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1995 - FDOT - FDEP Permit Applications & Preliminary Plats
MASTELLER & MOLER, INC. M - CONSULTING ENGINEERS - August 16 1995 Mr. Joel Koford City of Sebastian 1225 Main Street Sebastian, Florida 32958 RE: Indian River County Project 4fUW-93-30-DS Route 510/US #1 Water Transmission/ Sebastian Riverfront Area Dear Mr. Koford: AUG 1995 itved Ct Manag Managers office Enclosed please find the Florida Department of Environmental Protection Form #62-555.910(9) "Certification of Construction Completion and Request for a Letter of Clearance to Place a Public Drinking Water Facility into Service" for your signature. Please sign where noted and return two (2) copies to our office in order that we may forward to the County for signature and processing to the FDEP. I have also enclosed a copy of the bacteriological test results for your records. Please do not hesitate to contact our office should you have any concerns or questions regarding the enclosed. Respectfully, MASTELLER & MOLER, INC. Michael Delaney Project Manager NO/vk File #9459LB &081695.doc) �I 1623 N. U.S. Highway 1, Suite B2 O 7380 Murrell Road, Suite 106 Sebastian, FL 32958 Melbourne, Florida 32940 (407) 589-4800 (407) 255-1175 (407)589-2742 Fax (407)253-4439 Fax DEP Form No.: 62.555.910(9) Department of Foy, n"* Certification of f omtructbn Completion wo �! Request for a Loner of Clearance to Place Ar Environm ental Protection a Public Drinking Water Facility into Service �,0 A :`� -..Effective Date: December 19. 1994 •. _.. DEP Application No.: y40"mlove .... III Y+.y�.�1 Milled M by DEP? Certification of Construction Completion and Request for a Letter of Clearance to Place a -Public Drinking Water Facility into Service INSTRUCTIONS: This form shall be completed and submitted for projects permitted and constructed under specific public drinking water facility construction permits issued by the Department and for projects permitted and constructed under the "General Permit for Construction of an Extension to a Public Drinking Water Distribution System." AFTER SUBSTANTIALLY COMPLETING THE CONSTRUCTION OF A PROJECT OR A PORTION OF A PROJECT AND BEFORE PLACING ANY NEWLY CONSTRUCTED OR ALTERED PUBLIC DRINKING WATER FACILITY INTO SERVICE FOR ANY PURPOSE OTHER THAN DISINFECTION, TESTING FOR LEAKS, AND/OR TESTING EQUIPMENT OPERATION, complete this form and submit it to the appropriate district office of the Department or the appropriate Approved County Public Health Unit (ACPHU) along with applicable supporting documents. Applicable supporting documents include the following: (1) for projects and portions of projects where there is any deviation from the construction permit and approved engineering plans and specifications, a copy of record drawings; (2) for projects and portions of projects including new or altered public drinking water supply wells, new or altered treatment facilities downstream from the first point of application of disinfectant at a public drinking water treatment plant, new or altered treatedifinished drinking water pumping facilities, new or altered treated/finished drinking water storage facilities, or new or altered treated/finished drinking water mains, a copy of satisfactory bacteriological test results that indicate the date and time each bacteriological sample was collected and that demonstrate compliance with Rules 62.555.315(3), 62.555.340, and 62.555.345, Florida Administrative Code (F.A.C.) and applicable American Water Works Association (AWWA) disinfection standards (AWWA Standards C651, C65Z C653, and C654), which are incorporated by reference in Rule 62.555.330(4), F.A.C.`; (3) for projects and portions of projects including new or altered public drinking water treatment facilities that are needed to comply with, or affect compliance with, Part 111 of Chapter 62.550, Part VI of Chapter 62-555, or Rule 62.524.650(21, F.A.C., a copy of analytical test results that demonstrate compliance with these rules; and (4) for projects and portions of projects including new or altered wells, a copy. of the log completion report for each new or altered well if such report is applicable and has not been previously submitted to the Department or the appropriate ACPHU. All information provided on this form shall be typed or printed in ink. When submitting a copy of bacteriological test results, also submit a sketch or description indicating where each bacteriological sample was collected. NOTE THAT A SEPARATE CERTIFICATION OF CONSTRUCTION COMPLETION AND REQUEST FOR A LETTER OF CLEARANCE 1S REQUIRED FOR EACH PERMITTED PROJECT. DO NOT PLACE ANY NEWLY CONSTRUCTED OR ALTERED PUBLIC DRINKING WATER FACILITY INTO SERVICE UNTIL THE DEPARTMENT OR THE APPROPRIATE ACPHU ISSUES A LETTER OF CLEARANCE FOR THE FACILITY. for new and altered pubic• drinking water supply wells, bacteriological samprng shall be conducted, and in of bacteriological test results shall be made, in accordance with Rule 62-555.315Q, F.A.C. for all other new and altered public drinking water facilities, bacteriological sampling shall be conducted by first reducing the total chlorine residual in the water within the facilities to no more than 4 mg/L and then collecting daily bacteriological samples oaken at least 24 hours apart/ for two or more consecutive work -days until satisfactory, test results are obtained. Bacteriological test results for new and altered public drinking water facilities other than wells shall be considered satisfactory if two consecutive daily samples from each sample location show the absence of total coliform organisms Bacteriological test results for al/ new and altered public drinking water facilities other than wells will be considered invalid if the results are for samples collected more than 30 days before the results are received by the Department or the ACPHU, and bacteriological test results for newand altered. public drinking water mains will be considered invalid . if the pressure in the mains is not maintained at 20 psi or greater after the samples are collected. I. PROJECT NAME AND CONSTRUCTION PERMIT NUMBER, PORTION OF PROJECT THAT IS SUBSTANTIALLY COMPLETE, PERMITTEE, ETC. •Project Name: Tntiian Rivpr County=PW, Indian River County—South R/0 Plant,_ Sebastian Fact of U -S. lel . (0.1.475 MGD) *Project Construction Permit No.: WD31-264072 ; Date Permit Issued: 2/13/95 •Portion of Project for Which Construction Is Substantially Complete and for Which a Letter of Clearance Is Requested: .100% Page 1 of 3 Certification of Construction Completion and Request for a Letter of Clearance to Place a Public Drinking Water Facility into Service Project Name: Indian River County—Sebastian East of US #1 Project Construction Permit Number. WD31-264072 Substantially Completed Portion of Project: 100% 0 Permittee UtilitylCompany Name: City of Sebastian Utilities Dept. Address: 1225 Main Street City: gobas t:i qn oOwnerlOperator of Project After It Is Placed into Service, O t 7. 1 DEP Form No.: 62-555.910{9) Form Title: Certification of Construction Completion and Request for a Letter of Clearance to Place a Public Drinkino Water Facility Into Service Effective Data: December 19.1994 DEP Application No.: (Filled In by DEP) Telephone No.: (407) 589-5330 State: FL Zip Code: 11tilitVICompany Name: Indian River County Utilities Dept. Telephone No.: Address: 1840 25th Street City: Vero Beach State: FL Zip Code: j/_90U 32953 (407) 770-5311 *Professional Enqineer in Responsible Charge of Inspectina Construction of Proiect Name of Engineer: Earl H. Mai -teller, P.E. Firm Name: Masteller & Moler, Inc. Telephone No.: (407) 589--48UU Address: 162.3 N. U.S. Highway #J, Suite B-2 City: Sebastiin.n State: F, Zip Code: JZ9!).,) 11. STATEMENT BY PERMITTEE 1, the undersigned owner or authorized representative* of Sebastian Utilities Dept. certify the following: (1) that the contractor has furnished us With record drawings for the substantially completed portion of this project and that these record drawings are available for review at the following location: and 12) that, if this project involves the construction of any new or altered treatment facilities, an operation and maintenance manual for the new and altered treatment facilities included in the substantially completed portion of this project is available for review at the site of the new and altered treatment facilities. Also, I certify that, if we will not be the ownerloperator of this project after it is placed into service, we have provided a copy of the above mentioned record drawings and a copy of the above mentioned operation and maintenance .manual, if applicable, to the person or system that will be the ownerloperator of this project after it is placed into- service. Joel Koford. City Manager Signature and Da Name and Title (please type or print) Attack a letter of authorization. 