Loading...
HomeMy WebLinkAbout2004 Waterline ChecklistELFATHE LPA GROUP INCORPORATED Transportation Consultants 12000 RESEARCH PARKWAY, SUITE 152 ■ ORLANDO, FL 32826 -3287 ■ 407 - 306 -0200 ■ FAX 407- 306 -0460 April 16, 2004 Mr. Gordon Sparks Utilities Department PO Box 1750 1840 25th Street Vero Beach, FL 32690 -3365 Subject: Waterline Extension: Sebastian Airport UCP #2257 Permit Checklist Items Transmittal Dear Mr. Sparks: In reference to the subject project, please find the following items in an effort to complete the Utility Construction Permit Checklist- Water Distribution System: 1. 3 sets of record drawings for the waterline. These are Sheets 1 -4 from Masteller, Moeller and Reed, and Sheet 5 from LPA. These are all certified by myself, the Engineer of Record (construction). Please note that these drawings were reviewed by Mr. Eubank and returned to me February 13, 2003 with his comments, These record drawings are the final version, and have answered his comments. 2. Copy of Hydrostatic Pressure Test (p. 2 -1). 3. Copy of LPA inspection Reports (p. 3 -1 to 3 -4). 4. Copy of bacteriological tests (p. 4 -1 to 4 -4). 5. Approximately 43,500 gallons of water were used by flushing (see calculation p. 3 -3). 6. By this letter, I hereby certify that the waterline has been sanitized according to IRCO standards. 7. Certification of Completion (see letter and signed /sealed attachments to Cary Padell dated Jan 22, 2004, p. 7 -1 to 7 -5). 8. Copy of Clearance Letter from FDEP, dated February 6, 2004 (p. 8 -1). 9. Bill of sale (1 page, 9 -1) ATLANTA ■ BATON ROUGE ■ CHARLESTON ■ CHARLOTTE ■ COLUMBIA ■ GREENSBORO ■ GULFPORT ■ JACKSONVILLE KNOXVILLE ■ LITTLE ROCK ■ MOBILE a ORLANDO ■ RALEIGH ■ RICHMOND ■ SARASOTA ■ TALLAHASSEE ■ TAMPA ■ WEST PALM BEACH Mr. Gordon Sparks, Sebastian Airport UCP #2257, Page 2 I understand that items 10, 13, 14, and Sebastian. Also, I believe the City has 12. Finally, we have been working with and he should be able to complete item 15 will be completed by the City of paid the $150.00 fee mentioned in item Mr. Ron Lefebure in your department, 11 of the checklist. Also, please note that the Sanitary Sewer Extension was not constructed as part of this project, but may be constructed in the near future. On be half of the City of Sebastian, I appreciate your help in closing out the project. Please do not hesitate to call me in Orlando at 407 - 306 -0200, or Jason Milewski at the City of Sebastian at 772 -581 -0111 if you have any questions or need additional information. Sincerely, THE LPA OU NCORPORATED Marl: C. Jnsen, P.E. Florida P.E. Number 56059 Project Manager cc: Jason Milewski, City of Sebastian (wfattach) Mohsen Mohammadi, LPA (e -mail) File (ta412007.1 t -irco) TEST RESULTS: SECTICN SECTICH 2� TIME c- START OF TEST LEAKAGE AND PRESSU E TES t REPORT �,� - 31.tno�.� TI -f E @ END CIF. TEST i _G( AM(6) PMt+�S PRESSURE --------- EE =[]rE REr�JHP PROJECT �, �CC,T i �,� f�`�- �1�z�L�' �a��� ,!��� �_�_ �r�,,,r�, �� - - -�. Y G_�TE Ci" TES.T __ -�'�-1 19_��j �__- ___------ - - r CR REPUMP -__ GALLQNS PIP`L _\IE DESZRIPT [a4 ti4A7t- M Is1 - - -- C �S. FEREE ------------_-_---1,y---- �t�I�� C ), ❑ �iE C z '_ _ ALL❑VASLE " LINE LEAKAGE (D. -x E.) G. NUMBER OF CLOSER VALVES '- -_ - pE()U T PE D T EST P L SSCIRE i Si] F" I C `�, 1 00 Pc I C 1 Y• rr ALLOWABLE VALVE LEAKAGE ca. 'x G:_ x ht ) 4�QUrRED TEST DuRA —I 10x4 2 14CURS c� i HCUR RCu GALLOtIS TEST RESULTS: ALLOWABLE: LEAKAGE SECTICN SECTICH SECTION SECTION TIME c- START OF TEST - _� A:`ic �3 FMC ) PRESSLRE a START OF TE;T 6_6 TI -f E @ END CIF. TEST i _G( AM(6) PMt+�S PRESSURE --------- EE =[]rE REr�JHP PSI J�V ACTUAr TEST - T I ME ------ AVER+ Gc TEST PR45S URE _ __ P,T PSI CUM I T'f CAF ��.