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HomeMy WebLinkAboutpitkin.eh.264305300002 (2015)Document Layout (From Most Recent to Oldest Permit) Permit Application Log Sheet/Notes & Photos Communications As -built Design Engineer Design Soil Information Water Permit & Information Second System on property Third System.etc. Floor Plans Please See Building and Land Use Approvals Files for additional information. 01TKIN COUNTY 0 Pitkin County Environmental Hoh Department Onsite Wastewater Treatment System (OWTS) USE PERMIT Permit for Continued Use of an Existing OWTS 76 Service Center Road, Aspen, CO 81611 Phone: 970-920-5070 Fax: 970-920-5077 www.aspenpitkin.com/EHNR Parcel ID #: 2643-053-00-002 OWTS Use Permit #: I 0007.2015.POWU Date Issued: 3/19/15 Issued By: Bryan Daugherty Expiration Date: 3/19/2016 Owner(s): I Leslie Rudd Property Address: 6190 Upper River Rd (Main House) Legal Description: Sand mound bed Licensed Inspector: Doug Warren Inspection Date(s): 2/25/15 SYSTEM INFORMATION Components Type Capacity/Size Primary Treatment Unit Concrete 1 compartment tank Concrete 2 compartment tank Concrete 1 compartment tank 1250 gallons 1000 gallons 1000 gallons Secondary Treatment Unit Absorption Area Sand mound bed 25' x 30' (750 ft2) Other System Components Pump OWTS Use Status: ® In use at the time of the inspection. ❑Not in use at the time of the inspection.' "If the OWTS was not in use at the time of the inspection, it is recommended that the system be re-evaluated when it is in use for a more accurate evaluation of the system. System Records: Permit It: 78007, 86019 Date of Issuance: 3/27/78, 6/10/86 Date of Final Approval: 4/19/78, 7/30/86 # of Bedrooms or fixtures served by OWTS: System is designed for 5 bedrooms Operational Status: According the inspectors observations the system appears to be functioning as designed at the time of inspection. Inspector Recommendations: Risers and lids are deteriorating and should be replaced. Department Recommendations: N/A Issuance of this OWTS Use Permit is based solely on the conditions observed and reported by the inspector to the Department on the date of the Inspection(s) and on Department records at the time of permitting. The issuance of this permit does not constitute a guarantee, warranty, or representation by the Department that the system will operate properly or will not fail or that the system will not be subject to future enforcement action to correct non-compliant conditions. Estimated capacity of the system has been listed on the permit and we recommend that you monitor and/or meter water use to prevent overuse and possible failure. int 7 1witkin County Environmental Healp6epartmen O %JrK I N Onsite Wastewater Treatment System (OWTS) COU111TI USE PERMIT APPLICATION 76 Service Center Rd Aspen, CO 81611 Website: www.aspenpitkin.com/ehnr/ Application for Continued Use of an Existing OWTS Parcel ID# (available from the Pltkin County Assessor's Office ^� / _ 053 _ Op _ O© 2 970-9265160 or at www.pitklnassessor.orgl: Purpose of Use Permit: ❑PROPERTY TRANSACTION XFlE7v10DHlADDITION Property Address:/ G1170G%e 4)" Lot: Block: Residences: # of Bedrooms: 15 fi) Property Owner(s)': . ESL i E Owner's Mailing Address: /_EZZrE Home Phone: C�o�i mag /sem •Contact information must be provided for the owner sk 9ry0n q 5b -71a ��\J i i ()rhn w m I Primary Contact Persor/Applicant (if not owner): J Cld CYCz,-p., cP 1+ta [+% Contact/Appl7l.MMailing Ado;ss: `^ / 6 Cell Phone: 930 6gs /Bo.cF L e,t-�s . Fax Number: r Email Address: ll 11 �• Nr{Jw P Gran/�l0 %frPs' /✓J! . iO Indicate Preferred Method of Permit Receipt: ® Email El Fax ❑ lS Mail Licensed Systems Inspector: Phone Number: Email Address: Fax Number: &7b e6o,,4z P wNne I *do- 1,10 746-7�5 517 leok L'g. ce C, 0+2, % (01-1 Mailing Address: City, State, Zip: f0 Box IeCOo 14 6CV.Joio Swk;�/.dam Cd 7/6v2 PLEASE READ BEFORE SIGNING: I tartly that the above Information Is complete and accurate and that I have provided complete and accurate information In all of the documents Included In my application package. 1 acknowledge that this department may revoke any permit I am Issued H my application Is found to contain any Inaccurate, false, or misleading Information. Owner Signature (Required): Date: 3_ (6' - Applicant Signature: Date: 3. 