111. STATEMENT BY OWNERIOPERATOR OF PROJECT AFTER IT IS PLACED INTO SERVICE 1, the undersigned owner or authorized representative* of Indian River County Utilities Dept,.certify that we will be the ownerloperator of this project after it is placed into service. Also, I certify the following: (1) that we have received a copy of the record drawings for the substantially completed portion of this project and that these record drawings are available for review at the following location: Ind . n RiAro r Count:y U lities DeDar tment 1840 25th Street Vero Beach FL -:3Z90 ;and (2) that, if this project involves the construction of any new or altered treatment facilities, we have received a copy of the operation and maintenance manual for the new and altered treatment facilities included in the substantially completed portion of this project and that this operation and maintenance manual is available for review at the site of the new and altered treatment facilities. Signature and Date * Attach a letter of authorization. Paoe 2 of 3 Robert 0. Wisemen, P.E., Environmental Name and Title (please type or print) ELLYLi`"'-L Certification of Construction Completion and Request for a Letter of DEP form foto.: 62-5s5.910st Clearance to Place a Public Drinking Water Facilityinto Service Form noa: Certification of Construction Comolation and tf ReBuest for a letter of Clearance to Place Project Name: Indian River County -Sebastian East of US #1 a Public Drinkin Water Facility into Service Project Construction Permit Number. WD 31- 2 640 7 2 Etfec&o Date: December t s. 1994 DEP Application No.: Substantially Completed Portion of Project: 100/ (Riled in by DEP! IV. CERTIFICATION OF CONSTRUCTION COMPLETION BY PROFESSIONAL. ENGINEER IN RESPONSIBLE CHARGE OF INSPECTING CONSTRUCTION OF PROJECT 1, the undersigned professional engineer registered in Florida, certify that I am in responsible charge of inspecting, construction of this project. Also, I certify the following: (1) that construction of the substantially completed portion of this project has been finished to the point where the public water facilities are functionally complete; (2) that the substantially completed portion of this project has been constructed in accordance with the construction permit and approved engineering plans and specifications or that, to the best of my knowledge and belief, any deviations from the construction permit and approved engineering plans and specifications will not prevent this project from functioning in compliance with Chapters 62.550, 62.551, 62.555, and 62.560, Florida Administrative Code (F.A.C.); (3) that the record drawings for the substantially completed portion of this project are adequate and indicate all deviations from the construction permit and approved engineering plans and specifications; and (4) that, to the best of my knowledge and belief, all new or altered well facilities, new or altered treatment facilities downstream from the first point of application of disinfectant at a treatment plant, new or altered finished water pumping facilities, new or altered finished water storage facilities, and new or altered water mains included in the substantially completed portion of this project have been disinfected and bacteriologically tested in accordance with Rules 62.555.315(3), 62.555.340, and 62.555.345, F.A.C., and applicable American Water Works Association (AWWA) disinfection standards (AWWA Standards C651, 0652, C653, and)or C654), which are incorporated by reference in Rule 62.555.330(4), F.A.C. This certification is based upon on-site observation of construction conducted by me or by a project representative under my direct supervision and upon a review of record drawings performed by me or by a project representative under my direct supervision. This certification does not necessarily constitute a certification of final completion of construction. Additional construction may be needed to satisfy all conditions of the construction contract documents. The following is a description and explanation of all deviations from the construction permit and approved engineering plans and specifications for the substantially completed portion of this project. (Attach additional sheets if necessary.) The permitted 12tt'diameter PVC water main on U.S. Highway #1 (south end of project) Harrison Street, Indian River Drive, Davis Street, North Central Avenue, Jackson Street and U.S., Highway #1 (north end of project) was constructed as a 16" diameter D.I.P. water main. • ZZ Y_ .�. a .t . `r .r t ealP Page 3 of 3 Earl H. Masteller, P.E. FL #26658 Name and license Number (please type or print) I I ALre 14 195 09:11 EAST COAST LABS EAST COAST LABORATORIES 4074613162 TO: P01 1 FOR LAS USE ONLY 1600 South 29 St., Sul* 4 Dees Ttm. �Ivwkvd'Gy: Ft. Pierce, FL 34947-8943 DHRS J.D. #86257 Phone:407/461-3162 �l9 17&0�H� 407j484-9713 � - Date J Tkne f4ft'M A Wd 1 By! bV001", DRINKING WATER BACTERIOLOGICAL AIIALYSIS %� 15DV (Check One) NAME s Peee� cop rrt - - SYSTEM I.D. No 0 Seiler STREET ADVWQQ N Caw Mlh N 0* ` ! COU , b V � DEP DIMICT 0 JUvo' . 0 rw ystam CiTY--.s P 13AC774 t V g PHOI1C NO COILLECTOR s NAMFf� r I COL PKO N y b % �•� Z.. r o DATE AND TIME CouECTEo�! TYPE OF SUPPLY (Ords one): <Cemmunity water s3►ste I ncommunity water system Nor�tranWent • nonsommurtiy waisr system Private welt `Ottiv (a TYPE OF SAMPLE (Cirde one): Cormilance Repo" 4FRacornem ssriti - _ I oftr pWa water system Msln otearani Weis survey Omar (•p"(Check 80� k Bo>v QjqIdlbutbn 0 -NTC or C FMA VA Cone Zonal Loan 0 Raw C3 -urUd ` l o ` INSTRUCTIONS TO LAS (CW4 0 CO Retests to (Ph. Nr Rt:MARKS. ) S1 e sic 3 O fol PIG*Up ! E6" W trot Noin •t �1, 3p / 1 O sl y Aomr 3 06% 1 Tbne of R"uer. ( dim: gPRdquilgadW TO BE COMPLETED BY COLLECTOR Op PLE 1 TO MPLETED BY LAB ANALYSIS ME*O&. + MTF MMO-MUD P -A OQi,L. SAMPLE POINT �Ij ] 1 Nt?.INON (Spodac Location) R`3'Q pH &LE f UM R COLIFORM 'TOTAL TONTAL CFE FCAL ♦ 1 Aj 8pe. �, VIA US r ea", Y� 090 © A :'r At rte. •_sAlCT�rj 0.6 014 - � 4 o A ,.'.h, tom'.-r��So� sT. ;W jo 0 A y x.x, iv. —eo o uote all 0 A us ! - • efww arse 1L -y -, r z o A Ct,.tvGcufl•8�'' pardov�►�.. 310 l 3 0 A _� g VS t - SemyD -iWsrYo poaroa 0 rq "� IT' d A g rnAanO — We SIDe 0f 9016 4 A - T•at b,v-6 VI 01 V 17 0 A 1. L a Usrrt: 1-49 Non•Oollrorrn Casoraes M • m4arate: 5V4,00 Non-t,.otKorrn Coknles C - Ol,nt Am Growth TNTC • Too Numerous To Count 2• Results in this Wumn are prellMh". Feat Coliform W" follow In 24.46 hour. 'on In conmunky #Ad rwnoommurdty water sp e= and :otsl oOfomn conflmWon on tit groes oi water tytt" wiv P - Cottorrne are Present TA - T1 rbld. AW ef" of gas of acid A• Catforms we absent NAME AND MAILING ADDRESS OF PERSONfFIAM TOIRECEIVE I WORT — INTEPPRETA,-IONSiREMARKS BY PROGRAM RECEIVER ��p ❑ 13FACT0>�Y ❑ ACTORY (G) �TjC ! t LL.... qATn OIPL,:TE COLLEaT<vH IlvFpaM�►noN 0 T SAMPLES p D V Q 0 REPWICEMENT SAMPLES �. w� 2 21q7 Co REVIEWING CFFtCIAr • , r' ..... � � 71TI �' AUG 14 195 09:12 EAST COAST LABS � 4074613162 �_- TO: � - P02 • EAST COAST LA13ORTORICS ' FOR LAB USE ONLY 1500 South 29 St., Suit 4 ewe 1 Time , quelvid ' er: Ft. Pierce, FL 34847-6 45 DHRS I.D. #86257 Phone: (W) 4071461-3162 $ (� (H) 407/464-9713 One r Tlnw aseuth P >Rd / ey: r DRINKING WATER BACTERIOLOGICAL A (check & 5 ae 4 f 0 "rNAM (. ' SYSTEM 1.0. No Q Setter STRET A MSS P&A-) MAI VS d ju. ' couN7Y REPOISTRiCTeL�I&m*m8m CITY *r !hp SYST:M PmO E No • COLLECTO" NAMF r ri/ ,1 m ir.-- I I Co=cT131; PHONE Nrl flat - 3116 DATg AND TIME 00"Am,11 �g 13 •- 1 � Ly TYPE OF SUPPLY (Clyde one): rrtr»urdty castor syitent naommuft water ty m I Nontraniisnt - nono0 water iritenl Prlvats well Other (4R �., Other public water "em TYPE OF SAMPLE (Clyd* on*): Comolmoe AWa R ecsmom Main dNvencs well irrvsy Other u�, Thu Q�"t�tr! b ( ��Q noon O -NTC or C Fru► VA Con" atonal Low+ O Raw O -u,ad INSTRUCTIONS TO LAB (GheclQ REMARKS: O CW Results to (Ph. No ) rr-iv-r-- 7- lI fa O Kotd 1br Pldc-Up Access- _ O Fox to: (Fax No ) Dote / TITe of Rsqutot O AW to• R"uodgd by I _ TO BE COMPLETED BY COLLECTOR OFAMPLE TO MPLETEO BY LAB ANALYSIS METTOD: (. � MTF MM0-JAVO P-A COLL.SAMPLE POINT D .,,I j No. (SPeallc Location) Rr90 PN NON CONFIRM CONFIRM SAIY�PLrr NUM�EA L�LIFORM "TOTAL TOTAL. GAL It t+UAs tJ - US - s.s►p an. i. Q$Q� 4S `rIi Q A i err X ffY M F Ra oto — g 0 A ph 0 ki ! �u' To P qtr s.A•• d i4 7, s A )#6 w sjoe zpjL. V�^, ~oyrftrt• 17 j �, .. •� — x 464" a� sr, to o dw ��' � R t . t • tJgttt: 1•49 Non-Coliform CotvRtvs M • Motlerate: 501-200 Non•collrorrv► ColoMq' C = uent Growth TNTC •Too Numerous To CourR 2. Assume to this ootumn am prAWnmy. Feral cogtarrrt confln wlon M co rununtr/ and nar=mmwtltr wow syefm arid Lotaf cd tbrm Confirmitlon on all ureas of water systwa WU follow In 24-0 hours. P • Coliforms am praeent TA • T Ed, Absence of 4as or add A- Collforn►s are agent NAME AND MAILING ADDRESS OF PERSONIFIRM T0+ RECEIVE REPORT INTI PRETA'RONSIREMARKS BY PROGRAM RECEIVER //��� �.► i:O UN9 TISFACTORY Q SATIf FA=RY 113 INCOMPLETE; W ` j :O REPhATSAMPLES COLLECTION INFORMATION A 'O REPLACEMENT SAMPLES PO bbx L9, ��► aBVltwlNc oFFIcjAj COA _ l � TITt i _ 1 AUG 14 '95 09:13 EAST COAST LABS %vwra%7 1 &.MOL/rt� 1 Vn=* • 1500 South 29 St., St, e 4 Ft. Pierce, FL 34947-6945 DHRS I.D. #86267 Phone: (W) 407/461-3162 (H) 407/464.8X13 DRINKING WATER BACTERM (Ch"k ons) S'Pee Cf -L& sayer NAMt� O 9suer r wMatem ICAL A' VALYSIS 1 PS74 i 4074613162 TO: POA LAO 118E OIgLY Ws4 / Tin RogsMer 18y: P03 gp 9 fS'. 