�TER REQUIRED r CR REPUMP -__ GALLQNS M'EASUR'ED LEAKA sL (REPLIMP QUAbIT I TYITEST TIME) /� E;,Lt GPd$ /HCUR ALLOWABLE: LEAKAGE 4 SECTICN SECTICH SECTION SECTION No. I N13 A• LINE SIZE (INCHES] S- LINE TYPE (PVC, D1 P, ETC ) C. TOTAL LINE LENGTH (FEET) f 13 TOTAL LINE LENGTH .f 1000 FEET E. -ALLOWABLE LEAKAGE PEP, .1 000 FT. (SEE .TABLE) -" F. ALL❑VASLE " LINE LEAKAGE (D. -x E.) G. NUMBER OF CLOSER VALVES H -. ALLOWABLE LEAKAGE PER VALVE ...... 0.0078 0.0078 0.0778 0.0073 I . ALLOWABLE VALVE LEAKAGE ca. 'x G:_ x ht ) TOTAL' OF- J- Tr', ^L "ALLEIVABLE LEAKAGE rF..: RCu GALLOtIS PER HOUR ZIE. =ASEIVE TEST B ❑ES c�.Y DOES _Nvi c a t1EET. SPEi.i= ICATI N I3 S } f ZMARKS unr ACCEPTED BY _ ------------- - - - - -- uriLITY 5.�. iu �i_LP�r C-- _ ----------- - - - -_-�" lu`���,C _ f ENGINEER _ - - -- ------- - - - - -- �`- - _ __ - -- -- - -- - -- - _ -_ __ . CONTRACTOP: _ -- Y- ------------------- -•-- - -_ 4 AIRPORT: x BY: DATE: Lo SITE VISIT REPORT PROJECT: PROJECT NO.: LPA NO.: lo-, ��-V 1.1100 74M GENERAL: Piq c-tut J,eV,,�ej WaVl 6 PROBLEMS: COMMENTS: \AJUC� A4rk W r ♦� Sebastian Municipal Airport Project No.: TA412007 - ACCESS ROADS WATER AND SEWER November 13, 2003 Approximately 6,800 LF of 6" and 8" water main were flushed clean today. Those present to witness this are as follows; John Pratt, Airport Maintenance Ron Lefebure, County Inspector Randy, Jobear construction Superintendent Lori Cates, The LPA Group Procedure: 1. The water company was contacted to maintain the high pressure and to monitor the amount of water used. The City doesn't have to pay for the water used at the time of the flushing. 2. Gate valve at the in -field fire hydrant was turned off, and the gate valve up- stream of the hydrant was turned on. A 450 el was attached past this valve with an 8" PVC length of pipe. This pipe was 3'Ja' AG. Before the main is put in service, the el and length of PVC will be replaced with a cap. 3. The 6" PVC water main running along Central Airport Dr. was flushed first. The valves at the intersection with the 8" water main were closed and main valve to the 6" line was opened. The flush lasted about 5 minutes (flush the water from the line until clear water runs clear). 4. The north leg of the 8" water main running along Airport Drive West was flushed next. 8" valve at intersection to south leg was closed. The flush lasted 10 minx. 5. The south leg of the 8" water main running along Airport Drive West was done last. The flush lasted 10 min. 6. All 11 fire hydrants were then flushed. After opening one of the hose connection ports, the hydrant gate valve and the top hydrant valve were opened and the water that had been trapped inside the assembly was expelled. The contractor was instructed to close the top hydrant valve tightly, but leave the gate valve open. 7. 2" jumper pipe is in place on the north end of the water main loop to keep the system full and under pressure. 8. The system will be pumped with chlorine and let to sit for 24 hrs., after which they blow the chlorine off the system. it s 9. At this point 2 consecutive days are used to collect water samples for testing of containments. 10. Last of all, a pressure test of the system and a walk thru will occur. A representative of the engineering firm is to be present at each of these events. 11. As- builts are required for the water system by the County. Estimated water usage: 6" pipe = 1500 /gpm x 5 mins. flush = 7,500 gal. 8" pipe = 1800 gpm x 20 mins. flush = 36,000 gal. TOTAL = 43,500 GALLONS -� e' 4- SITE VISIT REPORT AIRPORT: /\ - PROJECT: 4,n to i a007 AM Liu BY: ` , PROJECT NO.: DATE: +�,` �� L03 LPA NO.: GENERAL: PROBLEMS: COINUNIENTS: RECEIUD ity I iron et FD H Q EC 3 " 2X3 EP L P. THE LPaI GROUP �'1 ro al 2) 97 -5: Orlando Office SYSTEM NAME ADDRESS of Ver each rtal Control Laboratory Lab No. E53303 aB No. FL00112 )- Box 1389 :h, FL 32961 -1389 244 • (772) 978 -5220 r 4110b_- R1 DRINKING WATER BACTERIOLOGICAL ANALYSIS 4 —I � c2,K lI w,-D 31- Gv G - FOR LAB USE ONLY Date/Time Received: DafeTme Analyz Analyst 1 r