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APPLICATION FOR APPROVAL OF PLANS AND SPECIFICATIONS FOR PUBLC WATER SUPPLY SYSTEM \ ,~ I I This Space For Use By Approving District Tract 90 - Phase 1 Countryside 525-623.10 STATE OF FLORIDA . DEPARTMENT OF ENVIRONMENTAL REGULATION ,APPLICATION FOR APPROVAL OF PLANS & SPECI FICATIONS FOR PUBLIC WATER SUPPLY SYSTEM This Space For Use By Approving District Approval Date , '). I'a 'C I of 4 . j , I I ; . Permit No. ---- . :") ~~: , ".' "'" I "" lu: J I.... 1)l;.t'AKIMCNI Ul" I:.NVIKUNMa:.NIAL Kt:.liULATlUN City of C1eal,,'w.ater Thc_ _' ~ L>ate February 1, 1980 1.--, , .;'- -~ whuse :address is (lnsen title of body makinj; application. i, e.. municipality, corporation or individual) P.O. Box 4748 Clearwater (Street and Number) (City) ~uthuriLed by law tu act for the said Ci ty (Insert city, town or corporation) ami \ll cxpcnd its funds fur water supply and treatment works, herewith submit for consideration the plans and specifica. tiuns and IIthcr necessary data (including Form PERM 13-2A) prepared by .' I ..Po,~~,_~I!~kl ey, Schuh & Jerni qan. Inc. (Engineer or rum) , or ....--. 2280 U.S. Highway 19 N., Suite 165, Clearwater, Florida 33515 (Address) whu is hereby authorized 10 represent the applicant in the engineering features including supervision of construction and appropriate certification as to compliance .with the approved plans and specifications of the project for the installation of A water distribution system (Oearly describe, new system. new plant. modiftcation, extension) Approx. 1 /4 mi. wes t Countryside - Tract 90 - Phase 1 I d intersection of SR 586 ocate at Countryside(~tl~ard of and to serve - - in/near the city of Clearwater in the county of Pinel1as . State of Florida. as required by the regulations of the Department and herewith make application to the Department for the appro- val of this project. (Subdivision, plant, school, other) ll1est: plans, specifications and related documents will be approved and accepted by when they have receiv,ed the approval of the Depar~men~. ,_ .. _' Cl earwater (Board. Council, Direeton, Etc.) Upon construction. tl;'ese facilities will be-owned by . ,;. ;-Above llnd will be operated and maintained by .--:~_ame -,~ '.. . wh'oSe addresiis - (City forces, name of utility, co., or owner) Above (Street and Number) (City or Town) This application is made under and in full accord with the provisions of Chapter 381, Section 381.031 (1 )(g) 3 and 5 and Sec. tions 381.251-381.291, inclusive, Florida Statutes. THE APPLICANTS AGREE THAT NO CHANGES IN OR DEVIATiON FROM THE PLANS AND SPECIFICATIONS APPROVED BY THE DEPARTMENT WILL BE MADE EXCEPT WIlli THE; CONSENT AND APPROVAL OF THE DEPARTMENT. FURTHER, THE APPLICANTS AGREE TO THE SPECIFIC RE. QUIREMENTS RELATIVE TO OPERATION AND OPERATiONAL FUNDS THAT ARE MADE A PART OF THIS APPLI. CATION. (See Proviso No.2. Page 4). I~ this application associated with or part of a Development of Regional Impact ( DR! ) pursuant. to Chapter 380, Florida Satutes. and Chapter 221-'-2. Florida Administrative Code? ....-- Yes _.l_..No ' REMARKs:/v6n e /1 i Edward Mazur, Jr., P.E. Signa re: Anthony L Shoemaker, City Manager I./) . Typqd name.and :ritle of above Attest: rt+--~ (,.. J2 p~ Signature: City Clerk. Board Secretary, Etc. Lucille Williams, City Clerk Ty~mrnd Title o\..A~ve ~ Iypcd Namc and Ha. Registr.llion No. , Countersigned: C / tr h~ e'/l? r ~( ~ Approved as to form &: Signature: ~Mr"fn(fl1llir)C~-"" Charles F. LeCher, Mayor-Corrunissioner c Typed Name and Title: ~ Pre pa nil ion of engineering documents certified by: B ~/ ~.-e-~ .