16S-0 o rb l id pate / est 1!p / 9 70v Oso /t'Inse Rseutts t�aad / 8y: IVentrltrsilsnt • norsLQ "aftlty Warr @MOM �+ ) $YBTFM t.0. Np STREET AWRESS—ijew Mei+ o CITY Sr; 845TIko 6 3z. — SYS M PHO ENO gag COLLECTOR'S NAMF &?,r . COL OIT PHONE NO o rb l id DATE AND TVAE COLLECTEp f ( 3 Z.,� �' f r -1 TYPE OF SUPPLY (Clyds one): mmuntty water system +lor=mmunity water systam 1 1 IVentrltrsilsnt • norsLQ "aftlty Warr @MOM Prlvsts we(1 Omar (600c ) TYPE OF SAMPLE (Girona one): Compliants R40P*4 Aa JaCsrnant Other PUNIC water system Main clvptrana HfeII allvay OtMr ) (Check 8010 poo Box) CttDfltr+txalon 'NTC Q a C ❑ Raw 0, .fid FNA VA Conwntionat Loan INSTRUCTIONS To LAB (Cnsclq OCIN Ras>its to (Ph. NM _ ) 0 P Wd for Pick -Up RF.MAFM: -s!O Aeon - C3 Fat m: (Fac No ) Data / 71ms of Requ at O MGH to• R"usatsd by TO BE COMPLETED BY COLLECTOR OF rPLE 1 I TO MPLETED BY LAB ANALYSISML �: MTF MMO-MUG P COLL. SAMPLE POINT I -A H0. (spaLocattop R! sv pN Z{ $A INWUM NON a COUPORM 1 CONFIRM CONFIRM 'TOTAL TOTAL PFECAL U3 I ' P. stp� of N. CtSN'I c.� (. d 24 7-Z -Dstvis OV v x I - s . s >, e ! zq L3 m koisi i, i � �' , s t oe, / o 47o {D A lit{ cowron.. hY rp — ?cM coin,". ewwT0L fro '� 1 o A IS' S t - ac�s�t� - S� c�rsi►►wL t -� ��. A 14 us I -come„ a& - los 110 D A 2-7 u S I . tuavi m&4;r. w . s`l ae 0� to .4 -sq. 0 A �US(- p.:fdaclabo s -w.&;ae dolp — 11 0 satft I 0 A I . L • LIS". 1-40 Non-Cotifofm Coson�ss M - Moosrsts: Non•CoAbrm Cvlonles Ce Vent Growth TNTC • Too Nummus To Count Z. Ruu is at this oolum aro pnli+MnW- Fecal C ftfm COnMtnaW to co wnurft end noncoMmurNty water sysalm and tOtst eolttorm Conhrtnalion an all types of water systems W11 foltow In 24.48 ton. P - Cotlbrrns ars prsasm TA • T Yb1d, ADoonce of pas or add A -Conforms are absent _NAME AND MAILING ADDRESS OF PERSOWFIRM TO RECEIVE REPORT .� INTTPRETA nONS/REMARKS BY PROGRAM RECEIVER �D�+ ,p �� S P`� P i� � ~x.31 t fj+O U TISFACTORY O SA FACTORY M+X We L L O I PLETE coLLECTION 1NFoRMAnoN O REP T SAMPLES A D Q../�! P 66)< ,O REPLACEMENT SAMPLES W n F-&.- 32-q REVtEWENG OFNGf Al• II .� TITI I II AUG 14 '95 09:13 EAST COAST LABS 4074613162 TO: PO4 1500 South 29 St., SLI to 4 Date / Tin P flown I / fir; FOR LAO USE ONLY Ft- PlOrM FL 349471- 945 bHaS 1.p, #8825) A0 AT Date! 80 up/ Br. Phone; (VV) 407/461-3162 �/J � O Li (H) 407/464-913 M / Time Assuta +two / f. DRINKING WATER sACTERIOLO ICAL ALYgIg 0/11 l b vv PeCk tin.) n�' o 8vyer NAME C4 &J. ❑ WorSYSTEM I.D. No 13 0"et STREET ADDRt $8 cOUWTY��D N vim. zw em CITY a g, l� l}DEP OISUICT 9YSTjEM PHO ce NO b V 7 COLLECTOR'S NAME --af � .�., j q b COICTGR1, P14ONE No �t � DATE AND TIME COL.LECTEr+ holq 115 q ?,.p TYPE OF SUPPLY (Circle ane): Ccrnmunlry water syattm 1 Ptivdta ws ncomtrzunEry wow system Nontranvism - tt nWrnmuntty water am Other ( 4„—� � TYPE OF SAMPLE (Girds, ons): Compliangs R ► p lc water systsra t R I0Cemant �Mdlr< cIsansece woo urvey OI?W, {saclhr? (C_ hsck�x) (C ,edc � Q-0strloution D rNTC or C FICA VA Conve ~t4orW Loan D Raw ❑ furbld (NSTRUCTIONS TO LAB (Cho*o R$MARKB: CD kD 2.— 0 Cal Ratu[:a t0 (Ph. NA) 0 Mold for Pick -Up _ '' fed" ` V .,3 C7 MaH to. -- I Dew Tlfna at'�+�' _ Requmsa ljr TO BE COMPLETED By COLLECTOR OF SAMPLE ToCOMPtETED BY LAS ANALYSIS MET! 100: r%&,11MTF MMQ-MUO P -A CALL. SAMPLE POINT �t I., go.. A(0. {SpsNSC IACaCOrsj RWS'D pH NON d CONFIRM CONFIRM SAMPLE NllM A COLIFORM *TOTAL TOTAL F CAL e.S Qlt-R.. 13 r e• n A#- us. o f o= — i A TIC, Pvwe- SP*qvMh0 M&10416 It A 3 T•a• ,r.f-j rr-+ o+N - !3 0 A +`4L 0 4 v s i all a A (a e, W% eLA4 PaWY jaymi d + y A �r !1 S 1 �4ebt�.t o u D+ a A 14 A1. L s Light 1.0 Non-Cworm Colonlss M = Modstaw: so. a Non-Coaterm (,"Alordee C 6fduent Growth TNTC s Too Numerous To Cavo Z. Atealta enthis aelt m ate pmRmk%q. Faotl C fttm Conflrtnat(on in unity and rtsncornmunity waMr sys�rllls and o� pptl(prm Dord{rntall0n an dl i►paa at �ratar systanri Mr111 follow in 2448 howl. P - Colffeems are present TA - T trbld. AbRanes at an Or acid A- ColMom ie die 4t:tenl NAME AND MAULING ADDRESS OF PERSOWFIRM TO RECEIVE REPORT IN*RETA "10NS/REMARK9 ey PRoaRAM RECEIVER ZD UN MFACTORY io �► ACTORY a 1❑ INCO PLETE COLLECTION INFORMATION L U REP T SAMPLES ;C] AEP CEMENT SAMPLES REVIEWING OFF1C,l+1 • COCO �r f f c• I _ ! � TTTI I 1 I i AUG 14 195 09:14 EAST COAST LABS 4074613162 FAST COAST L►BORATOR ES 1500 South 29 St,. Su to 4 Ft. Pierce, FL 34947-1945 DHRS 1.13. #86257 Phone: (M 407/461-3162 (H) 407/484-9T13 TO: FOR LAS U8E ONLY R.ai!r,f 41 By: �r Cats, efts 1 3; 8/0 l �� Date 1?'U t;tRGWt* Flead! Oy: DRINIONQ WATER BADTERIOL001CAL ANALYSIS /% % 1 b csv O�°tN) NAMF sPeec-Le— Ce1)s`r. o "Ier ❑ OVer STREZsTADCREBSJ� eW �� O� �' [System Cmc ft ( -T-1" COLLECTORS NAME C • �K� DATE AND TIME COLLECTW SYSTEM I.D. NO COUtu' ;p", i -AIV it QDO fEPCaSTRtCT AC . BY�M Pmo is NO & 32. —*'/& `& COLLECTOR'S PRONE NO % LL -j3 b L - TYPE OF SUPPLY (arose one): Commurti�r water eyvtsr� voncartt KAtAily want tybtartt Neetransltnt - rtanCOmrewft 1Yatet aysls�el TYPE OF SAMPLE (olds one): CarrsaaAee R*p@A cerrlsM M n dssanc I WMI s� Or (sPY) Othst pvttao weer eysw, ^ ttis (Cheek ft4 (CAadc Box} Jar�aldwwn 0 MTC or C FHA VA Carse OWN Loan D Raw O rurela iNSTgUCTlONB TO LAB T � +e (**doREMARKS:V ❑ Call Ro lte to (Ph. W -t— I , ❑ t,ole for Pick -Up S ee 2� 43 _ a fart 10: (irax No ) Acou- Daft! Tit" of A"Uw ❑mew R"U"Isd 0y I TO GE COMPLETED BY COLLECTOR OF JAMPLE ANALYSIS M TOBOMP>UEO BY LAB COLL. SAMPLE POINT -AMFr MTF MMO-MUG P -A NO. (Speoltta 1we"44M A i9v pM NUM R 1 NON COLIFORM 1 CONFIRM CONFIRM *TOTAL TOTAL FECAL ]` _ if -4SAMPPLL`E &n _. 1 /_ •% ` x `a I 91AI�1� 0.4 a "i 14 wevr-u PML*. retrr,ay Aq + 'Y O 64 O = L ~ ZL d A l� a �, +� -#"&a seg . , ,f a, -1-7 D A K .. s- 'DA�nr Ir'• IL � 0 f COO W. AA Noy-Collfwm Ootordss C - want &&Alh 1. L . LQM 1.411 NOrs-Cdltorm Colonies M . Moderate: zu" TNTC : Too Numerous To Court 2. I�fa In this lakam are pratlmltlary. Fend 4WWM C0nfttt9Mn in aee ., . , „ . ,Jnity wafer eytlWins aid aid aolttbrm aarMmotlon on all y1m of waw systema crit WOW IR 2448 haws. P - Cold w"w err pm"M TA - rabid. A evve Of Sas or add A • CdHorms we absent NAME AND MAILING ACDRBSS OF PERSONff(RM M RECEIVE REPORT INTE RPRETA VWREMARKS SK PROGRAM RECEIVER SPee(,-I.e copsr% UNW ❑ 8Ai1 $h q�Cw LL. PU C -op- ilei TITI F- ._ ! � ❑ FACTORY FACTORY � �r t! 1© INGp PLlE:TE C04LECTtaN INFORMATION o REP T SAMPLES ❑ FiEPiACEM>rNT SAMPLES REVIEWING ORFIt: �' .RUG 14 r 95 09 :15 EAST COAST LABS 4074613162 TO: P06 .—••.... %p%Wf0 ,v I aunkaV A 1 V til 1 b FOR LAB USE C LV ' 1500 South 29 St., 9U to 4 oats / Tim Aew"d ! By: Ft. Pierce, FL 34947-C 945 1 O a DHRS I.D. #8625. Wits! t3et 11P1 By: Phone! (M 407/461.3 62 1r 1 (H) 407/484-9713 I Cate / rbnt4Rswft IIReavi r ey: �! 1(' QRINKING WATER BACTERtt3LICAL ANALYSIS � f 4--o (Check onq) NAM 8Yt3T'EM LP. NC Cl tas�sr STREET ADDRESS � � t�►.3 m i�i� 4�'1� � S Cl Apw . � COV �a' �� u � DEP PIsT�itC7 04—L 1 tem cmy �. .,.. A N 8Y M PHo a N© `+' � �- I COLLECTOWS NAM. �-� r-YL(Wr.. I co Rip PMONtE No. -!#A l : 316 L DATE AND TIME COLLECTEn TYPE OF SUPPLY (Wols ttn Ct.rnm iy waterer Mt Yoncomnuncry water system NoritrsMlent - rovammunity water system Pdwo welt 0"* u Otho put4le water system cement TYPE OP SAMPLE (Ofde one): Compliance Repeat T(Ceacd Main Osaram* Well 04 Nly Other tasty} (Choc Box) stritwon 0 TNTC a C FHA VA j Cones, Monet Loan ❑ FlowI.�. furptt>I INSTRUCT1CNiS TO LAS (Cheats REMARKS: Dj I t� ;?.— f 0 Call PMft t* (Ph. W 1 s' 73 Q t- *W fOr ftk-Up ' ..+' Asper 0 rex to: (Fix NO t?Ms Mme of lt"UW 0 Maii to: Rsqussted by: TO BE COMPLETED 8Y CMACTOR OF UMPIE TO VWQMPLETED BY LA13 ANALYSIS METIKO&. (kmF A MTF MMO•MU4 P -A COLL. SAMPLE POINT �_ �- t s NO. (Sp�C LOC 1011) R ;g'D PH NON CONFIRM CONFIRM SAMPLE NUMBER} COUFORM *TOTAL TOTAL FECAL j } i� _ j , CfvW Ut I- 4ve oly floqr- I - p Ein"�-4t.. -� x �� -2,.y © Af d A 41� y • w1ft, MAv< - W - SIAS 37 0 A Wl 0 A t. L. Light: 1-49 Nen-c4ltfa rr Cmontes M » Moderate: 50-� 0 Non-CdfoM COON" C • usnt Growth TNTC • Too Numerous To Count t. Rewtls to thea cowrm+ sm V*M* ry. Faal COMM MOMSin;oLuntty and rwnwmmuntty water tly9t inis era 1 3W ap ftm coMinnadon an all "" of View "*toms wW %Now in I" hoots. P - Coliforms ase ps"M to - Turgid, Atooeno Of GO Or Add A- Catftrmt ate absent NAME AND MAIUN4 ADDRESS OF PERSONIFIRM TO RECEIVE KEPOST � INTEPRETA4ioNSIREMARKS BY PROGRAM RECF-IVF P �, >►.3 � UNSATISFACTORY :3 SATi8 FACTORY INFORMATION INCO PLETE COLLECTION T SAMPLES =REP MfiNT SAMPLES c4 coo6r Ru., REVIEWING OFFICI t _... TITI Lawton Chiles Governor Department of Environmental Protection Central District 3319 Maguire Boulevard, Suite 232 Virginia B. Wetherell Orlando, Florida 32803-3767 Secretary August 18, 1995 City of Sebastian Post Office Box 127 AUG' 1595 Sebastian, FL 32958 C/c1C. Attention: Joel Koford, City Manager O%,aeeq Indian River County - PW Indian River County - South R/O Plant Sebastian East of U.S. 1 (0.1475 MGD1 Dear Mr. Koford: This acknowledges receipt of certification that the subject water distribution system extension has been