HomeMy WebLinkAboutVJ Engineering-5/6/2013Iowa Department of Natural Resources
Wastewater Section
Construction Permit Application
SEWAGE TREATMENT AGREEMENT
INSTRUCTIONS
This agreement must be executed for all projects where construction and sewage treatment will be provided by different parties; i.e., a
private subdivision connecting to a municipal system. This agreement must be executed by the parties who are owners at the time the
permit is issued, regardless of whether title to the proposed construction project will be transferred after completion of the project.
This agreement is not necessary when a contract for sewage treatment already exists; i.e., service contracts between municipalities.
However, the Department of Natural Resources must be informed in writing that the contractual agreement does exist.
APPLICANT
ENGINEER
OWNER
Sunnyside South Addition, LLC
FIRM
VJ Engineering
ADDRESS
PO Box 447, Hudson, IA 50643
ADDRESS
1501 Technology Drive, Suite 100, Cedar Falls, IA 50613
REPRESENTATIVE
Jeff Stickfort
TELEPHONE
319-290-4357
PROJECT OFFICER
Bruce P. Radue, P.E.
TELEPHONE
319-266-5829
PROJECT IDENTIFICATION
Sunnyside South Addition
OWNER AND SYSTEM RECEIVING WASTES
City of Waterloo
CERTIFICATE
I am the authorized representative of the owner identified above and state that the proposed sanitary sewerage facilities shall be
constructed in accordance with the plans and specifications and all wastes contributed by this project shall be discharged to the
treatment system identified above.
SIGNATURE
TITLE
DATE
I am the authorized
sewerage facilities
treatment of all
of the Department
service agreements,
AGREEMENT TO PROVIDE
representative of the owner of the system identified
identified above is approved by the owner, and that
wastes contributed by this project, in accordance with
of Natural Resources. This agreement shall not
or fee systems entered into between the parties.
SEWAGE TREATMENT
above and state that the connection of the proposed sanitary
the owner accepts responsibility for providing adequate
the provisions of Chapter 455B, Code of Iowa, and the rules
be construed in any way to affect any local ordinances, sewer
SIGNAT i
.r
i ,ir ou
TYPED OR PRIty,v,4NTED b.NAME
1,16_,r)
TITLE
j6d141Y-
PHONE NUMBER
DATE
si a_ __
DNR form 29 (Nov 0 )
542-3219
Exhibit 11A
Iowa Department of Natural Resources Wastewater Engineering Section
Construction Permit Application
SCHEDULE A, General Information
APPLICANT
ENGINEER
OWNER E-MAIL ADDRESS
Sunnyside South Addition, LLC jeff@stickfortconstruction.com
FIRM E-MAIL ADDRESS
VJ Engineering bradue@vjengineering.com
ADDRESS
PO Box 447, Hudson, IA 50643
ADDRESS
1501 Technology Parkway, Suite 100, Cedar Falls, IA 50613
REPRESENTATIVE TELEPHONE
Jeff Stickfort 319-290-4357
PROJECT OFFICER TELEPHONE
Bruce P. Radue, P.E. 319-266-5829
PROJECT IDENTIFICATION
Sunnyside South Addition
ESTIMATED START DATE *
ESTIMATED COMPLETION DATE
PLEASE RESPOND TO ALL QUESTIONS YES
1. Has an engineering report, facilities plan or other information previously been submitted for this project? ❑
NO
r
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 plan?
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?
/1
/1
1
❑
❑
❑
If Yes=>
APPROVED STANDARD SPECIFICATIONS OF
(municipality or firm)
DATE APPROVED
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?
/./
12
❑
❑
❑
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❑
L-
r
/1
►•
❑
If No=>
NAME OF ENGINEERING FIRM CONDUCTING INSPECTION
11. Will this project utilize CWSRF loan funds? ❑
►1
CERTIFICATION
APPLICANT
I certify that I am the authorized representative of the owner and
state that the project identified above is approved by the owner.
,I
lia%� A" ' r— // — a
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 application, and to the best of my
knowledge, such information is complete and accurate.
SIGNATURE V 1 J DATE
SIGNATURE DATE
* Estimated Construction Start Date: Complete applications must be submitted at least 120 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
DNR form 28A (Sept 2010)
542-3129
Construction Permit Application
SCHEDULE A, General Information, page 2
SCHEDULE
B
c
D
E
F
G
HI
H2
H3
I
J
K1
K2
K3
L
M
N
0
P
Q
R1
R2(A & B)
R3
S
Identify all categories
TITLE
Collection system
DOCUMENT CHECKLIST
included in this project. Also, identify schedules attached to this application.