Laboratory Supervisor Date LLy �I n r� IL�f'' r �1l YSTEM I.D. NO: SYSTEM PHONE #. PR o ^ COUNTY: Mad 1 i n 1 `l. Lh DEp DIST IC7 L-ol COLLECTOR/TITLE: SAMPLE SITE (Locality or Subdivision): l COLLECTOR PH NEn: DATE AND TIME COLLECTED: I v( j 5 Q,5 �'I 0 ! TYPE OF SUPPLY ( Circle One): Community water sysle Non- Community water system Non- transient non community water system Private well Swimming Pool Bonled water Other public watersY stem TYPE OF SUPPLY (Circle One): REMARKS 5 58c� Compliance Repeat Replacement (Chec box} (check box) U-tistribulion i] TNTC or C a Raw ❑ Turbid ❑ Main Clearance Well Survey Other . (Specify) ALL ANALYSES PERFORMED INACCORDIANCE WITH NELAC STANDARDS T(1 PC' ('nhADI =17'r, ov" r rr.T...-, . .. . FIELD iD NO NON CONFIRM COLIFORM 'TOTAL TOTAL FECAL SAMPLE POINT CI (SPECIFIC ADDRESS) RES'D PR L-ol o5'g :�'4 �t y nr / ! , cC TO BE COMPLETED BEY � I ANALYSIS METHOD: MF MTF F MUr)_hAI tr- Dw LABORATORY ID NO. NON CONFIRM COLIFORM 'TOTAL TOTAL FECAL o5'g - Results in this column are pretaninatq. Fecal conform confirmation on community and noncommunity water systems and total wlilorm confirmation on an types a( water systems will follow in 24.48 hours P - Conforms are present C - Confluent growth TA - Turbid. Absence of gas or acid A - Coh orms are absent TNTC - Too numerous to count INTERPRETATIONS - REMARKS BY PROGRAM REVIEWER NAME AND MAILING ADDRESS OF PERSON /FIRM TO RECEIVE REPORT REVIEWING OFFICIAL: TITLE: (I (J SATISFACTORY I j INCOMPLETE COLLECTION INFORMATION ( j REPEAT SAMP "_ES ( I REPLACEMENT SAMPLES City of Vert. each Environmental Control Laboratory FDOH Lab No. E53303 EPA LAB No. FLOO112 P.O. Box 1389 Vero Beach, FL 32961 -1.389 (772) 978 -5244 • (772) 978 -5220 DRINKING WATER BACTERIOLOGICAL ANALYSIS FOR LAB LAB USE ONLY DateMme Received: -,/ / 5� Date /Tme Analy d- Analyst G Laboralor, Supervisor Jam, . I7,10 3 Date SYSTEM NAME: a-RI'arO n t I j2h*STEM I.D. NO: SYSTEM PHONED: J `� ADDRESS: COUNTY: � r� r �l lu_r— D P DI COLLECTORITITLE:_Ll ' �J) COLLECTOR ON SAMPLE SITE (Locality or Subdivisio S""RICT P Et#: 6 f� r DATE AND TIME COLLECTED: _ a - la5 0 � - TYPE OF SUPPLY (Circle One): �nvateu.,ll mnity wtem �3 Non- Community water system Non - transient non community water system Swimming Pool Bottled water Other public water system TYPE OF SUPPLY (Circle One): Compliance Repeat Replacement Main Clearance Well Survey Other �(c,he1ck box) (check box) (specify) �tstributfon ❑ TNTC or C ❑ Flaw 0 Turbid REMARKS: ALL ANALYSES PERFORMED INACCORO3ANCE WITH NELAC STANDARDS TO BE COMPLETED BY COLLECTOR OF SAMPLE FIELD ID NO SAMPLE POINT (SPECIFIC ADDRESS) Cl REST) pH r� r� G P ✓ t TO BE COMPLETED B ANALYSIS METHOD: MF MTF MMO -MUG PA LABORATORY ID NO. NON ICOLIFORM 'TOTAL CONFIRM TOTAL FECAL / Y ✓ t ' Results in this column are preliminary. Fecal coliform confirmation on community and nonecmmuniry water systems and total colilo(m confirmation on all types of water systems will follow, in 24-48 hours P - CoMorms are present C - Conlluant growth TA- Turbid. Absence of gas or acid A- Cotilorms are absent TNTC - Too numerous to count INTERPRETATIONS - REMARK'S BY PROGRAM REVIEWER NAME AND MAILING ADDRESS OF PERSON/FIRM TO RECEIVE REPORT i } ( }SATISFACTORY { I REPEAT SAM COLLECTION INFORMATION ( j REPEAT SAMPLES REPLACEMENT SAMPLES REVIEWING OFFICIAL: TITLE: City of Vero ach Environmental Control Laboratory FDOH Lab Noy E53303 EPA LAB No. FL00112 P.O. Box 1389 Vero Beach, FL 32961 -1389 (772) 978 -5244 • (772) 978 -5220 DRINKING WATER BACTERIOLOGICAL ANALYSIS 4_3 :, s 2—,6'- FOR LAB USE ONLY Date/Time Received: Dale/Time Analyzed: _446& Analyst Laboratory Supervisor /.e a 3 Da Ie SYSTEM NAME: O ) _i l,S' STEM I.D. NO: SYSTEM PHONED: n ADDRESS: COUNTY: R, V�( i� EP DI )TRICT: I� .q 1 19.5 7 G GOLLECTORITITLE: I COLLECTi O HONE #: ) SAMPLE SITE (Locality or Subdivision): �� _ _r11 IIx__ `��1 ( r 