completed in accordance with the plans and related materials permitted by this agency on Permit Number WD31-264072 dated February 13, 1995 and that the system has passed the pressure and bacteriological tests that were conducted in accordance with the AWWA standards. Based on this certification and satisfactory bacteriological results, we are clearing the system for service. The responsibility for the microbiological quality of the water at the time it ultimately reaches the consumer's meter remains entirely with the utility and/or the owner/operator of the system who should ensure that this quality remains as was represented by the bacteriological test results presented. This letter of clearance does not preclude the need for obtaining acceptance by other entities as may be required. Sincerely, Frl Huttner Section Supervisor Drinking Water Permitting FPH:Oi:pp 1 cc: Stephen E. Moler, P.E. Robert O. Wisemen, P.E., Environmental Engineer "Protect, Conserve and Manage Florida's Environment and Natural Resources" Printed an regded Paper. H CITY OF SEBASTIAN •SEBASTIAN, FLORIDA CHECK NUMBER 015P06 DATE (11/06/95VENDOR FI I -TF T IiA nFFARTM17 wr nF VOUCHER NO. VOUCHER DATE INVOICE NO. DESCRIPTION _iblUilh��� 05901062 01/05/95 CHECK FED 431•-60•-533-340 900.00 Please Detach Here Md Retain Top Potion For Your Records CITY OF SEBASTIAN SEBASTIAN, FLORIDA CONSOLIDATED ACCOUNT gi500. 0C) ) Itvnwv R1vER NATIONAL BANK 63-1206,670 015206 S.0SaWslian Office BRUNCH 004 ^ L 816 U.S. 01 SebasBan, FL 32958 DATE 01/o6/95 AMOUNT $500.00 VOID IF NOT PAID WITHIN 90 DAYS 1FiHiI iH iH 'aHar BH�t+1'1t'1<'iI Wil-�i '>fa'1t it'�I'�1'�t'*1t'�t>fel'�1'il' '�t'�t'a'a1'a'�t'11' '* '�t'* 'FIVE HUNDRED DOLLARS AND 00 CENTS PAY FLORIDA DEPARTMENT OF TOTHE ENVIRONMENTAL PROTECTION ORDER OF 3319 MAGUIRE BLVD. ORLANDO, FL 32803-3767 "015206iie I:DE70L20571: i i TWDAIGNATURES NEEBED ONLT OVER $500.00 l 0 L 7 7888911'0 2 City of Sebastian 1225 MAIN STREET 0 SEBASTIAN, FLORIDA 32958 TELEPHONE (407) 589-5330 o FAX (407) 589-5570 MEMORANDUM DATE: January 5, 1995 TO: Marilyn Swichkow,CPA, Director of Finance FROM: Joel L. Koford, City Manager �K—�2 �b SUBJECT: US #1 Riverside Drive Water Line Please issue a check in the amount of $500.00, made payable to Florida Department of Environmental Protection for the U.S. Highway #1/Riverside Drive Water Main Project permit fee. 533-3q0 This purchase should be charged to Contractual Services, Account #431-6053j> 0T-" Please return check to my office for mailing. Thank you. /jmt �So 6 ry, ( -i- -- b �✓�L' ((- City of Sebastian 1225 MAIN STREET o SEBASTIAN, FLORIDA 32958 TELEPHONE (407) 589-5330 o FAX (407) 589-5570 MEMORANDUM DATE: January 5, 1995 TO: Marilyn Swichkow,CPA, Director of Finance FROM: Joel L. Koford, City Manager SUBJECT: US #I Riverside Drive Water Line Please issue a check in the amount of $500.00, made payable to Florida Department of Environmental Protection for the U.S. Highway #I/Riverside Drive Water Main Project permit fee. This purchase should be charged to Contractual Services, Account #431-60536-3409. Please return check to my office for mailing. Thank you. /jmt i UA f rets VYA UJVX� MASTELLER & MOLER, INC. M - CONSULTING ENGINEERS - December 30, 1994 Mr. Joel Koford City of Sebastian P.O. Box 127 Sebastian, FL 32958 RE: City of Sebastian Water Main US Highway #1/Riverside Drive Dear Mr. Koford: Enclosed for your review and signature are five (5) FDEP permit applications and five (5) FDOT permit applications for the referenced project. Please sign four (4) copies of each and return to our office along with the FDEP permit fee in the amount of $500.00 payable to the Florida Department of Environmental Protection. Also, we have enclosed two (2) sets of preliminary plans your review and comment. Please do not hesitate to contact our office should you any questions regarding the project. MD/vk Enclosures File #9459LA (jkl23094) 1623 N. U.S. Highway 1 Sebastian, FL 32958 (407) 589-4800 (407) 589-2742 Fax Respectfully, MASTELLER & MOLER, INC. Michael De an y Project Manager Suite B2 O 7380 Murrell Road, Suite 106 Melbourne, Florida 32940 (407) 255-1175 (407) 253-4439 Fax DEP Form No.: 62-SS5.910111 Department of Form Title: Aop4cation for a Public Drinkino Water �� � ; • � Facility Construction Permit Etfactive Date: V~ t E n v i r o n m e n t s r o t e ct i o n DEP Apotication No.: FLORA ; (Filled in by DEPT Application for. a Public Drinking Nater Facility 'Construction Permit INSTRUCTIONS: This form shall be completed and submitted by persons proposing to construct new, or after existing, public drinking water facilities unless such proposed construction or alteration is permitted under the "General Permit for Construction of an Extension to a Public Drinking Water Distribution System," in which case Form 62.555.910(7) is to be completed and submitted. -Complete this form and submit it in quadruplicate to the appropriate district office of the Department or the appropriate Approved County Public Health Unit (ACPHU) along with a check for the proper application processing fee and the following supporting documents: a signed and sealed engineering report (including design data); signed and sealed engineering plans and specifications; a certificate that the project has been approved by the governing body of the applicant {city commissioners, corporation, board, etc.); and, for each project involving the construction of a new drinking water treatment plant in a county regulated by the Florida Public Service Commission (PSC), a copy of the PSC certificate authorizing the applicant to provide service or a copy of the PSC order exempting the applicant from PSC regulation. (Section 367.031, Florida Statutes, requires that a utility obtain a certificate of authorization or an exemption order from the PSC prior to being issued a permit by the Department for the construction of a new water facrifity.) All supporting documents, as well as - _ this form, shall be submitted in quadruplicate. All information provided on this form shall be typed or printed in ink. Complete Parts 1, 11, IV, V, and VLA of this form for all projects, and complete Parts III and VI.B through VLE of this form when applicable. A signature page or cover letter for engineering reports, each sheet of engineering plans, and a cover or index sheet for engineering specifications shall be signed, dated, and sealed with an impression•type metal seal by the professional engineer(s) in responsible charge of the documents. Also, engineering plans and specifications shall be those intended for construction and shall not be stamped otherwise (e.g., "For Permitting Only," "For Review Only," etc.). Application processing fees are listed in Rule 62.4.050, Florida Administrative Code. Checks for application processing fees shall be made payable to the Department of Environmental Protection or to the appropriate ACPHU. NOTE THAT A SEPARATE APPLICATION AND A SEPARATE PROCESSING FEE ARE REQUIRED FOR EACH NON-CONTIGUOUS PUBLIC DRINKING WATER DISTRIBUTION SYSTEM PROJECT. •' I. NAME, DESCRIPTION, AND LOCATION OF PROJECT; APPLICANT; ETC. *Project Name: Citv of Sebastian, US Highwav #I/Indian River Drive *project Description: Potable Water Distribution System to serve all units east of US #I within City of Sebastian City Limits aProiect Location 30 Fleming Grant County: Indian River ; Section: 6 & 7 ; Township: 31S ; Range: 39E Latitude and Longitude of Each New Treatment Plant and Each New Raw Water Source (attach additional sheets if necessary): ::Name af:blew::3reatment-Plant.::orRaw:iNater;:Soucce::`: :Latitude •::: `::::::::.::: . ;ton itvde `: a. «N o "W N/A O " N " W o «N o - "W 0 Aoolicant Utility/Company Name: City of Sebastian Utilities Department Address: P.O. BOx 1 ? 