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Home My WebLink AboutDNR - Schoitz_Addition_Private_San_Sew_Ext Permit - 1.3.2022Exhibit 11A Iowa Department of Natural Resources Wastewater Section Construction Permit Application SCHEDULE A, Construction Permit Application APPLICANT Owner: C10 Investments LLC Address: 3759 Ranchero Road, Cedar Falls, IA 50613 Representative: Jeff Stickfort Phone Number: 319-290-4357 Email: jeffstickfort@gmail.com ENGINEER Firm; Crawford Engineering & Surveying, Inc. Address: 118 Third Avenue NE, PO Box 793, Independence, Iowa 50644 Project Officer: Phone Number: Lawrence G. Crawford 319-334-7077 Email; cesil@indytel.com Project Identification: Schoitz Addition Sanitary Sewer Main Estimated Start Date*: March 2022 Estimated Completion Date; May 2022 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 LI El ❑ 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? If Yes: Approved Standard Specifications of (municipality Of firm): Iowa SUDAS 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 54213.16, 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? ® ❑ March 2010 ❑ 1=1 El 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? ❑ 11 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: Crawford Engineering & Surveying, Inc. 11. Will this project utilize CWSRF loan funds? IM ❑ 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. Signature 444.14 Date 12.1131Z *Estimated C s ruction Start Date: Complete applications must be submitted at least 120 ays in 4dva construction in accordance with Rules 567 IAC 60.4 and 64.2 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 h informationn.is,com le and accurate. Signature [ .- Date f 1.. -2/ d ce of the date for starting 04/2016 cmc DNR Form 542-3129; 28A Please complete the Schedule Checklist on the following page of this form. DOCUMENT CHECKLIST Identify all categories included in this project. Also, identify schedules attached to this application. Schedule Title Attached Included in Project Submittal Date B Collection System El C Lateral Sewer Extension EJ 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 ❑ H3 Mechanical Plant Reliability ❑ I Screening, Grit Removal and Flow Measurement ❑ J Septic Tank System ❑ K1 Controlled Discharge Pond ❑ K2 Aerated Pond E 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) ❑ S Land Application of Wastewater (To be developed) ❑ Sewage Treatment Agreement Identify any categories included in this project which are not provided in the above list of schedules. ❑❑❑❑❑❑❑❑ ❑❑❑❑❑❑❑❑❑❑ 01 f 2016 crn CAR form 542-3129; 28A IOWA DEPARTMENT OF NATURAL RESOURCES Wastewater Disposal System Construction Permit Application Fee Form CASHIER'S USE ONLY 0945-542-NPDE-CP-•0570 32-3202 Owner Owner Name: C 10 Investments LLC Address: 3759 Ranchero Road City, State, Zip: Cedar Falls, Iowa 50613 Project Identification: Schoitz Addition Sanitary Sewer Main $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 515-725-8427 or Donna.Gorrrmndnr.iowa.t;ov Signature of Owner or Representative: Q D i C f 1) Sys+ems UIL Printed Narne: Telephone or email contact: 31 °I 2 °I is +357 pt- jre, S'Ftci4✓t' . cy d , cam,. Mail to: Iowa Department of Natural Resources Wastewater Engineering Section 502 East 9th Street Des Moines, IA 50319-0034 11/2014 cmc DNR Form 542-1245 Date Prepared 12-10-2021 Date Revised Iowa Department of Natural Resources Wastewater Section Construction Permit Application SCHEDULE B, Collection System DNR USE ONLY Project No. Permit No. Project Identity Schoitz Addition Sanitary Sewer Main 1. Identify proposed construction which is subject to Flooding and explain what is proposed to prevent water from e system. If no portion is subject to flooding, state none. Segment Flooding Protection ntering the *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 Acadia/Van Syoc 0.82 0.0075 0.030 *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, IA079001, FED 0042650 Facility Loading Design Average Wet Weather (actual) Peak Hourly Wet Weather (actual) Provide projected design loading increase, which