INCLUDED IN
ATTACHED PROJECT
O ❑
Lateral Sewer Extension
Trunk & Interceptor Sewer
Wastewater Pump Station
Treatment Project Site Selection
Treatment Project Design Data
Schematic Flow Diagram
Treatment Process Loading and
Removal Efficiency
Mechanical Plant Reliability
Screening, Grit Removal and Flow
Measurement
Septic Tank System
Controlled Discharge Pond
Aerated Pond
Anaerobic Lagoon
Setting Tanks
Fixed Film Reactor — Stationary Media
Rotating Biological Contactor
O 0
O 0
O 0
O 0
O 0
O 0
O 0
O 0
O 0
Aeration Tanks or Basins 0 0
Gas Chlorination
Sludge Digestion and Holding
Sludge Dewatering and Disposal
Low Rate Land Application of Sludge ❑ ❑
O 0
O 0
O 0
Land Application of Sewage Sludge
(To be developed)
Land Application of Wastewater
(To be developed)
Sewage Treatment Agreement
O 0
O 0
O 0
SUBMITTAL
DATE
Identify any categories included in this project which are not provided in the above list of schedules.
DNR form 28A (Sept 2010)
542-3129
Iowa Department of Natural Resources
Wastewater Section
Construction Permit Application
SCHEDULE B, Collection system
DATE PREPARED
4/17/2013
DATE REVISED
PROJECT IDENTITY
Sunnyside South Addition
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
NW, Sec. 8-88-13 Flood Proof Casting (IMH)
*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.
Location
Design capacity, MGD
Peak Hourly Dry weather Flow
MGD (actual)
Peak Hourly Wet Weather Flow
MGD (actual)
Segment
Segment
Segment
SW1/4, 5-88-13
1.03
0.01
0.06
*3. 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 Plant
Facility Loading
Design
Average Wet Weather (actual)
Peak Hourly Wet Weather (actual)
MGD
#BODS/day
34.8
88,000
24.53
31,500
60+
48,000+
Provide projected design loading increase, which will be added to this facility as a result of this project.
Design Loading
Initial
Design Year (Line)
Residential service area 3— Acres (0 Acres
Population 42 Persons 84 Persons
Flow (100 GPCD) 4200 GPD 8400 GPD
BOD5 (0.17 #/d/cap) 7.2 #/day 14.4 #/day
Industrial service area Acres Acres
[dated flow GPD GPD
BOD5 #/day #/day
Other Acres Acres
Rated Flow GPD GPD
BOD5 #/day #/day
Total BOD5 7.2 #/day 14.4 #/day
Total Flow 4200 GPD 8400 GPD
Peak Hourly Flow 16800 GPD 33600 GPD
Include a written explanation of items 2 and 3 if the sewer system and/or treatment facility are overloaded.
DNR form 28B (Nov 00)
542-3095
Iowa Department of Natural Resources
Wastewater Section
Construction Permit Application
SCHEDULE C, Lateral Sewer Extension
DATE PREPARED
4/17/2013
DATE REVISED
PROJECT IDENTITY
Sunnyside South Addition
DNR USE
PROJECT NO.
PERMIT NO.
1. Design Basis Initial Design Year (2020 )
Residential service area 5 Acres 10 Acres
Population 42 Persons 84 Persons
Flow (100 GPCD) 4200 GPD 8400 GPD
BOD5 (0.17 #/d/cap) 7.2 #/day 14.4 #/day
Industrial service area Acres Acres
Rated Flow GPD GPD
BOD5 #/day #/day
Other Acres Acres
Rated Flow GPD GPD
BOD5 #/day #/day
Total BOD5 7.2 #/day 14.4 #/day
Total Flow 4200 GPD 8400 GPD
Peak Hourly Flow 16800 GPD 33600 GPD
2. Pipe
Diameter 8 Inch 10 Inch 12 Inch
Material PVC Truss
Joint Elastomeric
Minimum Slope 0.4 % % %
Maximum Manhole Space 387 ft. ft. ft.
Total Sewer Length 3,351 ft.. ft. ft.
Maximum Cover 12.2 ft. ft. ft.
Minimum Cover 8.5 ft. ft. ft.
3. Construction specifications (indicate ASTM No. or other standard included in the specifications). A brief description is required
in each part.
A. Bedding class ASTM Class II, D2321-75 except as modified by ASTM D2680-01
B. Pipe laying ASTM Class II, D2321-75 except as modified by ASTM D2680-01
C. Compaction 95% Standard Proctor Density
D. Manhole ASTM C478, 48" dia.
E. Specified maximum Infiltration/exfiltration rate 200 GPDPMPI
F. Infiltration/exfiltration test procedures v -notch weir, televising, or air test
G. Alignment & grade test procedures
(1) During construction: Stake & batter board yes Laser yes
(2) After construction: Lamping yes Other televising
H. Deflection test procedures NA
4. Are detailed manhole drawings included: Yes ❑ No
Typical frame and cover assembly Neenah R-1642
Are manhole covers nonvented: Yes ® No ❑
Manhole diameter 48 in.
Manhole opening diameter 24 in. Material Concrete
5. Minimum sewer & water main separation: Horizontal 10
Are specifications included? No
ft. Vertical 18 in.
6. Stream, road, or railroad crossing protection NA
Are specifications included? NA
DNR form 28C (Nov 00)
542-3096