7 City: RFsbas t i an *Public Water Svstem SuooiYino Water for Proiect (complete for distribution system projects) System Name:Smith Tndi_an River County R/O Plant' System Owner: Tndi an Rivpr roitnty_ITt-i 1 i r P Address: P n . Rnv 171;n City: Xhzrn Rpgrh Page 1 of 12 Telephone No.: (407) 589-5330 State: _ FT, Zip Code; 32958 PWS Identification No.: Mn f i t Telephone No.: (407) 77n -5:i11 State: FT" Zip Code: *117Q0;n Application for a Public Drinking Water Facility Construction Permit DEP Form No.: 62.555.91001 Project Name: „city of Sebastian, US Highway #1/Indian River Drive Form Title: Apolicationfor aPublic 0rinkinoWater Facility construction Permit Applicant: C i tv of Sebastian Effective: Date: DEP Apatication No.: (Riled in by DEPT -+OwnerlOperator of Proiect After It is Placed into Service. UtilitylCompany Name: fid; t,,, R;,r4.. irr,,,ntir Ut; l ; t; PS nggg . Telephone No: (4O7) 770-5323 Address: 184n 75th Streaf City: Vern 1RP,Prh State: _ET. Zip Code: 1?g6o *Professional Engineer in Responsible Charge of DesioninQ Proiect Name of Engineer:�i,.Ma0-P11Pro 1L Telephone No: (407) 58q-4800Firm Name: Mastal i Pr & Mal Pr . Tnr• Address: 1 h?"1 N TTS #1 giii tP R-7 City: CQha c t- ; ,an State: FT, Zip Code: 17958 11. STATEMENT BY APPLICANT 1, the undersigned owner or authorized representative' of City of Srebas t ian , certify that all components that will be installed under this project and that will come into contact with drinking water or drinking water treatment chemicals (except components that will come -into contact with raw water prior to its treatment by reverse osmosis) conform, or will conform, with American National Standards Institute (ANSI)1NSF International (NSF) Standard 61. Also, I certify that all drinking water treatment chemicals that will be supplied under this project except fluoridation chemicals conform, or will conform, with ANSIINSF Standard 60 and that all fluoridation chemicals that will be supplied under this project conform, or will conform, with ANSI and American Water Works Association Standard 8701, 8702, or 8703 as applicable. I agree that we will require the contractor to furnish us with record drawings for this project. Also, I agree that we will, retain a professional engineer registered in Florida to inspect construction of this project for the purpose of determining if work proceeds in compliance with the construction permit and approved engineering plans and specifications. I am fully aware that we must obtain a letter of clearance from the Department before we place this project into service for any purpose other than testing for leaks or testing equipment operation. Also, I am fully aware that, if we sell or legally transfer ownership of this project before obtaining a letter of clearance from the Department, we must submit to the Department an "Application for Transfer of a Public Water System Construction Permit" within 30 days after such sale or legal transfer of ownership. ature and Date f Attach a letter of authorization. Joel Koford, City Manager Name and Title (please type or print) 111. STATEMENT BY PUBLIC WATER SYSTEM SUPPLYING WATER FOR PROJECT (complete for distribution system projects) 1, the undersigned owner or authorized representative` of Indian River County Utility Dept certify that we will provide the potable water supply required by this project. As indicated below, the water treatment plant to which this project will be connected has the capacity to provide the potable water supply required by this project, and I certify—that said plant is 4n compliance with the standards and criteria set forth in Chapters 62-550, 62551, 62.555, and 62.560, Florida Administrative Code (F.A.C.). Also, said plant was constructed under one or more valid Department construction permits as indicated below, and I certify that connection of this project to said plant will not be a violation of any condition of this(these) construction permit(s). 0Name of Water Treatment Plant to Which this Project Will Be Connected: South Indian River County R/0 Plant *Construction Permit Number(s) for Plant: On File Date(s) Permit(s) Issued: On File o Permitted Maximum Day Capacity of Plant: • Maximum Day Flow at Plant as Recorded on Monthly Operating Reports During Past 12 Months: Furthermore, if this project involves construction of a new, or alteration of an existing, "regulated" consecutive public water system' that only sells water and that does not have any treatment facilities, I agree to the following: Page 2 of 12 eApplicition for a Public Drinking Water Facility Construction Permit DEP Focm Na.: 62-555-91011) Project Name: city of Sebastian, US Highway #1/Indian River Drive Form Title: ADolication for a Put9ic Drinkirw Water Facility Construction Permit e Applicant: --rDEP DEP AEflectivoDate: olication Na.: {Piked in oy DEP) EX we will consider said consecutive system as part of our system for the purpose of the microbiological and chlorine residual monitoring required by Chapter 62.550, F.A.C., and if applicable, the asbestos, total t6halomethane, and lead and copper monitoring required by Chapters 62.550 and 62.551, F.A.C. o we will not consider said consecutive system as part of our system for monitoring purposes. (In this case, the consecutive system shall be responsible for conducting monitoring in accordance with Rule 62-550.540, F.A.C-) - Robert 0. Wisemen, P.E.) Environmental Signature and Date Name and Title. (please type or print) Engineer Attach a letter of authorization. A consecutive public water system is a water system that provides piped water to the pubric for human consumption; that has at least 15 service connections or regularly serves at least 25 indi*vidvals di#y at least 60 days out of the year; and that receives all of its water from, but is not owned or operated by, another public water system. A consecutive system is lregulatedff4f it meets one or more of the following criteria: (al it has collection or treatment facilities; IN it se//s water; or Icl it is a carrier that conveys passengers in interstate commerce. IV. STATEMENT BY OWNERIOPERATOR OF PROJECT AFTER IT IS PLACED INTO SERVICE 1, the undersigned owner or authorized representative* of Indian River County utilities Deptdertify that we Will be the ownerloperator of this project after it is placed into service. I agree that we Will operate and maintain this project in a manner that will comply with Chapters 62.550, 62.551, 62-555, 62.560, and 62-699, Florida Administrative Code; and I certify that all drinking water treatment chemicals that we will use except fluoridation chemicals conform, or will conform with American National Standards Institute (ANSI)INSF International Standard 60 and that all fluoridation chemicals that we w * ill use conform, or will conform, with ANSI and American Water Works Association Standard B701, B702, or 8703 as applicable. Also, I agree that we will promptly notify the Department if we sell or legally transfer ownership of this project. Signature and Date * Attach a letter of authorization. Robert 0. Wisemen, P.E., Environmental Name and Title (please type or print) Engineer V. STATEMENT BY PROFESSIONAL ENGINEER IN RESPONSIBLE CHARGE OF DESIGNING PROJECT 1, the undersigned professional engineer registered in Florida, certify that I am in responsible charge of the preparation and production of engineering documents for this project; that I have expertise in environmentallsanitary engineering; and that, to the best of my knowledge and belief, the engineering design for this project complies with Chapter 62.555, Florida Administrative Code (F.A.C.), and provides reasonable assurance of compliance with Chapters 62.550 and 62-551, F.A.C. The plans and specifications for this project require that all new and relocated project components that will come into contact with drinking water or 'drinking water' treatment chernicalsi (except components that will come into contact with raw water prior to its treatment by reverse osmosis) be in conformance with American National Standards Institute (ANSI)INSF International (NSF) Standard 61. Also, the plans and specifications for this project require that all drinking water treatment chemicals supplied under this project except fluoridation chemicals be in conformance with ANSIINSF Standard 60 and that all fluoridation chemicals supplied under this project be in conformance with ANSI and American Water Works Association Standard 8701, B702, or B703 as applicable. Signature, Date, and Seal Page 3 of 12 Earl H. Masteller, P.E. FL #26658 Name and License Number (please type or print) I Application for a Public Drinking Water Facility Construction Permit O*EP Form No.: 62-555.910(11 Project Nam: ni t ,f Form Title: Apoftation for a Public Otinkino Water Facili-v Construction US HighWey #i� I.LdiCILL RivuL bLive Effective Oslo: Permit Applicant: X e4—E z b as vi e r. OEP Applicatton No.: (Filled in by OEPI VI. SUMMARY OF DESIGN DATA FOR PROJECT A.- General System _PWS Identification Number, Name, Owner, and Type. 1 System PWS Identification Number (if existing system): On File 3314092 2. System Name: Tndian Rivpr roiinry R/O Plani' 3. System Owner. Indian River County. Utilities Department 4. System Type: IX community; 0 non -transient noncommunity; 0 non -community; - C3 consecutive System'Service Area, 5. Nature and Extent of Existing Service Area and Design/Projected Service Area: 6. Number of Existing Service Connections: 20,753 7. Existing Significant Industrial Water Users (industries with an average or maximum daily water demand that is > 1% of the total average or maximum daily water demand an tki system) (attach additional sheets if necessary): N/A .... . ...... . eman 'D . . ... .......... r .... .... ........ a ... . . te. ... .. .. .... .. ......... ..... .. ..... :a._i .. .. _ .. .. ....... ......... . .................. . ........ . ... . :.:.:..:..Nara. ..... ....... Xtimm .... ......... . .... .... . .......... .... . . . ..... . . ... .. •:..: . Ma . .... ... ............ . Ver E ... ............. . ..... . .. ..... ......... . . ... ....... .. .. . ....... ....... . .. . . . ... . ..... 