16 IS . Please allow 3-5 business days for processing of Use Permits. Received by EH Staff: Fee & Receipt #: Date: 110 0 0 YOI JC K IN Onsite Wastewater Treatment Systems (OWTS) Use `lPermit Inspection Form COUNTS` Pitkin County Environmental Health Department 76 Service Center Rd, Aspen, CO 81611 Phone: 970-920-5070 Fax: 97D-920-5374 Website: www.aspenpitkin.com/ehnr Inspection form for continued use of an existing OWTS Owner's Name: Address: Parcel Number: "Z6c-i 3 - DS 3 y(7 -00 -L Inspection Date: Inspector's Name: Business Name: Qp{t, 12a�-f-�'EZ �L�Amf37.46. Phone Number q -)p- al2-S— (f-33 Email: �J.I t cn/ Pitkin County Systems Inspector Li nse Number: A copy of this inspection report will be remitted to Pitkin County Environmental Health Department by the Licensed Systems Inspector within 60 days of the inspection regardless of whether the system passes or fails. QUESTIONS FOR PROPERTY OWNER PRIOR TO INSPECTION:^ Is the home currently occupied? YES (3N :) If NO, how long has the home been vacant? ! How many bedrooms are in the home? If secondary treatment is used, who is the maintenance provider? NO RECORDS: Were system records available from Pitkin County? ES NO If YES: Permit number: Uo I Date of Final Approval: p of bedrooms permitted: 5 Was an as -built drawing available? S NO Is the as -built drawing accurate? YES NO If NO: Complete a drawing of the system on last page of this form as accurately as possible. Any question marked FAIL will require correction before an OWTS Use permit is issued. SITE CONDITIONS: Proper grading, no evidence of erosion?tN FAIL Improper vegetative cover? YES Evidence of compaction such as heavy machinery or livestock? YES Improper discharges such as straight pipes? FAIL Evidence of high ground water? YES, Snow cover present? NO YES Page 1 0 0 TANK: Tank 1 Tank 2 Y Tank 3 If YES, is the pump/dosing siphon functioning properly? Tank capacity 1,750 gallons DOO gallons /L)DO Is the high water alarm working, both visible and audible? gallons Tank material SECONDARY TREATMENT: YES 60AC,rek / _d(.tel-- NO # of compartments / 0 Z_ Does the owner have a current maintenance contract for the unit? YES / UNKNOWN Date of last pumping -27-f7 2--2.5-- Lids/risers in good condition PASS AI PASS AIL PASS 7 FAIL Risers to grade ES) NO E ? NO YES NO Riser height — Risercondition/watertightness Qw+SPoNgtJ4 7 Inlet sanitary T/baffle ASS FAILASS, FAIL PASS ? FAIL Outlet sanitary T/baffle FAIL PASS FAIL PASS 7 FAIL Effluent filter (if part of design) PASS FAIL / PASS FAIL /A PASS FAIL QA-) Condition of tank material FAIL P FAIL I PASS F Tank was pumped for inspection ES NO ES NO I YES 0 If YES, list the pumping company If NO, when was the last pumping Scum level (1st compartment) Z inches / inches inches Sludge level (1st compartment) 12— inches inches inches Scum level (2nd compartment) inches inches inches Sludge level (2nd compartment) inches inches inches Backflow (if pumped) P ` FAIL PASS FAIL Midtank baffle 94/-MS�) AIL N/A PASS FAIL N/A Watertightness FAIL PASS FAIL PUMPS/DOSING SIPHONS: FAIL Is a pump or dosing siphon present? Y NO If YES, is the pump/dosing siphon functioning properly? YES FAIL Does the pump/wiring/dosing siphon appear to be in good condition? PASS FAIL Is the high water alarm working, both visible and audible? PASS FAIL SECONDARY TREATMENT: YES NO Is a secondary treatment unit present? YES NO UNKNOWN If YES, does the unit appear to be in good working condition? YES 0 Does the owner have a current maintenance contract for the unit? YES O UNKNOWN Maintenance Provider: Phone: If there is no maintenance contract, a contract must be In place prior to occupancy of the home. A copy of the contract must be submitted to Pitkin County Environmental Health Department. ABSORBTION AREA: Effluent surfacing? Evidence of past surfacing? Surface dampness? Excessive odors? Field location verified by observation ports or probing: Liquid in observation port? If YES, record depth: Distribution Box or ADV part of original design? If YES, is it accessible from grade? Is it level and in good condition? Lj PASS FAIL YES N YES NO YES PortsProbin NO ES —inches YES NO NKNO YES NO PASS FAIL Page 2 L Any problems with the system that not addressed in the inspection checklist? 0 Please list any recommendations for the continued use of the system: LttNt-6 A2(— efi L;OS '7?fA'iAVC Clunv3u'd6 A,tjn n1 DT 50ALr.)n12'n/Z /3F46M4c67), RISLFS A^eE 1'TW—Tw tb _ oSE 4r0 A-LeLOW Z�-3 73 602JtW -1:)V_ St-WLD 6C R POCCf) L5AT-NOT- KEk)uXZ�T) LAE Sac6esr ,3 (z,SL-V-S vjprH t}Arre Were any repairs done as a result of this inspection? CNS YES f 1 If YES, please describe the repairs. WI Dew W c CAN Pq(ACC 1 16.5 r— p` i,iS '-- To To the best of my knowledge and training, the information colle this inspection is accurate as of 2-25 2015. Z�- Licensed Systems Inspector Signature: Additional No r � !� LOC Q�� O 1�1� SE4�rJp Li (� W CC- -Co iJCi TAW <, tyrbr3iOL WA -5 AnNC 13(,4 T- Di4F cL4c i LVJ [LiA C 6 6CC I Clearly label any pictures and attach them to this form. 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