The URL can be used to link to this page

Home My WebLink AboutIowa Department of Transportaiton-5/6/2013IOWA DEPARTMENT OF NATURAL RESOURCES Wastewater Disposal System Construction Permit Application Fee Form CASHIER'S USE ONLY 0945-542-N PDE -CP -0570 32-3202 Owner Owner Name: City of Waterloo, Iowa Address: 715 Mulberry Street City, State, Zip: Waterloo, Iowa, 50703 Project Identification: No Name Creek Interceptor Sewer, City Contract No. 849 ® $100 Fee enclosed Please sign and return this form with a check or money order payable to "Iowa Department of Natural Resources". Place it and the check or money order on top of other Construction Permit Application documents. Effective beginning July 1, 2006, Applications for Construction Permits for wastewater disposal systems required by Iowa Code 4556.173 and rules in Iowa Administrative Code 567 IAC 64, must be accompanied by the fee required by Iowa Code 455B.197 and Iowa Administrative Code 567 IAC 64.16(3)"c". The fee is $100 for each application, regardless of project size and project type including sanitary sewers, pump stations, treatment units or a combination thereof. The fee shall be submitted with the certified engineering documents necessary to apply for a construction permit (plans, specifications and related application schedules A, F, and G as well as the appropriate schedules indentified on page 2 of Schedule A). The construction permitting process is initiated as planning for construction begins. Planning coordination and submittal of preliminary engineering reports or facility plans precedes submittal of technical documents necessary to constitute a construction permit application. The application fee is not necessary when submitting a planning document but must accompany construction permit application documents. A fee should accompany each permit application received on or after July 1, 2006. Failure to submit a fee with the application may delay the processing of a construction permit. If you have any questions regarding the application fee, please contact Donna Gomm at 515-281-8502 or Donna.Gomm@dnr.iowa.gov Signature of Owner or Representative: Printed Name: r 4\y Telephone or email contact: 614-ta-P 10(46-1z Mail to: Iowa Department of Natural Resources Wastewater Engineering Section 502 East 9th Street Des Moines, IA 50319-0034 L:\work\projecfl60283855\400 Technical\420_Specs\60283855-No Name Creek Speaboc - Application Fee Form.doac Exhibit 11A Iowa Department of Natural Resources Wastewater Engineering Section Construction Permit Application SCHEDULE A, General Information APPLICANT ENGINEER OWNER E-MAIL ADDRESS City of Waterloo, IA larry.smith@waterloo-ia.org FIRM E-MAIL ADDRESS AECOM todd.allyn@aecom.com ADDRESS 715 Mulberry Street, Waterloo, IA 50703 ADDRESS 500 SW 7th Street, Suite 301, Des Moines, Iowa 50309 REPRESENTATIVE TELEPHONE Larry Smith 319-291-4553 PROJECT OFFICER TELEPHONE Todd Allyn 515-323-7921 PROJECT IDENTIFICATION No Name Creek Interceptor Sewer City Contract No. 849 ESTIMATED START DATE * 06/03/13 ESTIMATED COMPLETION DATE 08/30/13 PLEASE RESPOND TO ALL QUESTIONS YES NO 1. Has an engineering report, facilities plan or other information previously been submitted for this project? ❑>�� If Yes=> PROJECT IDENTITY DATE SUBMITTED 2. Does the project and construction permit application, as submitted, follow the recommendations, design loadings, construction schedule, permit limits, and conclusions of the approved engineering report or facilities If No=> Provide the design basis and technical information justifying all changes. 3. Are there three complete sets of plans and specifications accompanying this application? For a minor gravity sewer extension within the meaning of 455B.183.3 Code of Iowa and Design Standard 11.1, two complete sets will be adequate for expeditious approval. For more complex projects, three sets of plans and specifications may be requested. 4. Are approved standard specifications a part of this application? ■ A ® 0 0 0 If Yes=> APPROVED STANDARD SPECIFICATIONS OF (municipality or firm) SUDAS Specifications DATE APPROVED 2012 5. Does each set of plans and specifications or engineering report accompanying this application contain a "professional engineering seal" executed in conformance with 542B.16, Code of Iowa? If No=> Processing will be delayed pending receipt of applicable design schedules and certified plans, specifications or engineering report. 