0 8. Regulated Consecutive Public Water Systems Presently Connected to this System (attach additional sheets if necessary): N/A int'iih ':I*"**' :._Any.14stihq��S em" T t .... ... . . .. .... ... ... . .. If YES, PROVIDE ON AN A rTA CHMEN T THE NAMES Of THE USERS AND THEIR PRESENT A VERA GE AND MAXIMUM DAIL r WA TER DEMANDS Present Population Served by System and Present Water Demand 9. Present Population Served Directly (excluding all regulated consecutive public water systems): 56,970 10. Present Total Population Served (including all consecutive public water systems): RA 0-7n 11. Present Annual Average Day Water Demand: 3.15 MGD 12. Present Per Capita Annual Average Day Water Demand: 55 GPD 13. Present Maximum Day Water Demand: 9. 1 A Mr.1) 14. Present Maximum Hour Water Demand: 5.14 MGD Page 4 of 12 -Application for a Public Drinking Water Facility Construction Permit DEP Form No.: 62-555.910(1) Project Name: City of Sebastian, US Highway #1/Indian River Drive ForrnTitle: Aoaication for a Public Drinking Water Applicant: City of SEbas t ian Facility Construction Pen -nit Effective oats: DEP Application No.: (Filled In by DEP1 Design Population and Water Demand for System 15. Design Year and Estimated Total Population to Be Served in Design Year: N/A 16. Projected Annual Average Day Water Demand in Design Year and Basis of Projection: N/A 17. Projected Maximum Day Water Demand in Design Year and Basis of Projection: N/A 18. Projected Maximum Hour Water Demand in Design Year and Basis of Projection: N/A 19. Design Fire Demand (flow rate and duration) and Basis of Design: 2,500 GPM for 3 Hour Basis of design is from I.S.O. Regulations for commercial facilities System Raw Water Sources and Collection Facilities N/A 20. Existing Ground Water Sources and Wells (attach additional sheets if necessary): .•n??:��i::$n:4:. :r}r...'riri�Y�{}•..,..: .1. .L ..Y. SELL. . ..L .••!: ti{r r.-{{�v{• :ntaiCapaci ::o%:otal::Ca acii.:�f-:fxisfio .::.:.:..:...::. .....:: hlame me.:af.:Tseatment :.PJant:::5 Iced.:::. •:;.. ::... L ..:... ::::..:::::: . .. . L... . ::: ::.::.:;-}:: ? :L. .. .. :.....xrstrn :.... Ezisti : :e- :; :.::::.:::.::::::... ::::::.:..:::•: •.:•: •:::.:i? .... II Q :fiA alis >1fYfieii Car,{j}est:UYell. •�•....::•::!•::::::::..1}Y.:Y'ti.,y. ..L.•.L L•.Yf•.. .L• •.. .L:i•Y ..j•}.. ......?....:.V:::ti• V••� :N. lflfater:•1s.Wit drawn.: :::....:.....:::..: •L ::.:......: .. ......... .. . ...........L ........:.....:........:,...:....::.:.::....::.L...:..::..::::::... �tls........1lNells:rn'�Sernce)� Dit�ofSe�in..e������=. 21. Existing Surface Water Sources and Raw Surface Water Pumps (attach additional sheets if necessary): ::........:...:.....:: •::. :... - ... Capacityofzistin9 �Number�:�of:r 7ota1 :.:. :.. •: :..::..:.. _:.} :>;lame;nf :Surface:.Water..#rom:Which :R�w.::! : ':.::: • :.:. `Name sof ;Treatment P1ant`.Suppl�ed -: : : E dstmg ;Pumps ;Wnen..: -argent`':. : ... ......Water:::ls::.Withdtawn:�:�:�:: ;-. :::,.:.<......:. .::..: Pup p s c :.:......-. m s ; .:Pum l `Otitiif Secvi e 22. Existing Purchased Water Sources (attach additional sheets if necessary): "Name:;bf-* iimarV <Water System: SupplyingWatet 23. Will existing raw water sources and collection facilities (including raw water pumping facilities) be altered under this project, or are new raw water sources or collection facilities (including raw water pumping facilities) proposed under this 'project? IF YES, COMPLETE PART VLB BELOW. Page 5 of 12 Application for a Public Drinking Water Facility Construction Permit DEP For, No.: 62•SSS.91001 Project Name: City of Sebastian _ ITS Highway #1 /Indian River Drive For T'tle: Acolication for a Punic Drinkino Water Facility Construction Permit Applicant: � t y o f $ eb a s t: i. � n EHactiye Date: DEP Application No.: (Filled in by DEP) Svstem Treatment Facilities N/A 24. Existing Treatment Plants (attach additional sheets if necessary): Ustin .Perms :. u >:>.D� onen Tha •:::.: _:= =::: .8. tted £x)strn . Max(m t .. t .... 9.. :dr t + : '.a:>: Ne ' =.`' : ' M m : Da' :Hoin:: a :<limitsti:fx sri :. X1:, in' . T.. f:...� n t am azim Iva cit st e' :� at n Ta tt Pla anti .Y�: p� Y .9� �����: � .9 yp.. 4 aci�• o 'Plant- PaCa: is f f ! n :Plan act :a i?jan }> t - P tY. P. Y . Provide this only if increased treatment capacity is provided in lieu of sufficient storage capacity to meet peak water demands 25. Will existing treatment facilities (including in -plant and finished water pumping facilities) be altered under this project, or are new treatment facilities (including in -plant and finished water pumping facilities) proposed under this project? IF YES, COMPLETE PART VI.0 BELOW. Svstem Finished Water Storage Facilities N/A 26. Existing Plant and Distribution System Finished Water Storage Facilities (attach additional sheets if necessary): •: !.: •• h•�:•:::•f/•......J...•.............:!!.:.•:�:f �::!:':til:::-: �!:.t �.-:V:•%: .....: .•.•h•.•.:•. e:of::iora eFar.Rtt . clearw�Izistiri if srful:: ::.>::....::::.::::::::!::::::.::•.::.:: :Paul . ;< e o •:... :.Stora a tt filam tsitr :h dro neumat c`tarik �r;uniileiel>: :boli#mea Sty a i' ..Y: r Evi.:...sand -elevated se d`t.iamto n k; 7i 27. Will existing plant or distribution system finished water storage facilities be altered under this project, or are new plant or distribution system finished water storage facilities proposed under this project? IF YES, COMPLETE PART VI.D BELOW. Svstem Distribution Facilities N/A 28. Will existing distribution facilities including booster pumping facilities) be altered or extended under this project, or are new distribution facilities (including booster pumping facilities) proposed under this project? IF YES, COMPLETE PART VI.E BELOW. Interconnections with Other Public Water Svstems that Have Seoarate Water Suoolv Sources N/A 29. Natr%s of Existing'lntetconnected Public Water Systems and Purpose 'of Each 'Existing Interconnection: B. Proposed Altered/New Raw Water Sources and Collection Facilities (including raw water pumping facilities) N/A Ground Water Sources 1. Name of Treatment Plant to Be Supplied with Raw Water from Proposed AlteredlNew Wells: 2. • Name of Aquifer from Which Raw Water Will Be Withdrawn by Proposed Altered/New Wells: Page 6 of 12 Application for a Public Drinking Water Facility Construction Permit DEP Form No.: 62•s55.91001 Project Name: Citv of Sebastian, US Hiehwav #I/Indian River Drive For-rrtle: Apolication for a Public Drinking Water Applicant: City of Sebastian Effective Date: Facility Construction Permit DEP Application No.: (Filled in by DEPi 3. Existing and Proposed AlteredlNew Wells Supplying Raw Water to the Treatment Plant Named in Part VI.B.1 Above (attach additional sheets if necessary): eti ezi ing .`����:<�_= st lev� a II �1?um air � f ::....:. :::. ,:::..:... .. n .,. ...... ::... •:. :.: .:: ;:: .: .,<_:::=<:�::.:;:;Prng:> �� *pe::bf1Natl:: - apa ..:tY:....: :�;:�iVe(I.ILocat�onlNamelf�fumber..:,::�.; t .7op::of: .. :.•..:•.. •::::: :. altersd;;::or �:...;: ;::;: •-: Water.::eve1..:.-<7ota1 D namrc r .g> rd ' i w o e' e o' d: I Total Capacity of Existing and Proposed Altered/New Wells (all wells in service): Total Capacity of Existing and Proposed AlteredlNew Wells When Largest Well Is Out of Service: Provide this only for proposed aMered/new wells ' ATTACK. PUMP AND SYSTEM HEAD CURYES FOR PROPOSED ALTERED/NEW WELLS 4. Water Management District Construction Permit Numbers) (if appricable) for Proposed AlteredlNew Well(s): i Date(s) Permits) Issued: 5. ATTACH A COPY OF THE LOG COMPLETION REPORT (if applicable) FOR EACH PROPOSED ALTEREDINEW WELL. B. ATTACH A MAP OF THE AREA WITHIN 500 FEET OF EACH PROPOSED ALTEREDINEW WELL INDICATING SANITARY HAZARDS. 7. ATTACH RESULTS OF LABORATORY ANALYSES OF RAW WATER FROM PROPOSED ALTEREDINEW WELLS (analyses shall be conducted for each applicable water quality standard in Part III of Chapter 62.550, Florida Administrative Code). 8. Standby Power Source for Well Pumps: Well Pumps Connected, or Proposed to Be Connected, to Standby Power: 9. 100 -Year, or Highest Known, Flood Elevation in Area of Wells: Surface Water Sources N/A 10. Name of Treatment Plant to Be Supplied with Raw Water from Proposed AlteredlNew Facilities: 11. Name of Surface Water from Which -Raw Water• -Will -Be -Withdrawn ty Proposed Altered/New Facilities: 12. Estimated Dry -Weather Flow at Surface Water Intake and Basis of Estimate: 13. Description of Existing and Proposed AlteredlNew Diverting Dams, Impounding Reservoirs, Intake Structures, and/or Infiltration Galleries (attach additional sheets if necessary): 14. FOR A PROPOSED NEW OR RELOCATED SURFACE WATER INTAKE, ATTACH A DESCRIPTION AND MAP OF THE WATERSHED AREA ABOVE THE INTAKE INDICATING SANITARY HAZARDS. . 15. ATTACH RESULTS OF LABORATORY ANALYSES OF RAW WATER FROM NEW SURFACE WATER SOURCES (analyses shall be conducted for each applicable water quality standard in Part III of Chapter 62.550, Florida Administrative Code). Page 7 of 12 Application for a Public Drinking Water Facility Construction Permit DEP Form No.: 62-555.91011) Project Name: City of Sebastain, US Highway #1/Indian River Drive Form Title: Aooltcarionfor aPublic DrinkinoWater Applicant: U l t y or Sebastian Effective Data: Facility construction Permit DEP Application No.: (Filled in by DEP) 16. Existing and Proposed Altered/New Raw Surface Water Pumps for the Treatment Plant Named in Part VI.B.9 Above (attach additional sheets if necessary): '� ` Pi •:: �::'�laniels apacity: andfiotalDynarn(c:: Total Capacity of Existing and Proposed Altered/New Pumps When Largest Pump Is Out of Service: ' A TTACH PUMP AND SYSTEM HEAD CURVES FOR PROPOSED AL TERED/NEW PUMPS 17. Standby Power Source for Raw Surface Water Pumps: Raw Surface Water Pumps Connected, or Proposed to Be Connected, to Standby Power. 