1� �i Y—C DATE AND TIME COLLECTED: - f l r7 I, �1 � TYPE OF SUPPLY (Circle One): TYPE OF SUPPLY (Circle One}: 1EMARKS lD Community water system Private well Compliance Repeat (check box) �tribution ❑ Raw Non - Community water system Non - transient non Community water system Swimming Pool Battled water Other public ,,eater system Replacement Main Clearance Well Survey Other (crleck box) (Specify) ❑ TNTC or C ❑ Turbid ALL ANALYSES PERFORMED IN ACCORDIANCE WITH NELAC STANDARDS TO BE COMPLETED BY COLLECTOR OF SAMPLE FIELD tD NO SAMPLE POINT (SPECIFIC ADDRESS) CI RES'D pH CONFIRM FECAL TOTAL �j J� ~ I 4 r � SEA "i"* I _ �13 1 I r I�( I. ,✓ =cj U)d _ 15 1� ! .Se. lip fl EFL TO BE COMPLETED B ANALYSIS METHOD: MF MTF MMO -MUG PA LABORATORY ID NO. NON CCLIFORM 'TOTAL F' CONFIRM FECAL TOTAL �j J� 7 d� 1� Results in this cotumn are preliminary. Fecal coli €orm confirmation on community and rencommunity water systems and loyal cofilorm ccnfirmaiion on all types of wafer systems will follow in 24.49 hours P - Col;€orms are present C - Ccnllueni growth TA - Turb +a, Absence of gas or acid A • Colilorms are absent TNTC - Too numerous to count INTERPRETATSDNS- REMARKS BY PROGRAM REVIEWER NAME AND MAILING ADDRESS OF PERSON/FIRM TO RECEIVE REPORT t J I I SATISFACTORY {) INCOMPLETE COLLECTION INFORMATION { J REPEAT SAMPLES { J REPLACEMENT SAMPLES REVIEWING OFFICIAL: TITLE: City of Verc ;ach Environmental Control Laboratory FDOH Lab No. E53303 EPA LAB No. FL00112 P.O. Box 1389 Vero Beach, FL 32961 -1389 (772) 978 -5244 • (772) 978 -5220 DRINFJNG WATER BACTERIOLOGICAL ANALYSIS FOR LAB USE ONLY Date/ Time Received: ?7 Date/Time Anal zed: Analyst f Labcrata Supervisor /� Dale SYSTEM NAME: I 1 k) V'Ir O YSTEM I.D. NO: SYSTEM PHONE #: ADDRESS: COUNTY: I t Id I (Lr) I c t DEP DIS R1CT Y 1 r V r y1 �'%`��i `'� C4LLEGTOR/TITLE: COLLECTOR ��" ONE) : ___l , ! )a SAMPLE SITE (Locality or Subdivision): "qC [lot- r 1 ; .rnd r:L DATE AND TIME COLLECTED:. IQ_ I LL(' - l � 2 J 1(C2 TYPE OF SUPPLY (Circle One): TYPE OF SUPPLY (Circle One}: ;EMARKS: Community water system rivate well Compliance Repeat (Chef box) a'-Distribution ❑ Raw Non - Community water system Non - transient non Community water system Swimming Pool Botiled water Other public water system Replacement Main Clearance Well Survey Other (check box) (Specify) ❑ TNTC or C ❑ Turbid ALL ANALYSES PERFORMED IN ACCORDIANCE WITH NELAC STANDARDS TO BE COMPLETED BY COLLECTOR OF SAMPLE FIELD ID NO SAMPLE POINT (SPECIFIC ADDRESS) CI RES'D pH r7 TO BE COMPLETED ANALYSIS METHOD: MF MTF MPA LABORATORY 10 NO, NON COLIFORM 'TOTAL FTOTALFECAL ONFIRM Results in this column are prei;rrunary. Fecal cClilorm confirmation on community and noncommumly water systems and total colilorm confrrmalion on al types of water systems win lone w in 24-aa hours P - Coliforms are present C • Confluent growth TA • Turpid. ACsence of gas or acid A - Conforms are aoseni TNTC - Too numerous to count INTEERPRETA7IONS • REMARKS BY PROGRAM REVIEWER NAME AND MAILING ADDRESS OF PERSONIFIRM TO RECEIVE REPORT F -1 REVIEWING OFFICIAL: TITLE: () ( } SATISFACTORY ( I INCOMPLETE COLLECTION INFORMATfON ( ) REPEAT SAMPLES ( ) REPLACEMENT SAMPLES ILPATHE LPA GROUP INCORPORATED Transportation Consultants 12000 RESEARCH PARKWAY, SUITE 152 ■ ORLANDO, FL 32826 -3287 ■ 407 -306 -0200 ■ FAX 407 -306 -0460 January 22, 2004 Mr, Cary Padell Florida Department of Environmental Protection 3319 Maguire Boulevard Orlando, Florida 32803 -3767 Subject: Sebastian Municipal Airport Waterline WD- 31- 0039 -206 -344 Certification of Construction Completion Dear Mr. Padell: Please find the enclosed regarding the above referenced project and permit: + 1 copy of FDEP Form 62- 555.900(9) + 1 copy of as -built drawings + 1 copy of Bacteriological Analysis + 1 copy of Leakage and Pressure Test report As you and I discussed on the telephone, we have had a challenge getting