6. Is this a joint wastewater and water supply project? If Yes=> A construction permit application for the water supply project should be submitted separately to the Water Supply Section. A water supply permit fee may be required. 7. Is the applicant to provide treatment of effluent resulting from this construction? If No=> A Sewage Treatment Agreement (DNR Form 29) executed by the authority providing treatment must accompany this application. 8. Is a new or amended operation permit necessary to use the facilities described in this application? If Yes=> A new or amended permit to operate may be requested prior to the receipt of a construction permit. 9. Is any waterline located within 10 feet; or any private or public well, lake, or public recreation area located within 400 feet of the proposed construction? If Yes=> Identify and locate the facility(s) relative to the proposed construction. 10. Will construction inspection be conducted by a licensed engineer employed by the applicant? e 0 ►1 ■ A ■ 0 0 0 ►1 0 ►1 If No=> NAME OF ENGINEERING FIRM CONDUCTING INSPECTION AECOM 11. Will this project utilize CWSRF loan funds? ❑ 0 CERTIFICATION APPLICANT I certi at I am the authorized representative of the owner and state that the ro ct identified above is app ed b e owner. r ' „I 1,9...6application, ENGINEER I certify that all aspects of design included in this application conform to applicable standards contained in Chapter 567 IAC 64, or that an explanation and justification for any proposed variations from such standards is attached. I am familiar with the information contained in this and to the best of my knowledge, such information is complete and accurate. y NATURE DATE r,(1 Ups 1 l / J� I SIGNATURE DATE r JJ P * Estimated Construction Start Date,'iComplete applications mus be submi - . a ea ' 0 days in advance of the date for starting construction in accordance with Rules 567 IAC 60.4 and 64.2 PLEASE COMPLETE THE SCHEDULE CHECKLIST ON THE FOLLOWING PAGE OF THIS FORM L:\work\project\60283855\400 Technical \420_Specs160283855-No Name Creek Spec\WC-No Name Creek -SCHEDULE A.docc 542-3129 Construction Permit Application SCHEDULE A, General Information, page 2 DOCUMENT CHECKLIST Identify all categories included in this project. Also, identify schedules attached to this application. SCHEDULE TITLE B Collection system C D E F G H1 H2 H3 Lateral Sewer Extension Trunk & Interceptor Sewer Wastewater Pump Station Treatment Project Site Selection Treatment Project Design Data Schematic Flow Diagram ATTACHED 0 0 0 INCLUDED IN SUBMITTAL PROJECT DATE 04/08/13 ►1 0 0 0 0 Treatment Process Loading and ❑ ❑ Removal Efficiency Mechanical Plant Reliability ❑ ❑ I Screening, Grit Removal and Flow 0 ❑ Measurement J Septic Tank System 0 0 K1 Controlled Discharge Pond 0 0 K2 Aerated Pond 0 0 K3 Anaerobic Lagoon 0 0 L Setting Tanks 0 0 M Fixed Film Reactor— Stationary Media 0 0 N Rotating Biological Contactor 0 0 O Aeration Tanks or Basins 0 0 P Gas Chlorination 0 0 Q Sludge Digestion and Holding 0 0 R1 Sludge Dewatering and Disposal 0 ❑ R2(A & B) Low Rate Land Application of Sludge 0 0 R3 Land Application of Sewage Sludge 0 ❑ (To be developed) S Land Application of Wastewater 0 0 (To be developed) Sewage Treatment Agreement 0 0 04/08/13 Identify any categories included in this project which are not provided in the above list of schedules. DNR form 28A (Sept 2010) LAworklproject 1802838551400 Technical1420_Specs\80283855-No Name Creek SpecWC-No Name Creek -SCHEDULE A.docc 542-3129 Iowa Department of Natural Resources Wastewater Section Construction Permit Application SCHEDULE B, Collection system DATE PREPARED 04/08/13 DATE REVISED PROJECT IDENTITY No Name Creek Interceptor Sewer, City of Waterloo, Iowa City Contract No. 849 DNR USE PROJECT NO. PERMIT NO. 1. Identify proposed construction which is subject to flooding and explain what is proposed to prevent water from entering the system. If no portion is subject to flooding, state none. Segment Flooding Protection Raised Manholes Above "Most" Flood Events and Provided Gasketed Manhole Lids for Extreme Floods *2. Indicate hydraulic capacity of: 1) the nearest downstream main or interceptor, 2) the nearest downstream lift station, and 3) all downstream segments where flow restriction may occur. Indicate the source and accuracy of numerical data. *3. Location Design capacity, MGD Peak Hourly Dry weather Flow MGD (actual) Peak Hourly Wet Weather Flow MGD (actual) Segment Segment Segment MH #858 @ Downstream End of Project* TITUS (Midland St.) Pumping Station 24.5 31,500 Firm - 0.54 Total - 0.72 48,000 