18. 100 -Year, or Highest Known, Flood Elevation in Area of Intake: C. Proposed Altered/New Treatment Facilities (including in -plant and finished water pumping facilities) N/A� 1. Name of Proposed AlteredlNew Treatment Plant: 2. Previous Construction Permit Number(s) for Plant: ; Date(s) Permit(s) Issued: 3. Design/Projected Annual Average Day Water Demand for Plant and Basis of Design/Projection: 4. Design/Projected Maximum Day Water Demand for Plant and Basis of Design/Projection: 5. DesignlProjected Maximum Hour Water Demand and DesignlProjected Fire Demand Plus Coincident Draft for Plant and Basis of Design/Projections (provide this only if increased treatment capacity will be provided in lieu of sufficient finished water storage volume to meet peak water demands): 6. Design Daily Operating Period for Plant: Design Daily Operating Period for Finished Water Pumping Facilities: 7. Design Peak Sustained Operating Flow Through Plant: 8. ATTACH RESULTS OF LABORATORY ANALYSES OF RAW WATER FOR THE PLANT (analyses shall be conducted for each applicable water quality standard in Part III of Chapter 62.550, Florida Administrative Code). 9. ATTACH A FLOW DIAGRAM SHOWING ALL EXISTING AND PROPOSED ALTEREDINEW TREATMENT PROCESSES (including waste handling processes), CHEMICAL APPLICATION POINTS, PUMPING FACILITIES, AND TREATMENT BYPASS ARRANGEMENTS FOR THE PLANT. 10. ATTACH A SUMMARY OF DESIGN CRITERIA FOR EACH EXISTING OR PROPOSED ALTEREDINEW TREATMENT PROCESS Finciuding waste handling processes) AND FOR EACH EXISTING OR PROPOSED ALTEREDINEW CHEMICAL TO BE APPLIED AT THE PLANT (design criteria should include basin capacities, retention times, unit loadings, surface loading rates, backwash rates, feeder capacities and ranges, etc.). Page 8 of 12 Applit;ation for a Public Drinking Water Facility Construction Permit DEP Form No.: 62.555.91001 Project Name: City of Sebastian, US Highway #I /Indian River Drive Form Title: Application for a Public Drinkino water Applicant: City o f Sebastian Facility Construction Permit PP Effective Onto: DEP Application No.: IF"�iletf in by DEP) 11. Existing and Proposed AlteredlNew In -Plant and Finished Water Pumps (attach additional sheets if necessary): Pump Function/Flow Stream Pumped: .P u' ;Pu :Name( INumber(s '::`::: ed :��.:�.::;•;:�•:::..:::.:,ajiecit ':aridTpfat:a:ynari�c-: VMP::.:.:'.::.:: l::::. ....... :....�:.: :.:::: ro osed:altered,:: r ro osed:inew� :......, :.:..:1P:.......... p..P...... ... :}iead:for.:Fadi.:P Total Capacity of Existing and Proposed Altered/New Pumps When Largest Pump Is Out of Service: ATTACH PUMP AND SYSTEM HEAD CURVES FOR PROPOSED AL TERED/NEW PUMPS Pump Function/Flow Stream Pumped: ::alters ::..:...mP....:..:. 9:.. ..:..:... _ :Ca acit...:an�Tota10.`nairgc< Pu Naiiis)INumberls .:::; .:•.: :.... :YP . ed.a e . ... It red -ur ro ose.... . .. .... ....... ................... .. ,new .,,:.:.,• ..:.::.:..;.:,::.:;:::..::.,. ......; .. , .. ; ... .... P ....... ... •- - . P .... li d <#or:>E chPump I Total Capacity of Existing and Proposed Altered/New Pumps When Largest Pump Is Out of Service: A TTACH PUMP AND SYSTEM HEAD CURVES FOR PROPOSED AL TERED/NEW PUMPS. Pump Function/Flow Stream Pumped: :: : Ptr :.Status. exp an to be.a st .not /tare :..;: :: .... ,.:...:. - ...... :..::::::.::::C•a aci :::arid " ota �� 'aria ....,.::.::...:..:.::..:. -P Pu::.:..:::::::•.::..::.::.:::..::Y. <.::::.:.:::: ::Name Number: s ... .... . ... ro sed altered .�r r ...:.......:....:::.�..:..:.:::::..::::.::::..:.:.::.:.......P.. >ro ........ . ,.:..::.P... P. or:.,ac Total Capacity of Existing and Proposed Altered/New Pumps When Largest Pump Is Out of Service: A TTACH PUMP AND SYSTEM HEAD CURVES FOR PROPOSED AL TERM/NEW PUMPS 12. Method of Disposal of Plant Wastes (Aluminumllron Coagulant or Lime Softening Sludge from Clarification, Waste Backwash Water from Filtration, and/or Waste Brine from Ion Exchange or Membrane Processes): 13. Standby Power Source for Plant: - •.. Plant Equipment Connected, or Proposed to Be Connected, to Standby Power: 14. 100 -Year, or Highest Known, Flood Elevation in Area of Plant: Page 9 of 12 Application for a Public Drinking Water Facility Construction Permit DEP Form No.: 62-555.91001 Project Name: Form Title: Application for a Public Drinkino Water j C�t;T.taf Sebastian,-1TC Ai�l•�wav �itl /Tnrlian Ai�rar Tlriue FscilitvconstructionParmit Applicant: ; f. , e%f Cra}, a f- i n 4' g Effective Date: DEP Application No.: (Filled In by DEPI D. Proposed Altered/New Plant and Distribution System Finished Water Storage Facilities N/A 1. Existing and Proposed Altered/New Plant and Distribution System Finished Water Storage Facilities (attach additional sheets if necessary): - ef: o S a e a 'li Ty p . .9 :F G �:��at�:a:�•`�x sti�: fro iieumatic ^Gross: volume ::of ::: .. ....:..::::......::.::....,,...::.:..,:::..;::.::::..;.....:...:.::..Y..:., P..-.:� .. �.:.::�::� � :.::.::..�.. .. Useful:Volume::.of:> :S toragefictltty:aUamelLocat�on . be:•alteredj,::proposed :.:..: .. , ::.- :. tank;`ground-level;iesenroir'' ::Stora a Faclllt :::Stora e:f..acilit ....::,.:.� ::.....-::,....,..:.. �Iterad,�or. •r.� osed>:newi. e,lev ated jank .sterid -'i' P.. . y - I o E. Proposed Altered/New Distribution Facilities (including booster pumping facilities) Distribution Facilities 1. Design/Projected Annual Average and Maximum Day Water Demands for Proposed AlteredlNew Distribution Facilities (i.e., water mains) Under this Project: ............:::::::::::. . t -Total:Aveia � e".: ............. :...::: ,,.:13:.::::Number., .0 .. .... .....:.... . •I:> ... ...... ............. - : ...:.: ;;.:::::.A: •:-.: e.:of .Unci.:.: ;: ,.:;>..<:.:-.:.:.:•.::.:::::.:::.::.:>:::::..:.:::::::;:..>.....: :: ;:: ..........:......:. ::..:..:.:.:::.::1!I?.::::.....:..::.::.:::..::..: ...:::.:.<.,;.:. .,. ..::::...:.:.::.Po ulaban:::::::.:.:.:�►vera eD ..:>::.Da ..illfater.mand Maximum: ,. >......:-.:::>,,• :: >:;::..:::::::.::::::<:;,::...: •:::..:::::.;<:.::::..::;:::.::::.;:::<.::;::::.:.:::: Co unms:B:.x .....alNater.:.Demand._:_.::. I ::: ; ns.•D. x. E) ...�..._..:.:. ::.•:. :.�:.::,.:::..:::.:::.:.:.::::..::::::.:::.::.. .::--.;.�:.:...:i:---:...:.� .:> :::>..:.1..:::.....::.:.::..:::::..:.:� .::::Water.;Dernand....•: Single -Family Home 47 3.5 164.5 100GPD 10-0165 MGD 0.037 MGD Mobile Home 54 2.5 135.0 100GPD 10.0135 MGD 0.0304 MGD Apartment 135 2.5 337.5 100GPD 10.0338 MGD 0.0759 MGD Commercial, institutional, or Industrial Facility' 67 XXXXXXXXXX XXXXXXXXXXXX XXXXXXXXXXXX .0837 MGD 0.1882 MGD Total 303 i XXXXXXXXXX1 637 1 XXXXXXXXXXXX 10.1475 MGD 10.3315 MGD Description of Commercial, Institutional, and Industrial facilities and Explanation of Method Used to Estimate Average Day Water Demand for These facilities- See Attachment A 'Explanation of Method Used to Estimate Maximum -Day Water Demand. — Average_ Day Water Demand * 2.25 Peak 2. Design/Projected Maximum Hour Water Demand for Proposed Altered/New Distribution Facilities Under this Project and Basis of DesignlProjection: 147,500 GPD/1440 min * 4.5 Peak = 460.9 GPM Design/Projected Fire Demand Plus Coincident Draft (usually maximum day water demand) for Proposed Altered/New Distribution Facilities Under this Project and Basis of Design/Projection: 3500 GPM 3. Operating Pressure Range for Proposed Altered/New Distribution Facilities Under this Project: 50 psi Page 10 of 12 . hpplifation for a Public Drinking Water Facility Construction Permit Project Name: City of Sebastian, US Highwav #I/Indian River Drive Applicant: City of Sebastian DEP For.. No.: 62-555.910911 Form Title: AoDlication for a Public Drinkino Water Facility Construction Permit Effective Date: DEP Application No.: (Filled 1n by DEP) 4. Will any proposed alteredlnew distribution fatuities under this project be installed in areas where there is existing documented evidence that the ground water is contaminated by organic compounds?-. NO If yes, describe the nature and extent of such areas: 5. Will any proposed alteredlnew distribution facilities under this project connect previously separate public water systems that have separate water supply sources? NO If yes, provide the names of the systems proposed to be interconnected and explain .. the purpose of each proposed interconnection: 6. Will the proposed alteredlnew distribution facilities under this project be part of a community water system or a public water system that has a service area also served by a reclaimed water system? NO If yes, document that the system has a routine cross -connection control plan, including a written plan, in accordance with Rule 62-555.360, F.A.C.: Booster Pumoino Facilities N/A 7. Name/Location of Proposed Altered/New Booster Pumping Station: 8. Design/Projected Annual Average and Maximum Day Water Demands for Booster Pumping Station: .... .:........::.E<-,•fer::Ca�ita�::f...:T.otal�:�Avera �e ; �?B=>�?iktat�:��: _... :.