all of the required information assembled over the holidays and the first part of the year, and your discretion is greatly appreciated. Thank you for your help with this project, and please contact me with any questions or concerns at 407 - 306 -0200. Sincerely, THE LPA RMP INCORPORATED Mark C. Jansen, P.E. Project Manager cc: Jason Milewski, City of Sebastian (e -mail) Steve Snoberger, Carter & Associates (e -mail) File (TA412007.4g) ATLANTA a BATON ROUGE ■ CHARLESTON a CHARLOTTE ■ CHICAGO ■ COLUMBIA ■ GREENSBORO ■ GULFPORT a JACKSONVILLE KNOXVILLE a MOBILE ■ ORLANDO ■ RALEIGH ■ RICHMOND ■ SARASOTA ■ TALLAHASSEE ■ TAMPA a WEST PALM BEACH ��jwon^ra .,_ CERTIFICATION OF CONSTRUCTION COMPLETION AND REQUEST FOR 3 FIOR CLEARANCE TO PLACE PERMITTED PWS COMPONENTS INTO OPERATION Seepage 5 for instructions. 1. General Project Information A. Name of Project-. E�L�ST r#ni !t (yrV 1 G �, ?;Q/o G� _ f Yc'G lzv;L- B. Department of Environmental Protection (DEP ) Construction Permit Permit Number: 1A10 - o o 4 - 2-06 -1544 1 Date Permit Was Issued: 12- X44-2 -c C. PortiGn of Project for Which Construction Is Substantially Complete and for Which Clearance Is Requested EPIEntire Project ❑ Following Portion of Project: D. Permittee PWS/Company Name: Ctry of 5-.5e,{5,(-10 -, PWS Identification Number:* PWS Type:* Communi Non - Transient Non-Cornmunity F1 Transient Non-Community Consecutive Contact Person: ,<AkA,E /t,(oortF I Contact Person's Title: GtT1'�lr4,v,¢ Contact Person's Mailing Address: /2-2-57 st..v Contact Person's Title: ie Lu ,4 Ci �F-,q A M/W I State: Zip Code: 295a Contact Person's Telephone Number: -772-584" 5-3 3 d I Contact Person's Fax Number:'�zlSgy- Contact Person's E -Mail Address: -t-Moc rC Contact Person's Telephone Number: * This information is required only if the permittee is a public water system (PWS). E. Public Water System (PWS) Supplying Water to Proiect a PWS Name: lAldl4l et tJ?'r1 a. i`Y a r14177ZES PWS Identification Number: '331-4c.,52 PWS Type: El Cotnmuni Non - Transient Non-CommunitZ F1 Transient Non-Community Consecutive PWS Owner: 1Pva^,i oeivEZ CovvTV PWS Owner: Contact Person: lLL TiCSk1 n( Contact Person's Title: ie Lu ,4 Contact Person's Mailing Address: 18¢n ,vt �4r.� STET Contact Person's Mailing Address: Ci : vew, o Y Ci : State: L Zip Code: 3 u 90 Contact Person's Telephone Number: Contact Person's Fax Number: Contact Person's Fax Number: 72 -- 770 -- Contact Person's E -Mail Address: Public Water System (PWS) that Will Own Proiect After It Is P[ ed into Permanent OtSeradon PWS Name: 154-,,4,c 45 A-$DU6 I PWS Identification Number:* PWS T e :* --[]Community Non- Transient Non-Community Transient Non -Com mw-d Consecutive PWS Owner: Contact Person: Contact Person's Title: Contact Person's Mailing Address: State: L Zip Cade: 2 2- 4,-' Ci : State: Zi Code: Contact Person's Telephone Number: Contact Person's Fax Number: Contact Person's E -Mail Address: * This information is required only If the owner /operator is an existing PWS. G. Professional Engineer in Rest)onsible Charze of Inspecting Construction of Proiect* Compan Name: '1?fE Q,4 t5;,ev-.0 A,1CxXe,w Engineer: C_ J-A ISI Engineer's Florida License Number: Engineer's Title: _-z-F Engineer's Mailin Address: _e � Z City: 2 rr��r> State: L Zip Cade: 2 2- 4,-' Engineer's Telephone Number: 467-2o6 - bZ Engineer's Fax Number: p Engineer's E -Mail Address: This information is required if construction of this project is inspected under the responsible charge of a professional engineer licensed in Florida. Whenever a project is designed under the responsible charge of a professional engineer licensed in Florida and is permitted by the Department, construction of the project shall be inspected under the responsible charge of a professional engineer licensed in Florida. oEP FDrm e2- s5s.soot9t Page I Effective August 28, 2007 Jan 2C C4 02:17p Indian River Utilities 772 770 b143 p.2 7-3 CERTIFICATION OF CONSTRUCTION -OOMPLETMN AND REQUEST FOR CLEARANCE TO PLACE PERMITTED PWS COMPONENTS INTO OPERATION CEP (c�t.;t:VS riot Pa.:,it Number IAIQ — 19 f t3 -1 Substantially Corrplcrc Portion of project if Ot.