__ _..h . _,_ -- 21318 El"~GINEER'S SEAL Ci ty A tty ~o-Signature: Agent for Operation and Maintenance if different 1', .... f .,~,. '"") . lNFORMATIct REGARDING PROPOSED PUBLIC WATERtORKS . Submit comprehcnsive engineering report with all plans and specifications, and complete such portions of this form as relate to the treatment plant. (Use supplemental sheets if necessary.) Name of Water System Supplying Water City of Clp~rw~tpr Previous appToV'oIl Pcrmit Number(s) Est. Cost this Project: Supply S Treatment S Distribution S 85 ,000 EXISTING SUPPLY AND TREAlMENT F AOunES: Total S 85,000 Supply _____ MGD, Treatment MGD Storage: Ground ~I. Bev g;d: Pressure Tm~ glI1. Service Pumping or..l1 Capacity of emergency pumpi.ng units: Well gpm, service gpm Utility i!i Capable of Supplying F-quivalent Residential Connections. Max. Daily output MG. date F.quivalent Residential Connection't PROPOSED IMPROVEMENT OR DlSlRIBUnON EXTENSION Plant increase MGD Supply: Pressure Tank Plant: Aer:ltoL Gnd. Storage F.1ve. Storage Chlorin:ltor Service pumping gpm Aux. Power for Present Population (Municipality, institution, etc.) Additional Population (served by this project) ,216 F-quivalent to 90 re~idential services. . Estimated population to be connected: 5 y!=3rs 216 10 years 216 20 years 216 Prcsent per capita consumption 1 00 GPD Per capita estimated future 1 00 GPD Give any industrial users or abnormal demands Inten.:onncl:tio/1 with other system None cross connections None Min. size pipc. _.Ji~Residual pressure at peak load 20 psi Is fire control provided? Yes No permanent dead end connection within thi s proj ect. Ucscribc dead-cnd conditions and necessity for nushing U't I ,. 1- ...... dl 1770 LF 12" DIP, 5500 LF 611 PVC sl L11};t IS II new plpc Illes u an :Jrger__ Renurks None I PROVISOS . - " The plans 10' Ihe p,opo"d imp,o"men" dIed In the lo"going app\icotion are hlebY app,o"d und" authodlY 01 Chap''' 381. 50cl ion 38\.031 (I) (g) 3 and 5 amI Sections 38\.251.38 \.291. Incluslv<. Flodd. S ta lot". w; <h th e lollowing provisions: I. Con,tluct ion 01 ,his p,oj<ct must be commenced within one y= ftom the d. Ie 01 this appllcallon; othe,w;" plan..nd -",callons must be ",uhmllled 10' app'Ova! by Ihis ll<p',tmenl. The engine" 01 ,,,o,d in this application lxxo<P.ltSb~e fautJp<I.'li""",.li<ll< ~.ItllIUCXio.)(l('1xix:PJ<lj"",,,,,Ji upOn completion sh.Il inspect 10' eomple" conlonnity 10 the plan1an.d -",cation'" approv<d, A "pO,t ofsuch insp"tion in wrilinpnd ~gned by the enginee< shall be "nde"d to the intmsted County Health Department and to the Department of Environmental Regulation. 2. ThIs ,ppro,,1 is given with the understanding thaI upOn the installation of soch wod,s. ils op""tions sholl be placed un. de< doe ca" ul, compelent pelSon. who" qualifications a" app,oved by the Departmenland the ope"tion sholl he carried ..,t a"OIding 10 b,,1 accepted p"ctice ..d in a"OId.nce w;th the "quirements of Ihe ",I"..d "8Olations 01 the ll<p"" """I. This includes not only the p,ovlslon of continuing essenWl Innds fo, ope"tion and m.In"nance of chemical suppli<s ... plant ope"tion; but dso the funds for ""inten..'" equipment..d supplying the needs of a suitahle w"," planllabo'" tory which is required for proper operation of this water treatment facility. 3. W"e< supply facilities includIng m,;ns shall he inswled. cleoned. disinfected. ..d bacledologically cI=ed f 01 """"" in. K<D'd..ee wilh the blest appli"ble A WW A Stand.,ds ..d [)epartmenl n>les and regulations. . 4. Whe" Wolte< and "we< moins ClOSS with less than 18" vertl'" clearan"'. \he sewe< will be 20' of ei\h" cast i,on pIpe or amerele encased vitl!fied cloy pIpe. cente<ed on the poinl of Clossing. When a wale< ""in parallel.. sewe, main. a separation of at lcastlO' should be maintained where practical. .. \ , \ \ \ , ! ,.... The orfidal copi" of pl..s and spedt1cations accomp'nying this applIcatIon hav<been sealed and stamped with the pe,m'l ",'mb" " indicated he<eon. Only such plans aud sp"ifocations a" Included in this approval and any erasu"'. additions 0' aHe"tiuns ,fl"llng Ihe effidency of ope"tion 01 pubtic hcalth p.oleCtlv,VOIu. of the propO"d Unprov<m.." wU\ mal<< such approval null and void. District Manager C )07:,9"'/ By: ...~<:nt