-.::.;::-: umber.: ............. ' a Df..iirnt............... :::: ' ....Y�. ............. l t ver �: �� •�::::.... ..................:.:.::..�:.::...::.......... :.:::...:. :. .. ........ a e.Da ::.<._ .Da:.,Watec'Deitiari� :.:..:.::...... of i!n t ....:..:..... ..,::....... lCalmm�s.:Bater::3eColumnsarid'.: Single -Family Home Mobile Home Apartment Commercial, Institutional, XXXXXXXXXX XXXXXXXXXXXX XXXXXXXXXXXX or Industrial Facility' • Total XXXXXXXXXX [ XXXXXXXXXXXXl Description of Commercial, Institutional, and Industrial facilities and Explanation of Method Used to Estimate Average Day Water Demand for These facffl es - f Explanation of Method Used to Estimate Maximum Day Water Demand. 9. Design/Projected Maximum Hour Water Demand and DesignlProjected Fire Demand Plus Coincident Draft (usually maximum day water demand) for Booster Pumping Station and Basis of Design/Projections (provide this only if increased pumping capacity will be provided in lieu of sufficient finished water storage volume to meet peak water demands): Page 11 of -12 Application for a Public Drinking Water Facility Construction Permit DEP . Fwm No.: 62-555.9101;1 Project Name: City of Sebastian, US Highway #I /Indian River Drive Form Title: Avolication for a Public Drinkino Walef. Applicant: City of Sebastian Effective Date: Facility Construction Permit DEP Application No.: Miled in by DEP) 10. Existing and Proposed AlteredlNew Pumps at Booster Pumping Station (attach additional sheets if necessary): Pu m::Status : axistEn C - T "ac �.p :Rrqp., .... Total Capacity of Existing and Proposed Altered/New Pumps When Largest Pump Is Out of Service: A TTACH PUMP AND SYSTEM HEAD CURVES fOR PROPOSED At rEREDINEW PUMPS. 11. Standby Power Source for Booster Pumping Station-:' Pumps Connected, or Proposed to Be Connected, to Standby Power. 12. 100 -Year, or Highest Known, Road Elevation in'Area of Booster Pumping Station: Page 12 d1l' 12 BARS 3 30 GPD/SEAT * 60 SEATS (AVG) 5400 GPD DRY CLEANER 1 350 GPD 350 GPD VETERINARY CLINIC 1 (1) PRACTITIONER * 250 GPD 250 GPD (3) EMPLOYEE * 20 GPD 60 GPD (10) CAGES * 20 GPD 200 GPD TOTAL 83,660 GPD (dpl22894) ATTACHMENT "A" DESIGN FLOW TOTAL ----------- FLOWS RESTAURANTS ----------------------------- 11 50 GPD/ SEAT * 60 SEATS (AVG) 33,000 GPD 5 50 GPD/SEAT * 100 SEATS (AVG) 25,000 GPD BANKS 5 20 GPD/100 SF * 3000 SF 31000 GPD COMMERCIAL 38 20 GPD/100 SF * 2000 SF 15,200 GPD FUNERAL HOME 1 350 GPD 350 GPD PUBLIC RESTROOM 2 5 GPD/PERSON * 50 500 GPD FIRE STATION 1 350 GPD 350 GPD BARS 3 30 GPD/SEAT * 60 SEATS (AVG) 5400 GPD DRY CLEANER 1 350 GPD 350 GPD VETERINARY CLINIC 1 (1) PRACTITIONER * 250 GPD 250 GPD (3) EMPLOYEE * 20 GPD 60 GPD (10) CAGES * 20 GPD 200 GPD TOTAL 83,660 GPD (dpl22894) STATE OF FLOnI0A DEPARTME14T OF TRANSPORTATlOt1 FOnM 692-03 UTILITY PERMIT uTtt<rnt:0 05180 (In compllante with chapter air. Florida SieluteS) DATE PERMIT NO. 44144900071 SUBJECT: Section State Road 5 County Indian River PERMITTEE r4 t -y nf v,,-hngf-; qn ADDRESS P.O. Box 127 Sebastian, FL 32958 'Telephone Number- (407) 582-5330 Requesting permission from ilia State of Florida Department of Transportation, hereinafter called the Department, to construct, operate and maintain .17" Dil" .Potable Water Main within State Road #5 R.O.W. 400± LF south of Harrison St. (along east side), 250± LF north of Jackson St. (along east side), 310± LF north of Jackson St. (along west side) and a Jack & Bore. From MP/Station to MP/Slalion 1. Proposed work is within corporate limits of q municipality. Yes (X) No ( } Name of Municipality City of Sebastian 2. Applicant declares that prior to filing this application he has ascertained the location of all existing utilities, both aerial and underground and the accurate locations are shown on the plans. A letter of notification was mailed on 12/29/94 to the following utilities/municipalities. Falcon Cable, , Southern Bell. and Fp&1: 3. The office of Ilia local Maintenance or Resident Engineer shall be notified twenty -tour (24) hours �rrto starting work and again mmedialel upon completion of work. The Engineer is G • Mc Sween , located at , Telephone Number 1407) 468-3995 4. All work, materials, and equipment 'sholi be subject to Inspection by the local Maintenance or Resident Engineer and shall meet Department standards. 5. All Department property shall be restored to Its original condition as far as practical, In keeping with Department specifications, and In a manner satisfactory to the Department. 6. All Installations shall conform to the Department's Utility Accommodations Guide In effect the date permit Is approved. 7. Plans of this Installation shall conform to the Department's Utility Accommodations Guide and shall be made a part of this permit. 8. This permlitee shall commence actual construction In good faith within 60 days from the day of said permit approval and shall be completed within 180 days. if the beginning date Is more than 60 days from date of permit approval, then permillee must review the permit with the D.Q.T. Maintenance Engineer to make sure no changes have occurred In the highway that would affect the permitted construction. 9. The construction and maintenance of such utility shall not Interfere with the property and rights of a prior permittee. 10. it Is expressly stipulated that this permit Is a license for permissive use only and that the placing of facilities upon public property pursuant to this permit shall not operate to create or vest any property right In said holder. 11. Whenever necessary for the construction, repair, Improvement, maintenance, safe and efliclent operation, alteration or relocation of all, or any portion of said highway as determined by the District Director of Operations, any or all of facilities and appurtenances authorized hereunder, shall be Immediately removed from said highway or reset or relocated thereon as required by the District Director of Operations and at the expense of the permittee unless reimbursement Is authorized by separate agreement. 12. it is agreed that In the event the relocation of said utlllty facilities are scheduled to be done slmtillaneously with the Department's construction work, the permittee will coordinate with the Department before proceeding, shall cooperate with the Department's contractor to arrange the sequence of work so as not to unnecessarily delay the work of the Department's contractor. defend any legal claims of the Department's contractor due to delays caused by the pormittea's failure to comply with the approved schedule, and shall comply with all provisions of Ilia law and Rule 14-46, Florida Administrative Code. The Permittee shall not be responsible for delays beyond its normal control. 13. Special conditions: 14. Special Instructions: 15. It Is understood and agreed that the rights and privileges herein set out are granted only to the extent of the State's right, title and interest in the land to be entered upon and used by the perrYtlties, and the permlilee will, at all times, assume all risk of and Indemnify, defend, and save harmless the State of Florida and the Department from and against any and all loss, damage, cost or expense arising In any manner on account of the exercise or attempted exercises by said permillee of the aforesaid rights and privileges. 16. Outing conMrtiction, all safety regulations of the Department shall be observed and the holder must take measures, including placing and display of safety devices, that may be necessary In order to safely conduct ilia public through the project area In accordance with the Federal manual on Uniform Traffic Control Devices (MUTCD), as amended, and the Department's latest Roadway and Traffic Design standards. 17. in case of non-compliance with the Department's requirements In effect as of the approved date of this permit, this permit Is void and the facill til have to be brought into compliance or removed from the R/W at no cost to the Department. Submitted by: -f-f' /,/PeittPlace Corporate Seal rmee Joel Koford City Manager Signature and Title Attested "Waivur of Corporate Seal on Filo with the State of Florida DoparUnenl of Transporlation, Tallahassee, Florida. Yes ( ) No ( ) Roadway construction Is proposed or underway, No (X) Yes ( } W.I.I. No. Recommended for approval Title Date Approved by: Dale District Permit Engineer or Authorizoci nopresonta liva 622.733 STAT! OF FLORIDA DEPARTMENT OF TRANSPORTATION UTILITY PERMIT FINAL INSPECTION REPORT DATE: PERMIT NO.: COUNTY SECTION NO.: STATE ROAD NO.: COUNTY: CITY: PERMITTEE: ADDRESS: CITY: STATE: ZIP CODE: TELEPHONE: DATE WORK STARTED: DATE WORK COMPLETED: INSPECTED BY: REMARKS: FORM 062.02 UTILITIES Oslo* I the undersigned do hereby attest that the utility �oonstruotlon approved by the above numbered permit was Installed In accordanoe with the permit requirements and In accordance with the Department's Utility Accommodation guide. SIGNED: TITLE: ' DATE: oo; I]ISTRlCi`MAINTENANCE OFFICE LOCAL MAINTENANCE OFFICE $2!•723