*rer thart Entire Project: to the best of my knowlcdl;c and belict; all new or altered public %vatcr system components that arc included in the substantially complete portion of this project and that mast be disinfected and bacteriologically surveyed or evaluated per subsection -63- 555.315(6). F•A.C., or Role 62- 555.34A, F.A.C•, have been disinfected and bacteriologically surveyed or evaluated in accordance -rich saint subsections or•sud_; ;fie; the petrnit:cc has had complete record drawings produced for the sAstantlally complete portion oflhis-project; to tltc be5t.of my knowledge and belief, said record- drawings adcgtratcly depict the substantially complete portion of this project as consmucte:d and idcmrfytbe deviations described and-explaiaied irrPatt tt of this form, anti said record drawings are available for review at the following locanon_ • if the substamially complete portion of this project includes any ncw-or altered drinking waterireannent facilities, an operation and rrtainrrnam-L -r null forsaid treatarunC fatuities iravailablc for reference x the site of said treatment facilities or ar a convenient location near the site-of said u=uTtent facilities. I also certify that, if the pertnince will-not own this project after it is placed into pemuncnt operation, the pertnince has provided a copy of the above mentioned record drzwings anda copy eNhe abnvc rrx=Uonr,t ope-Irian-and.=mIcnaact-;nsnull, if applicable. t;R" he PW that wileses wr rroject after it is placed into oncnr operation`) I //Iv /'/ ✓�f_. I Nr2r,_C t�� �,t� J C�I^�- ��.,. , ! Gt Sit to and' ate Printed or Typed Name Title B. Certification by PWS Supplying Water toPE*ct I am duly authorized to-sign this forman behalf of the-PWS identified in-Part LE of this form is crtify that said PWS will supply the water accessary to mccrtht: water dcrntnds for the substantially complete portion of this project, and I certify the following: • to the best of my know lcdge-.an&beficf. said p WS -s connection to thc-substantially complete- pottion of this project will not cause said PWS to be, orconrribrumto said PWS being; in noncompliance with Chapter 62 -550 or 62 -555, F.A.C.: • said PWS considers the carmccdon(s}hetwccrt the substantizllycomp lctrportiorrof this, project and said _PWS acceptable as constructed. V,,L,,Am B. EUt3ANK -JR —r= VIRCIrMc':N raL ENGINEEF S37znature and Date Printed-orTYPL&Namc- Title C. Certification by PWS that Will Oven Project After It Is Placed into Permanent Operation I am duly authorized to sign this farm-tm behalf of the PWS identified in Part I.F of this form. I certify that said PWS will own the substantially complete portion of-chi-, project after it is placed into permancn[ operation, and I certify the following: • said PWS considers the substantially complete portion of this project acceptable asconstructcd; • said PWS has received complete record-drswings forihe substantially complete portion of this project and the record drawings are available for rtvicw at Ore—fallowing location: • if the substantially complete portion of this project includes any new or altered drinking water treatment facilities, said PWS has teccived an operation and: maintenance manual for die new oraltercd treatment facilities, and the.Gpetarion and maintenance manual is available -for reference-at the site of the new or altered treatment facilities or at a convenient location near the site of the new -or altctcd trcatmnent facilities_ I understand that said PWS must opermte and.rnaintain this project.in.a.such a mztanacr as to comply with Chapters 62 -550, 62 -555, 62 -560, and 62 -699. F•A.C_ `itarI ;''AM fi-s'. 