will be added to this facility as a result of this project. Design Loading Initial Design Year (2041) Residential Service Area 1.88 Acres 1.88 Acres Population 28 Persons 56 Persons Flow (100 GPCD) 2800 GPD 5600 GPD BCD, (0.17/4/d/cap) 476 If/day 952 #/day Industrial Service Area Acres Acres Rated Flow GPD GPD BOD5 #/day tt/day Other Commercial 6 Acres 6 Acres Rated Flow 30,000 GPD 30,000 GPD BOD5 51 #/day 51 it/day Total BOD5 527 #/day 1003 4/day Total Flow 32,800 GPD 35,600 GPD Peak Hourly Flow 5470 GPD 6000 GPD MGD #BOD5/da 34.8 88,000 24.53 31,500 Avg. 60+ 48,000 Avg. *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 [P&4 Date Prepared 12-10-2021 Date Revised Iowa Department of Natural Resources Wastewater Section Construction Permit Application SCHEDULE C, Lateral Sewer Extension DNR USE ONLY Project No. Permit No. Project Identity Schoitz Addition Sanitary Sewer Main 1. Design Basis Initial Design Year {2041) Residential Service Area Population Flow {100 GPCD) BOD5 (0.17/#/d/cap) Industrial Service Area Rated Flow BODs Other Commercial 1.88 Acres 1.88 Acres 28 Persons 56 Persons 2800 GPD 5600 GPD 476 H/day 952 tt/day Acres Acres GPD GPD it/clay tt/day 6 Acres 6 Acres Rated Flow 30,000 GPD 30,000 GPD BODS 51 t!/day 51 If/day Total BOD5 527 ft/day 1003 it/clay Total Flow 32,800 GPD 35,600 GPD Peak Hourly Flow 5470 GPD 6000 GPO 2. Pipe Diameter 8 Inch 10 Inch 12 Inch Material PVC Joint Gasketed Minimum Slope 2.16 9/0 % % Maximum Manhole Space 329 ft. ft. ft. Total Sewer Length 734 ft. ft. ft. Maximum Cover 12 ft. ft. ft. Minimum Cover 8 ft. ft. 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 SUDAS Class F-3 B. Pipe laying SUDAS Section 4010 C. Compaction 95% Std. Proctor Density D. Manhole SUDAS 6010 SW 301 E. Specified maximum infiltration/exflltration rate 200 GPDPMPI F. Infiltration/exfiltration test procedures low pressure air test G. Alignment & grade test procedures (1) During construction Stake & batterboard (2) After construction tamping X H. Deflection test procedures 9-fin mandrel, 30 days after installation Laser X Other Internal TV Inspection 4. Are detailed manhole drawings included: ® Yes ❑ No Typical frame and cover assembly SUDAS 6010.601-A Are manhole covers nonvented: ® Yes ❑ No Manhole diameter 48 in. Manhole opening diameter 27 in Material Precast Conc. ASTM C-478 5. Minimum sewer & water main separation: Horizontal 10 ft. Vertical 18 Are specifications included SUDAS Standard Spec. in. 6. Stream, road, or railroad crossing protection Are snPrifiratinnc inrli114Pri 'CI InAS Ctanriarri per 11/2015cmc DNR Form 542-3096; 28C Iowa 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 treatrnent 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 Owner: C 10 Investments LLC Address: 3759 Ranchero Road, Cedar Falls, IA 50613 Representative: Jeff Stickfort Phone Number: 319-290-4357 ENGINEER Firm: Crawford Engineering & Surveying, Inc. 118 Third Avenue NE, PO Box 793 Address: Independence, Iowa 50644 Project Officer: Lawrence G. Crawford Phone Number: 319-334-7077 Project Identification: Schoitz Addition Sanitary Sewer Main Owner and System Receiving Wastes: City of Waterloo CERTIFICATION I am the authorized representative of the owner identified above and state that the proposed sanitary sewage 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 lib Z)2.- 1 AGREEMENT TO PROVIDE SEWAGE TREATMENT I am the authorized representative of the owner of the system identified above and state that the connection of the proposed sanitary sewage facilities identified above is approved by the owner, and that the owner accepts responsibility for providing adequate treatment of all wastes contributed by this project, in accordance with the provisions of Chapter 4558, Code of Iowa, and the rules of the Department of Natural Resources. This agreement shall not be construed in any way to affect any local ordinances, sewer service agreements, or fee systems entered into between the parties. Name: Quentin Hart Title: Mayor Signature Date 1/3/2022 Phone: 319-291-4301 9/2018 caw DNR Form 542-3219; 29