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Home My WebLink Aboutpitkin.eh.246315200003 (2010)(Main House/CDU)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. �l Jr K I N Onsite Wastewater Treatment Systems (OWTS Permit Inspection Form COUN?Y Pitkin County Environmental Health Department 0405 Castle Creek Road, Suite 10, Aspen, CO 81611 Phone: 970-920-5070 Fax: 970-920-5077 Website: www.aspenpitkin.com/ehnr Inspection Form for continued use of an existing OWTS OWNERS Name:L, /C IQ 1Z /C/— Address: lea i ] lU i_,, 4_ 0_,,,4b j% -A.4 Parcel Number: 4,;64j3 -IS.Z '06 -003 Records Were system records availabl f the department? es No If Yes: Permit number: MJ 3 Date of Installation:II�ank sizer Absorption area size: Nazt A2 Permitted Use: Ctr�fy�(,t.G;rr„ Is this system permitted for its current use? .d Use If no, describe the change in use. Was an As -Built drawing available? VO Is the As -Built Drawing Accurate? — If No: Complete a drawing of the system on last page of this form as accurately ash n , ` 2 possible if as -built was not available or is not accurate. A -9t R --/ J(�Q�l' CNK Site Conditions: TANK: ,Iev /V Erosion PASS FAIL Improper Vegetative cover NO YES Evidence of Compaction NO YES Improper Discharges PASS FAIL High Ground Water NO YES Snow Cover YES Property Vacant NO YES UNKNOWN 41, _C/ WA �..rwyy Was the tank pumped as part of the inspection? If No, skip to Tank Components. If No: When was the tank last pumped? If the tank has not been pumped in more than 2 years, please attach additional information for justification. Information to be included in justification : Depth of scum layer, Depth of sludge layer and/or Verification of limited occupancy 11 Yes: Discharge/leakage Infiltration Back Flow after pumping p� ,r VAS FAIL PAS FAIL N YES 4 - 1 1; Any problems with the system that were not list any recommen9atioiWfor the 4-4.1,..-0BonAi tA.YL tressed in the inspection checklist? "&�d-�a � , re.. 4uca _ to continue its urrent usage. Were any repairs done as a result of this inspection? NO YES If Yes, please describe the repairs. To the best of my knowledge and training, the information collected in this inspection is accurate as of 20 i . 17 Inspector's Signature Business Name: Phone Number Address: Email: Pitkin County Inspector License Number: ,t_02 L A copy of this inspection report will be remitted to Pitkin County Environmental Health with 60 days of the inspection. 9 Tank Components: Tank 1 U U( I lA Y Ury LIUV& i Lids PASS Tank Integrity A Mid -Tank Baffles PASS ' Sanitary Tees / Inlet & Outlet Baffles PAS Effluent Filter/Screens PASS Water TightPAS FAIL Pump/Dosing Siphon PASS Tank Material PAS Pump Alarm Yes 1 Tank Components: Tank 2 S�'0 PASS Lids PASS% Tank Integrity PASS Mid -Tank Baffles y ( PASS Sanitary Tees / Inlet & Outlet Baffles x, PASS Effluent Filter/Screens �q�\y PASS Water Tight yS PASS Pump/Dosing Siphon ��j�^ PASS Tank Material �� PASS Pump Alarm ^a Alf- dk Yes o PASS ,ye ADV Accessible from grade? If additional tanks are present, include reports for each. 0 FAIL NP FAIL FAIL' FAIL FAIL NP FAIL No A)p ��A n m .-L FAIL FAIL FAIL FAIL FAIL FAIL FAIL No NP A�NP � SECONDARY TREATMENT: Is a secondary treatment unit part of the system design? /1% If Yes: Make/Model: Lids PASS FAIL Tank Integrity PASS FAIL Media Container PASS FAIL NP Media Condition PASS FAIL NP Mechanical Systems PASS FAIL Controls/Alarms PASS FAIL Expires: Maintenance Agreement PASS FAIL Provider Name Provider Phone Number ABSORBTION AREA: Distribution Box Accessible from grade? Yes No NP Distribution Box PASS FAIL ADV Accessible from grade? Yes _ No NP Automatic Distributing Valve (ADV) PASS FAIL (nl p Observation PortsPASS FAIL �J Effluent Surfacing PASS FAIL Evidence of Past SurfacingINO YES Surface Dampness YES Excessive odors YES Liquid in observation port inches 13 If no as -built drawing exist for this system or the as -built was inaccurate, please diagram the system as accurately as possible, being sure document all parts of the system, well locations and accurate distances. i POJG- i6-2ulO 02:35 FROM:VILLAGE PLUMBING 9706252149 0 Al TO:19709205077 P.4/4 0 If no as -built drawing exist for this system or the as -built was inaccurate, please diagram the system as accurately as possible, being sure document all parts of the system, well locations and accurate distances. Sl L I 4i ---- ;---- ....... 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