'r'13Ai�ti, j Sicnarure and Date printed or Typed Name n�P Form 6i -.Sd wi)(91 Page 3 C nml+ nuauor 23• 2007 Title -7-s4 CERTIFICATION OF CONSTRUCTION COMPLETION AND REQUEST FOR CLEARANCE TO PLACE PERMITTED PWS COMPONENTS INTO OPERATION DEP Construction Permit Number: WA 31 ^ c>o 3 't— 20 & 3�$ Substantially Complete Portion of Project if Other than Entire Project: i t i 1'r 71MM, r i MMIT101MY i i t Description and explanation of all deviations from the DEP construction permit, including the approved preliminary design report or drawings and specifications, for the substantially complete portion of this project: I completed Part II of this form, and the information provided in Part II is true and accurate to the best of my knowledge and belief. atum', Sea] Sigr urz, and) PeMtiuCe* I Date of Professional Engineer or o =`Authorized Representative of Printed or Typed Name License Number of Professional Engineer or Title of Authorized Representative ofPermittee* * Whenever a project is designed under the responsible charge of a professional engineer licensed in Florida and is permitted by the Department, construction of the project shall be inspected under the responsible charge of a professional engineer licensed in Florida. If construction of this project is inspected under the responsible charge of a professional engineer licensed in Florida, Part II of this form shall be completed, signed, sealed, and dated by the professional engineer in responsible charge. If this project is not inspected under the responsible charge of a professional engineer licensed in Florida, Part II shall be completed, signed, and dated by an authorized representative of the permittee. 1 111. Certifications A. Certification by Permittee I am duly authorized to sign this form on behalf of the pemzittee identified in Part I.D of this form I certify the following: • to the best of my knowledge and belief, the substantially complete portion of this project is sufficiently complete to be utilized for the purposes for which it is intended; • to the best of my knowledge and belief, the substantially complete portion of this project has been completed in accordance with the Department of Environmental Protection construction permit, including the approved preliminary design report or drawings and specifications, for this project; or to the best of my kmowledge and belief, the deviations described and explained in Part II of this form will not prevent the substantially complete portion of this project from functioning in compliance with Chapters 62 -550 and 62 -555, F.A.C.; DEP Fom62- 555.9oo(s) Page 2 Effective August 29. 2003 CERTIFICATION OF CONSTRUCTION COMPLETION AND REQUEST FOR CLEARANCE TO PLACE PERMITTED PWS COMPONENTS INTO OPERATION DEP Construction Permit Number: td-C' 3 I — _Cep 3 S Z Substantially Complete Portion of Project if Other than Entire Project: D. Certification by Professional Engineer in Responsible Charge of inspecting Construction of Project* I, the undersigned professional engineer licensed in Florida, am in responsible charge of inspecting construction of this project for the purpose of determining in general if the construction proceeds in compliance with the Department of Environmental Protection (DEP) construction permit, including the approved preliminary design report or drawings and specifications, for this project, 1, or a person acting under my responsible charge, observed construction of the substantially complete portion of this project and reviewed shop drawings, test results, and record drawings for the substantially complete portion of this project, and based upon said observation and reviews, I certify the following: • the substantially complete portion of this project is sufficiently complete to be utilized for the purposes for which it is intended; the substantially complete portion of