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Garfield County Building & Planning Department
108 8th Street Suite 401
Glenwood Springs, CO 81601-
Phone: {970)945-8212 Fax: {970)384-3470
Project Address
4110 CR 213 DEBEQUE, CO 81630-
Owner Information
OXY USA WTP LP
Parcel No.
216921400026
Address
760 Horizon DR
Subdivision
Grand Junction CO 81506
Permit NO. SEPT -1-12-2345 Pennit Type: Septic Permit
Work Classification: New Permit Status: Approved
Issue Date: 3/19/2012 Expires: 03/19/2013
Section Township Range
Phone Cell
Contractor{s) Phone Primary Contractor Required Inspections:
Proposed Construction I Details Septic for a MINOR temporary employee housing .
FEES DUE
Fee
Septic Fee - New
Total:
Monday, March 19, 2012
Amount
$73.00
$73.00
Valuation: $0.00
Total Sq Feet: 0
FEES PAID
lnv Total Paytype Amt Paid Amt Due
lnv # SEPT-1-12-21629 $ 73.00 Credit Card $73.00
$0.00
For Inspections call : 1 (888)868-5306
Inspection IVR
See Permit Record
Building Department Copy
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GARFIELD COUNTY SEPTIC PERMIT APPLICATION I 08 8'11 Street, Suite 40 I, Glenwood Springs, Co 8160 I
Phone: 970-945-82 12 I Fax: 970-384-3470 / Inspection Line: 888-868-5306 fi ld www.gar te -countv.com
Parcel No: (this information is available at the assessors office 970-945-9134) 2 169-2 14-00026
605-13-22 Minor 1505
Job Address: (if an address has not been assigned, please provide Cr, Hwy or Street Name & City) or and legal description
_t.-H\0 ll~l~, b'BF<\U 605-13-22 Well Pad NWSW Sec. 5, T6S, R97W, 6th PM, Garfield County, CO Lot Size: Lot No: Block No: Subd./ Exemption:
10,303 n/a n/a n/a Owner: (property owner) Mailing Address Ph: All Ph:
OXYUSA WTP LP 760 Horizon Dr. Ste. 1 01 Grand Junction 81506 970-263-3668 970-985-1835
Contractor: Mailing Address Ph:n/a All Ph: n/a n/a n/a
Engineer: n/a Mailing Address Ph: n/a All Ph: n/a n/a
PERMIT REQUEST FOR: (X) New Installation ( ) Alteration ( ) Repair
WASTE TYPE: ( )Dwelling ( )Transient Use ( )Commercial or industrial ( )Non- Domestic wastes ( X)Other- Describe Temoorarv Emolovee Housing Facilitv sewaae vault
BUILDING OR SERVICE TYPE: I t::IC1U CIIIIJIVVt::t:: "lVU">I I \.I Ullll"> ">t::VVC1\.It:: VC1Uil">
Number of bedrooms n7a Garbage Grinder ( )Yes ( X)No
SOURCE & TYPE OF WATER SUPPLY: ( )WELL ( )SPRING ( )STREAM OR CREEK (x)CISTERN If supplied by COMMUNITY WATER, give name of supplier: Down Valle~ Se12tic from various 12otable water s~stems
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: I own or 1-'aracnute Was an effort made to connect to the Community System? no distance too far
YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITH OUT A SITE PLAN GROUND CONDITIONS:
Depth to 1'1 Ground Water Table a~~- 80' Percent Ground Slope < 10%
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM (ISDS) PROPOSED: ( )Septic Tank ( )Aeration Plant ( )Vault ( )Vault Privy ( )Composting Toilet ( )Recycling, Potable Use ( )Recycling, other use ( )Pit Privy ( )Incineration Toilet ( )Chemical Toilet ( )Other- Describe FINAL DISPOSAL BY: ( )Absorption trench, Bed or Pit ( )Underground Dispersal ( )Above Ground Dispersal ( )Evapotranspiration ( )Sand filter ( )Wastewater pond (x)Other- Describe Town of New Castle wastewater treatment facilit~ or other J2ermitted site
Will effluent be discharged directly into waters of lhe state? ( )YES (x)NO
PERCOLATION TEST RESULT: (to be completed by Registered Professional Engineer, if the Engineer does the Percolation Test) Minutes n/a per inch in hole No.1 Minutes n/a per inch in hole No.3 Minutes n/a per inch in hole No.2 Minutes n/a per inch in hole No._
Name, address & telephone of RPE who made soil absorption test: Name, address & telephone of RPE responsible for design of the system:
Applicant acknowledges that the completeness of the application is conditional upon such further mandatory and additional test and reports as may be required by the local health department to be made and furnished by the applicant or by the local health department for purposed of the evaluation of the application; and the issuance of the permit is subject to such terms and conditions as deemed necessary to insure compliance with rules and regulations made, information and reports submitted herewith and required to be submitted by the applicant are or will be represented to be true and correct to the best of my knowledge and belief and are designed to be relied on by the local department of health in evaluating the same for purposes of issuing the permit applied for herein. I further understand that any falsification or misrepresentation may result in the denial of the application or revocation of any permit granted based upon said application
and l eg~~ /}/1'/) o!?...__
OWNERS SIGNATURE DATE
1.)()1)\t \':>SUe \Jf\f\1-L Hrc \-\ - II I ~ ~ 1- 9 ~p . STAFF USE ONLY
Permit Fee: !.\~·\"2..-VI~ Perk Fcc: Total fees: Building Permil #:
t-3 Fn6 1-3 BtCO- ~~yy Septic Permit #: Issue Date:
"'5FPt -l-\~-cr~45 Building & Planning Dept:
L/z~:z-ftP~~ APPROVAL DATE
Down Valley Septic, LLC P.O. Box 1929 • Rifle, CO 81650 970-625-5556 www.dvseptic.com
June 15, 2011
Occidental Petroleum
Attn: Daniel Padilla
Fred Jarman
Director - Garfield County Building and Planning Department
108 81h Street, Suite 401
Glenwood Springs, CO 81601
Re: Hauler Affidavit for temporary housing units in Cascade Creek
Dear Daniel,
Please accept this letter as certification that Down Valley Septic, LLC provides septic hauling and portable restroom services for Occidental Petroleum.
I certify that Down Valley Septic, LLC will provide above services for Occidental Petroleum for the temporary housing un its in Cascade Creek. Service will be provided as needed. Down Valley Septic is available 24 hours a day, 7 days a week, and 365 days a year.
age and portable restroom waste will be disposed of at a state certified location .
. · 0 v // (Signature)
5 c_o tt YY\ o~ c
(Printed name)
Please contact me if you need any additional information at 970-625-5556
Thank you,
Scott Moyer
Down Valley Septic, LLC
(Date)
C. oo (Title)
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