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Home My WebLink AboutIowa Department of Natural Resources-11/7/2016IOWA DEPARTMENT OF NATURAL RESOURCES Wastewater Disposal System Construction Permit Application Fee Form CASHIER'S USE ONLY 0945-542-N P D E -C P-05 70 32-3202 Owner Owner Name: City of Waterloo Address: 715 Mulberry Street City, State, Zip: Waterloo, IA 50703 Project Identification: F.Y. 2017 Wagner Road Sanitary Sewer & Grading - Contract No. 899 ® $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 4558.173 and rules in Iowa Administrative Code 567 IAC 64, must be accompanied by the fee required by Iowa Code 4558.197 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: Telephone or email contact: 31 - 2. l (2 - Mail to: Iowa Department of Natural Resources Wastewater Engineering Section 502 East 9th Street Des Moines, IA 50319-0034 06/2011 cmz DNR Form 542-1245 Exhibit 11A Iowa Department of Natural Resources Wastewater Section Construction Permit Application SCHEDULE A, Construction Permit Application APPLICANT Owner: City of Waterloo, Iowa Address: 715 Mulberry Street Representative: Dennis Gentz, P.E. Phone Number: 319-291-4312 Email: dennis.gentz@waterloo-ia.org ENGINEER Firm: JDE Engineering, PLC Address: 3731 Pheasant Lane, Suite 201 Project Officer: Jim D. Ellis, P.E. Phone Number: 319-464-7913 Email: jdeeng@Ipctel.net Project Identification: F.Y. 2017 Wagner Road Sanitary Sewer Extension and Grading, Contract No. 899 Estimated Start Date*: Dec. 2016 Estimated Completion Date: June 2017 PLEASE RESPOND TO ALL QUESTIONS 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 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? Yes No 0 ® ❑ For a minor gravity sewer extension within the meaning of 4558.183.3 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? If Yes: Approved Standard Specifications of (municipality or firm): SUDAS Standards Date Approved: 2016 Edition 5. Does each set of plans and specifications or engineering report accompanying this application contain a ® ❑ "professional engineering seal" executed in conformance with 5428.16, 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 Sectipn. 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 executed by the authority providing treatment must accompany this form. 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(ies) relative to the proposed construction. 10. Will construction inspection be conducted by a licensed engineer employed by the applicant? If No: Name of Engineering Firm Conducting Inspection: 11. Will this project utilize CWSRF loan funds? El El 111 A, CERTIFICATION El IZ APPLICANT I certify that I am the authorized representative of the owner and state that the project identified above is approved by the owner. Signature j .. Date *Estimated Construction Start Date: Complete applications must be submitted construction in accordance with Rules 567 IAC 60.4 and 64.2 t2.(., llc, ENGINEER I certify that all aspects of the 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, su infor tion is c• •tete and accurate. Signature i .era. �� ` Date / /Z. !, east 120 days in advance of the date forastarfirig Please complete the Schedule Checklist on the following page of this form. 04/2016 cmc DNR Form 542-3129; 28A DOCUMENT CHECKLIST Identify all categories included in this project. Also, identify schedules attached to this application. Schedule B Collection System C Lateral Sewer Extension D Trunk & Interceptor Sewer E Wastewater Pump Station F Treatment Project Site Selection G Treatment Project Design Data H1 Schematic Flow Diagram H2 Treatment Process Loading and Removal Efficiency 113 Mechanical Plant Reliability Screening, Grit Removal and Flow Measurement J Septic Tank System K1 Controlled Discharge Pond K2 Aerated Pond K3 Anaerobic Lagoon L Setting Tanks M Fixed Film Reactor -Stationary Media N Rotating Biological Contactor O Aeration Tanks or Basins P Gas Chlorination Q Sludge Digestion and Holding R1 Sludge Dewatering and Disposal R2 (A&B) Low Rate Land Application of Sludge R3 Land Application of Sewage Sludge (To be developed) 5 Land Application of Wastewater (To be developed) Sewage Treatment Agreement Title Attached Included in Project Submittal Date ® ❑ Dec. 2016 ►1 ❑ Dec. 2016 Identify any categories included in this project which are not provided in the above list of schedules. 