this project has been completed in accordance with the DEP construction permit, including the approved preliminary design report or drawings and specifications, for this project; or to the best of my knowledge and belief, the deviations described and explained in Part II of this form will not prevent the substantially complete portion of this project from functioning in compliance with Chapters 52 -554 and 62 -555, F.A.C.; • all new or altered public water system components that are included in the substantially complete portion of this project and that must be disinfected and bacteriologically surveyed or evaluated per subsection 62- 555.315(6), F.A.C., or Rule 62- 555.340, F.A.C., have been disinfected and bacteriologically surveyed or evaluated in accordance with said subsection or said rule; and • the record drawings for the substantially complete portion of this project adequately depict the substantially complete portion of this project as constructed and identify the deviations described and explained in Part II of this form. and Date • C. JfWs�"�' Printed or Typed Name )"L -SGcS? License Number Whenever a project is designed under the responsible charge of a professional engineer licensed in Florida and is permitted by the Department, construction of the project shall be inspected under the responsible charge of a professional engineer licensed in Florida. If construction of this project is inspected under the responsible charge of a professional engineer licensed in Florida, Part 111.D of this form shall be completed, signed, sealed, and dated by theprofessfonal engineer in responsible charge. If this project is not inspected under the responsible charge of a professional engineer licensed in Florida, Part III.D does not have to be completed, DEP Forin 62- 555,900(9) Page 4 Etfeclive August 29, 2003 Jamag iaaem speoy 10 111 110 L b00Z /9 L/tr 6LL`£LZ$ JateM 01!5 -u17 :11401 009'a 00'009'3 Sl L N0I1VH01S3H 3ab'dans Lose qe 000,0 t$ 00'000'0!$ Sl L AVMIXVl d0 NO11V8O1S31d 3OVd8ns LOSE ee 09L$ 00'0SL$ S-1 L 01ddVd1 AVMIXV -L AO 1N343JVNV4 LOSE 000'E3$ 00'000'EZ$ S-1 L H30VdS /M 3dld EJNISVO 13315 „9L &1 907, lose Obtb'E$ 00'90E$ V3 9 1NIOd 31dWVS W0100101H31OV9 LOSE X 069$ O0'OB9$ S-1 L H3d4nr A1ddnS H31VM AHVHOd431 1092 m 096'96$ 00'09E`E$ V3 11- (3131d40C) A- 19W3S9V 1NHHaAH EHU LOSE n OOE'E$ 00'09x$ V3 9 (3131&400) 301AHES H31VM „L LOSE n OS -&$ 00'09-&$ V3 L dO-LS 'ddOO'8 dV13d 03010A-3Hd „L LO9Z 1 SM 00'9£s$ V3 1 3A1VA 31VJ 3903M OIIOS „9 L093 s 000'6$ 00.09L$ V3 ZL 3A-iVA 31VJ 3903M ©IIOS „E LOSZ J 009$ 00'009$ dl L 3A1VA JNlddV1 „9 LOSe b 0010' L$ 00'OOL$ V3 Z 3A-lVA JNIddV1 „E LOSZ d OWES 00'000'M V3 L 3A33-1S JNlddVl „9 x „ZL LOse o OLO'17$ 00'$00'E$ V3 E 3A331S JNlddVI „E x ,ZL LOS-& u EOE$ Ob'1S$ V3 9 SHENIVH1S38 d]a /0Ad „9 Los? w 966' L L$ 0E•9E$ V3 EEL SH3NIVH1S3H d]a/OAd „E L093 I 966$ 007EE$ V3 E SH3NIVH1S3H 3dOH , >9 L09Z �I 09L'9$ QO'OV.V$ V3 V S83NIVUS38 3dOH „8 LOSE 000'9$ 00'000`9$ NOl L SE)N1LL1& LOSE 09L`1, $ 00'09L'L$ V3 L SNOI1V11V-LSN! 3H091VNO]103H10 „9 LOSE 4 000'09$ 00'000'0 L$ V3 S SNO11V11V1SN1 3&013 WN01103H10 „9 1093 6 EM 0E'9$ &1 OV 3dOH „9 Lose 11 NE$ 00'9L$ dl OF d10 ,.9 LOSE a 696'9$ 00' L L$ dl EE9 OAd „9 LOSE p -&ZL'L$ 06'6$ dl OEL 3dC]H „6 L093 a L6L'L$ 00'LE$ dl LL£ d10.9 LOSE q 9trE'LL$ 00'EL$ dl L6E'17 0Ad „E LOSe e 301AN39 831VM „8 u0isu61x3 aaiJd ;iun ;ruil i ;uen0 uol;diJOsa(] wall 'ON-Dads ON wall row JO;Lw11s3 b0 -Jdb -9 L :aLeO ales 1!O 1119 siNninsNo9 Nonvitiodsm"mi ___ dnobe �1%fdi 3H1 I- b LSZZ# don:wodJiv uel;segas alas 10 II!8 ua!jsageS jo ALi0 jaodjiV ladloiunn ua!lsegas :13aloJd 1JO JIIV lVd10INn1Ai Sep 25 03 01:35p The LPR Group - Orlando (4071306 -0460 p.l THE LPA GROUP INCORPORATED SHEET NO 4503 Woodland Corporate Blvd., Suite 400 ,/r TAMPA, FLORIDA 33614 CA.�utATEaFx_ UAiE__- (813) 889.3892 Fax (813) 889 -3893 cAIiCHED BV _ - -__ -- -� DATE _ I Ab6 eo Fmt