0.25** 0.25** 0.70** 0.70** *Will be upgraded with new TITUS Pumping Station in Future **Estimated From Previous Modeling Identify treatment facility, the design loadings and present raw waste loadings. Indicate source and accuracy of numerical data. Facility name and number Waterloo Water Pollution Control Facility - IDNR Permit #0790001 Facility Loading Design Average Wet Weather (actual) Peak Hourly Wet Weather (actual) MGD #BOD5/day 34.8 88,000 24.5 31,500 60± 48,000 Provide projected design loading increase, which will be added to this facility as a result of this project. None. This project replaces an existing 12 -inch interceptor and adds no area or flow. Design Loading Residential service area Population Flow (100 GPCD) BOD5 (0.17 #/d/cap) Industrial service area Rated flow BOD5 Other Rated Flow BOD5 Total BOD5 Total Flow Peak Hourly Flow Initial Acres Persons GPD #/day Acres GPD #/day Acres GPD #/day #/day GPD GPD Design Year ( * Include a written explanation of items 2 and 3 if the sewer system and/or treatment facility are overloaded. Acres Persons GPD #/day Acres GPD #/day Acres GPD #/day #/day GPD GPD DNR form 28B (Nov 00) L:\work\project\602838551400 Technica11420_Specsl60283855-No Name Creek SpecWC-No Name Creek -SCHEDULE B.dooc 542-3095 DATE PREPARED 04/08/13 DATE REVISED Iowa Department of Natural Resources Wastewater Section Construction Permit application SCHEDULE D, Trunk & Interceptor Sewer PROJECT IDENTITY No Name Creek Interceptor Sewer, City of Waterloo, Iowa City Contract No. 849 DNR USE PROJECT NO. PERMIT NO. 1. Design of reach above A. Manhole No. Initial area — acres Ultimate area — acres Initial — BOD5, #/day Ultimate — BOD5, #/day Initial PHWW flow— MGD Design PHWW flow - MGD Ultimate PHWW flow - MGD B. Critical section of reach Pipe diameter - inches Slope -% Carrying capacity - MGD 2. Pipe Diameter— inches Material Joint Maximum manhole space — feet Total length - feet 1 11 18 18 0.20 0.25 3. Construction specifications (indicate ASTM No. or other standard included in the specifications). A. Bedding class Type A-1 or Type CSE Embedment B. Pipe laying SUDAS Spec 3010 Class F-3 w/ Type 1 Bedding Material C. Compaction SUDAS Spec 4010 for PVC Pipe D. Manhole Precast Concrete Pipe Manhole E. Specified maximum infiltration/exfiitration rate 200 GPDPMPI F. Infiltration/exfiltration test procedures Low Pressure Air G. Alignment & grade test procedures (1) During construction: Stake & batter board (2) After construction: Lamping X H. Deflection test procedures Go/No Go Mandrel (95% Inside Diameter) Other Laser X 4. Are detailed manhole drawings included? Yes ® No 0 Typical frame and cover assembly : Neenah R6461 GH Ring and Cover Are manhole covers nonvented? Yes 0 No 0 Manhole diameter 48 in. Manhole opening diameter 24 in. Material Precast Concrete 5. Minimum sewer & water main separation: Horizontal 10 ft. Vertical 18 in. Are specifications included? Yes ® No 0 6. Stream, road, or railroad crossing protection No Are specifications included? DNR form 28D (Nov 00) L:\worklprojecfl602838551400 Technical1420_Specs160283855-No Name Creek SpecWC-No Name Creek -SCHEDULE D.docx 542-3097 18 Inch 18 Inch PVC PVC Integral Bell & Spigot w/Gaskets (Restrained Joints @ Trench less Locations) Integral Bell & Spigot w/Gaskets 383 390 3,020 1,755 3. Construction specifications (indicate ASTM No. or other standard included in the specifications). A. Bedding class Type A-1 or Type CSE Embedment B. Pipe laying SUDAS Spec 3010 Class F-3 w/ Type 1 Bedding Material C. Compaction SUDAS Spec 4010 for PVC Pipe D. Manhole Precast Concrete Pipe Manhole E. Specified maximum infiltration/exfiitration rate 200 GPDPMPI F. Infiltration/exfiltration test procedures Low Pressure Air G. Alignment & grade test procedures (1) During construction: Stake & batter board (2) After construction: Lamping X H. Deflection test procedures Go/No Go Mandrel (95% Inside Diameter) Other Laser X 4. Are detailed manhole drawings included? Yes ® No 0 Typical frame and cover assembly : Neenah R6461 GH Ring and Cover Are manhole covers nonvented? Yes 0 No 0 Manhole diameter 48 in. Manhole opening diameter 24 in. Material Precast Concrete 5. Minimum sewer & water main separation: Horizontal 10 ft. Vertical 18 in. Are specifications included? Yes ® No 0 6. Stream, road, or railroad crossing protection No Are specifications included? DNR form 28D (Nov 00) L:\worklprojecfl602838551400 Technical1420_Specs160283855-No Name Creek SpecWC-No Name Creek -SCHEDULE D.docx 542-3097