04/2016 cmc DNR Form 542-3129; 28A Iowa Department of Natural Resources Wastewater Section Construction Permit Application SCHEDULE B, Collection System Date Prepared 12/13/16 Date Revised Project Identity F.Y. 2017 Wagner Road Sanitary Sewer Extension & Grading - Contract No. 899 DNR USE ONLY 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 None None Flooding Protection *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. Segment Segment Segment Location Design Capacity, MGD Peak Hourly Dry weather Flow MGD (actual) Peak Hourly Wet weather Flow MGD (actual) 12 -inch None None 1.03 60+ 48,000 0.07 0.17 *3. Identify treatment facility, the design loadings and present raw waste loadings. Indicate source and accuracy of numerical data. Facility Name and Number Waterloo Wastewater Pollution Control Plant Facility Loading Design Average Wet Weather (actual) Peak Hourly Wet Weather (actual) MGD #BODS/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. Design Loading Initial Design Year (2017) Residential Service Area N/A Acres N/A Acres Population N/A Persons N/A Persons Flow (100 GPCD) N/A GPD N/A GPD BOD5(0.17/#/d/cap) N/A #/day N/A #/day Industrial Service Area 13.95 Acres 13.95 Acres Rated Flow 69,750 GPD 69,750 GPD BOD5 118.6 #/day 118.6 #/day Other N/A N/A Acres N/A Acres Rated Flow N/A GPD N/A GPD BODS N/A #/day N/A #/day Total BOD5 118.6 #/day 118.6 #/day Total Flow 69,750 GPD 69,750 GPD Peak Hourly Flow 173,678 GPD 173,678 GPD *Include a written explanation of items 2 and 3 if the sewer system and/or treatment facility are overloaded. 11/2015 cmc DNR Form 542-3095; 28B Iowa Department of Natural Resources Wastewater Section Construction Permit Application SCHEDULE C, Lateral Sewer Extension Date Prepared 12/13/16 Date Revised Project Identity F.Y. 2017 Wagner Road Sanitary Sewer Extension & Grading - Contract No. 899 DNR USE ONLY Project No. Permit No. 1. Design Basis Residential Service Area Population Flow (100 GPCD) BOD5 (0.17/#/d/cap) Industrial Service Area Rated Flow BOD5 Other N/A Initial N/A Design Year (2017) Acres N/A Acres N/A Persons N/A Persons N/A GPD N/A GPD N/A #/day N/A #/day 13.95 Acres 13.95 Acres 69,750 GPD 69,750 GPD 118.6 #/day 118.6 #/day N/A Acres N/A Acres Rated Flow N/A GPD N/A GPD BOD5 N/A #/day N/A #/day Total BOD5 118.6 #/day 118.6 #/day Total Flow 69,750 GPD 69,750 GPD Peak Hourly Flow 173,678 GPD 173,678 GPD 2. Pipe Diameter 8 Inch 10 Inch 12 Inch Material PVC Truss N/A N/A Joint Elastomeric N/A N/A Minimum Slope 0.40 % N/A % N/A Maximum Manhole Space 275 ft. N/A ft. N/A ft. Total Sewer Length 810 ft. N/A ft. N/A ft. Maximum Cover 11.6 ft. N/A ft. N/A ft. Minimum Cover 7.6 ft. N/A ft. N/A ft. 3. Construction specifications (indicate ASTM Number 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 H, D2321-75 except as modified by ASTM D2680-01 C. Compaction 95% Standard Proctor Density D. Manhole ASTM C4782 - 48 -inch 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 & batterboard yes Laser yes (2) After construction Lamping yes Other televising H. Deflection test procedures N/A 4. Are detailed manhole drawings included: ® Yes ❑ No Typical frame and cover assembly SUDAS SW-306&SW-601TypeA Are manhole covers nonvented: // Yes ❑ No Manhole diameter 48 -inch in. Manhole opening diameter 24 -inch In Material concrete 5. Minimum sewer & water main separation: Horizontal 10 ft. Vertical 18 in. Are specifications included no 6. Stream, road, or railroad crossing protection N/A Are specifications included N/A 11/2015 cmc DNR Form 542-3096; 28C ( 11/07/2016 2017-00001063 -/ WASTEWATER DISP SYS CONST PERMIT -2017 WAGNER RD SAN SEW CONT 899 1 L 1 r Th CHECK NO. f— "7 V V V 1 "Th 10000 100.00 POSReorder f/ 120598G (MOW& aMallatrlAg.), VIIIISMW IM§YINRWWWiatr CITY OF WAThRLS9, IOWA 715 MULBERRY ST. WktTERLOO, IA 50703 31S-291-4323 PAY — TO , THE ORDER OF IOWA DEPARTMENT OF NATURAL RESOURCES WASTEWATER ENGINEERING SECTION 502 EAST 9TI21 STREET DES MOINES, IA 50319 DATE ':11.. 11/14/201, One Hundred and 00/100 Dellais DMA 33 44@M LX0t2MWM : GIONSA- 02079907e or.'07390041814000000.p__ 600 tall° $100.00 F?,!!;;,• 249907, VOID AFTER 120 DAYS By Order of the City Council PeAdte) 6)&112,zeit) Chief Rwanda! Officer