HomeMy WebLinkAboutGround Water Pump Test Discharge Permit JEHN H20 CONSULTANTS 3033218346 10119105 03:50pm P. 001
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Jehn Wafer Consultants, Inc.
95fi5 Gilpin Street
Denver, Colorado 80218
(343)32 9-8335
(3U3)32�-�346 (fax)
To: Leonard Sandoval Date: October 19, 20Qa
Company� Town of Vai( - ----._._ ..._ .._— ___. .._ ___.
Fax#: 970/479-2166 Pages: 3, including this cover sheet_
From: Bill Fieselman
Subject: Ground Water Pump Test Discharge Permit–Ritz Carlton Project
Job No: 561.8
COMMENTS:
ttem No. 21 - Pleas�provide the discharge manhole Latitude and Longituc{e, and the receiving
� waters.
Item No. 32–Please sign and da�e, granting permission to discharge ta the stormwater system.
Thank you.
Hard Gopy to Follow: No
The informa6ion contained in this facsimile message (and any documents accampanying it) is corfidenfial and
intended only for the use of the individual or entity named above. Unauthorized disclosure, distribution or copying of
this information is strictly prohibited. If you have received #his Nansmission i� erro�, please notify this office
immEdiately to arrange for its retum.
JEHN H20 CONSULTANTS 3@33218346 10119/05 08:50pm P. 002
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20. Aven�c flows and treatment: Please provide a nurrxtive identircation of each type of process,operatian,or production area which
contributes wa�towntor to the effl.uent for each outfnll including process wastewflter,cooJing wnters.domestic wastewater and storm-
water runoff;the average,mxximum and design Ilow which oach prooess contributes;and a descriptioa of the treuttnent t�c
wastowatcr rcceives including thc ultimute disposul of any soJid or fluid wastes other tha�6y diqcl�arge. 1'roccsses,operatioos or
production areas may be described in general terms. 'I'he average Ilaw of point sources cnmposed oi'stormwater may bo estimated.
Use additionul pnges us nocded.
OtJTFAI�L WASTF..VJATER TR�ATMENT AVERAGE. 1�fSIGN DAILY
NUMBER SOURCE USL•:D rLOW FLOW MAXIMUM
gp�+ gp�*r FLOW '
g m
V\1�. � �`.t2 r � �'( '� �l�G�� �4/CrI ��4./✓
oOL
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�l/Y
WS
•gpm-�allnne/minuto
'"lf scdimanl pm�d,inAicatn ep�xuximetu vulume of watui.
21. For cach outfall provide thc latitude,longitude and recciving waior.
LATITUDE LONGITiJDE '
OUTFALL RF.CEtVIN('�WATERS
DEIGR8E5 MINUTL�g SCCOT3D3 DE(iREEB MINUTES 86COND$
9oc ineUnoNon�
OOl 3'j` �.��3� 7,�(9� u��fiSts' � Ca� �a,k.
002 '
003
004 _
p05 �
22. Wilt the dischargc cnter a ditcb or storm sewer prior to entering the receiving waters? ❑No �Ycs soc iie�n a_.
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JEHN H20 CONSULTANTS 3033218346 10119t05 03:50pm P. 008
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30. Please include un other information which ou feel the Division shauld be awarc i f� dr f rm
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31. Sig��a6ure uf Appficant �
"! eertify undcr pcnally of law thal this daeument and all attaehments worc preparcd under my direction or supervision in accordance
with a system dcsi�ncJ to assure that quali�cd personnel properly gutherad a.nd evaluatcd thc information xubmikted. Bascd on my
inquiry oftbc person or parsnns wbo manage tbe system,orthaso persans directly responsible for gnthering thc information,the
information submitted is tc�thc best of my�nowledge and beliof,true,accurate�and completa. I am aware that lhere are si�nifcant
penullies for submitting falsc information,inciuding thc possibility�f finc and imprisonment f�r knowing vioIations."
'� ' ��•- c'a� u1 � r � � f�,�.e ��,��e�� C� /� a�
Signaturc o Owner ' Datc igncd ° '
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���� -f ���P ,��c N� Yt'L�'l f'�-�� r�F'_n�ct,�s� �,J����-1 �� •!'Le��sr.'�r��
Name(printed) i�1� `` �
Signaturc af Operator Dnte Signed
Name:(prinled) Titic
32. In t6e case of facilities thutintend to discharge to storm sewers,permissiam to discharge inM stormwater syrtems must be obtained
from the owncrs or owners agc��ts ot'cach systcm intu which the permittec intenJa to disc6argc.
"t certify that I havo tead and understand the preceding paragraph and will comply with it by obtuining pormission to dischur�e
into thc stormwatex sysccros from thc awncr or owncrs ngonts of cach systcm ialo which 1 iniend tu dischar�c".
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Si�{aturc D c Signcd
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� /l�i'r��i-� �'- • f�r�jss ����! /�'�v;;, G''vk,ir��r�r;/
Name(pri nted) Titic .
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MiN!)1 APP.1/!�9 . 1�
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