Of Sawape Sysbm
calf
pitldn
SW +w of w SE +w
® Septic tank / absorption leach field
❑ Central system: District name:
seam Tonft NaaRWge
EaW w -pa mm"r
24 8 ❑ ®
87 ❑ ® 6th
❑ Vaut Location sewage to be hauled to:
❑ Other (attach copy of engineering design and report)
brrodwea ftm eecllm ew t.em bw We 49iceH Mprdpwb axe)
R. from ❑ N ❑ S Fr. ham ❑ E ❑ W
F«MW WMrr..rmr-u..wMNI - mm,mdd. W n11W W n
W. Proposed Well Driller License o tional :1095
feet direction
11. Signature Of Applicant(s) Or Authorized Agent
War araam adma "We Oty, eAM ml U check awn aadw is vrw "'^ +.
The making of false statements -herein constitutes perjury in the second
2053 E, Sopris Creek Road
degree, which is punishable as a class 1 misdemeanor pursuent to C.R.S.
Basalt CO 81621
24++04 (13Xa). I have rad the statements herein, know the contents
ereof and state that May are true to my knowledge.
opiate: opa vAa be amvaamamn UTM
mar ops u d wave n enema:
si�ear r offo. aQrare)
osr
Feer mr be VTM
or 12maz i3
EM&W-6 3
ql 0.13
urvW mur a Mtrry
Nornng:FL,4,r-_3
pink earn a aria
oes scow NAM
16/
Urrl merle M w b mp,nM
fLLOA
Wee Opo krr tlwded fdr ebovev ®YES
Ramembw to ar Datum to NADaa
Office Use Only
S. Parcel On Which Well Will Be Located
USGS map tNmw
DWR mW re
sure wr.
PLEASE ATTACH A CURRENT DEED FOR THE SUBJECT PARCEL
A. You must d+edk ant couplets one of the following:
Reodpt st" only
® Subdivision: Nene Flathush Farm
Lot 2 Block Fllkg/Una _ _
[I County County exemption (attach copy of county approval & Survey):
NameAr Lot Y
❑ Parcel less than 35 acres, not in a subdivision, attach a deed with metes
and bounds description recorded prim to June 1, 1972, and a current
Tre isachon * 3880959
deed
Dal : 7M b/2018 11:45:33 AM
❑ Mining claim kmbd+a mgr a ended a wvwy): Name*
Trenset9on Total: 580.00
❑ Square 40 acre parcel as descrl0ed in Sem 4
VVE CIiECKrf8700 $80.00
❑ Parcel of 35 or more acres (dash a mwe W,d ecuw aewipw w WrAY)
'^R
❑ Other (en.uk mew &bWrw d.eolpfrmw a9vey ane r4pWbp doc%m )
CWC8
Topo
B. a of ace m pato C. Inydutwminiirdarpsres,
46i
M,�
so DN S WD 3g 9A_ MD
�pr,OYES❑Na(/ro-rMnWuraan)
D. wamba+Morirwaamaeepwoo? OYES ❑ ND(dro-Agrwrwla)
90
AfF
• �ti
L CONSTRUCTION TEST REPORT
ROFFICE USE ONLY
TE OF COLORADO, OFFICE OF THE STATE ENGINEER
1•
WELL PERMIT NUMBER 160673-A
2
Owner Name(s): Bob & Sue Pietrzak LLC
Mailing Address: 1796 East Sopris Creek Road
City, State, Zip: Basalt, CO 81621
Phone #
APPROVAL aGWS31-91-03
3
WELL LOCATION AS DRILLED SW 1/4 SE 1/4 Sec: 24 Twp: 8 S Range: 87 W 6th PM
DISTANCES FROM SEC. LINES
ft. from Sec. line and ft. from Sec. line OR Easting: 3 22 664 Northing: 43 56 255
SUBDIVISION: Flatbush Farm LOT: 2 BLOCK: FILING (UNIT):
STREET ADDRESS AT LOCATION 2053 East So ris Creek Road, Basalt, Co 81621
GROUND SURFACE ELEVATION ft. DRILLING METHOD Air Rotary
4
DATE COMPLETED: 7/15/2013 TOTAL DEPTH: 41 DEPTH COMPLETION: 33
5.
GEOLOGIC LOG 6. HOLE DIAMETER (in) FROM (ft) TO (ft)
Depth Type of Material Size, Color, and Type) 9.0 0 33
000-008 Clays 6.5 33 41
'008-041 Cobbles, Gravels, Clays
7. PLAIN CASING
OD (in) Kind Wall Size From (ft) To (ft)
7.0 Steel 0.188 -I 23
PERF. CASING: Screen Slot Size
7.0 Steel 1 0.188 1 23 1 33
8. Filter Pack 9. Packer Placement
Water Located: 19+ Material : Type
Size : Depth
Remarks : Interval
W. GROUTING RECORD
Material Amount Density Interval Pleament
Cement 5 sks 6 Usk 5-20 poured
11. DISINFECTION : Type : HTH Amt. Used: I oz.
12. WELL TEST DATA : () Check Box If Test Data Is Submitted On Supplemental
TESTING METHOD: Air Compressor
Static Level: 4 ft. Date/Time Measured 7/15/2013 Production Rate 15 gpm
Pumping Level: Total ft. Date/Time Measured 7/15/2013 Test Length : 2 hours
Test Remarks:
13I haus read the statements made ham and know the canteots therm(, and that they are true to my kwwkdgc. (P rsumt to Section 24-4-14 (13xa) QRS, the roakinp of false stetenems
. cpa Wce m he a and deg tt and is p m shable as a dans I rn demeattQ.)
CONTRAC OR Shelton Drilling Corp. Phone: (970) 927-4182
Mailing Address : P.O. Box 1059 Basalt, Co. 81621 Lic. No. 1095
Name / Title (Please Type or Print)
Signature
Dam
7/152013
Wayne Shelton / President
M