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3. Contractor Information <br /> First Name Middle Initial Last Name Suffix <br /> Unknown <br /> Name of Company <br /> F--- <br /> Phone Number Email Address <br /> Mailing Address City State Zip Code <br /> 4. Name of Dam <br /> 9A-P3 <br /> 5. Dam Location <br /> To determine the location information, please use the Location Spotter at: <br /> https://dwr.state.co.us/Tools/LocationConverter <br /> Water Division Water District <br /> [Division 6 (Steamboat/ Yampa/White Drainage 44 - Lower Yampa River <br /> PLSS <br /> Q40 Q160 Section Township Range PM County <br /> NW SE 30 6.0 N OS 91.0 OE OW Moffat <br /> GPS Location <br /> • Point taken should be at the crest of the dam above the streamline/outlet <br /> • Datum should be UTM, NAD 83 <br /> Zone Easting (UTMx) Northing (UTMy) <br /> Zone 13 275891.2 4480514.9 <br /> 6. Tank Dimensions <br /> Vertical Length (ft) Width (ft) Upstream Downstream <br /> Height (ft) (Horizontal : 1 Vertical) (Horizontal : 1 Vertical) <br /> Dam: 11 30 Crest: 8,75 Slopes: 2:1 3:1 <br /> ' Vertical Height is measured from the elevation of the lowest point of the natural surface of the ground or the invert of the outlet <br /> conduit(whichever is lower)where that point occurs along the longitudinal centerline of the dam up to the crest of the emergency <br /> spillway of the dam. <br /> 7. Reservoir <br /> Stream Name or Water Source Unknown <br /> The Water Course must be dry 80%of the time to qualify. <br /> Surface Area (acres) Capacity (acre-feet) Drainage Area (acres)' <br /> 0.13 0.46 <br /> If the drainage area is unknown, leave blank and a spillway size will be assigned <br /> DRS-11:Application for Livestock Water Tank and Erosion Control Dam-Page 2 of 3 <br />