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HomeMy WebLinkAboutpitkin.eh.264316200011 (2012)(2)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. ��P1 1- H IN Pitkin County Environmental H•th Department Onsite Wastewater Treatment System (OWTS) USE PERMIT COU N T � 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 p: 2643-162-00-011 OWTS Use Permit q: I 0036.2012.powu (2) Date Issued: 11/6/2012 Issued By: Bryan Daugherty Expiration Date: 11/6/13 Owner(s): I Karen Wells Property Address:24 Liberty Lane Legal Descri tion: Absorption Area Licensed Inspector: Jeff Warren Inspection Date(s): 6/1/12 SYSTEM INFORMATION Components Type Capacity/Size Primary Treatment Unit Concrete 2 Compartment tank 1000 gallons Secondary Treatment Unit N/A N/A Absorption Area Dry well Minimum 346 sq ft Other System Components N/A N/A 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 N: 93060A Date of Issuance: 9/23/93 Date of Final Approval: N/A N of Bedrooms or fixtures served by OWTS: This system was designed to serve 2 bedrooms In the caretaker unit. Operational Status: According to the inspector observations that system was working properly at the time of inspection. The 1000 gallon, 2 compartment tank was water tight and in good condition. Both the Inlet and outlet tees were In place. The lids and risers were repaired so they are now water tight. This tank flowed into a dry well 11' deep and 10' around. The dry well showed no signs of surfacing effluent or other indicators of failure. Inspector Recommendations: N/A Department Recommendations: We recommend adding an effluent filter to the outlet tee on the tank to prevent solids from entering the dry well. luwme of this OWTS Use Permit is based solely an the conditions observed and reported by the Inspector to the Department on the dme of the Inspecuor4s/ and on Deportmentrecords at the time of permitting. the issuume of this permit does trot constitute a guarantee, warranty, orrepresentation by the Department that the system wfa operate properly w will not fall or that the system will not be sub/cct to future enforcement action to correct non< mjauant candalons. Estimated caporty of rite system has been listed an the permit and we recommend that you Monitor and/or meter water use t0 prevent overuse and possible failure. Witkin County Environmental HAh Department / T K I N Onsite Wastewater Treatment System (OWTS) V GUNTUSE 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 Pitkin County Assessors Office Company: 970-9205160 or at www.oitkinassessor.ora): - - - Purpose of Use Permit: PROPERTY TRANSACTION ❑ REMODEUADDIrfON Property Address: e (ti�tr�J G„ e ,.rod J GRIL C Lot: lock: Filing: Subdivision: Residences: Other # of Bedrooms: 1 fixtures/uses. 1 Property Owner(s)': ' a6 LSdun,1 &Z Email Address: p,r L/ ejVN Owners Mailing Address: 1325 :tUnnA 6 Fifa City, State, Zip: p Ppu vie& 1-71)Home Phone: ry - Lill- yo73 Business Phone: 17- - -contact inrormanon must oe provided ror the owner signing this application. Primary Contact Person/Applicant (if not owner): Company: Contact/Applicant Mailing Address: City, State, Zip: Cell Phone: Business Phone: Fax Number: Email Address: Indicate Preferred Method of Permit Receipt: ,Email Fax ❑ US Mail Licensed Systems Inspector: Phone Number: Email Address: Fax Number: SSOd C176'1.171 -133G D05,tE!)iStnw[l1 Mailing Address: City, State, Zip: PLEASE READ BEFORE SIGNING: I certify 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. I acknowledge that this department may revoke any permit I am issued If my application Is found to contain any Inaccurate, false, or misleading information. Signature Please allow 3-5 business days for processing of Use Permits. FOR OFFICE USE ONLY Received by EH Staff Fee & Receipt #: Date: I '53.7.0 . pew 0 L 0 (�11' K I N Onsite Wastewater Treatment Systems (OWTS) Use �Y Permit Inspection Form r � OLI N rY Pitkin County Environmental Health Department 76 Service Center Rd, Aspen, CO 81611 Phone: 970-920-5070 Fax: 970-920-5374 Website: www.aspenpitkin.com/ehnr Inspection form for continued use of an existing OWTS Owner's Name: Ken Stiller Address: 24 Liberty Lane Woody Creek, CO Parcel Number: 2643-162-00-011 Inspection Date: 2/25/2015 Inspector's Name: Jason Daubs Business Name: D&D Septic Services Phone Number 970-471-13330 Email: DDSepticServices(cDgmail. com Pitkin County Systems Inspector License Number: 19 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 posses or fails. QUESTIONS FOR PROPERTY OWNER PRIOR TO INSPECTION: Is the home currently occupied? ®E NO If NO, how long has the home been vacant? How many bedrooms are in the home? 4 If secondary treatment is used, who is the maintenance provider? RECORDS: Were system records available from Pitkin County? ®E NO If YES: Permit number: 93060 Date of Final Approval: 1993 # of bedrooms permitted: 4 Was an as -built drawing available? YES 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? AS FAIL Improper vegetative cover? ® YES Evidence of compaction such as heavy machinery or livestock? YES Improper discharges such as straight pipes? PASS FAIL Evidence of high ground water? NO YES Snow cover present? NO ES 3 Page 1 0 E TANK: Tank 1 NO Tank 2 PASS Tank 3 Does the pump/wiring/dosing siphon appear to be in good condition? Tank capacity 1250 gallons PASS gallons SECONDARY TREATMENT: gallons Tank material Concrete ® UNKNOWN If YES, does the unit appear to be in good working condition? YES NO inches # of compartments NO UNKNOWN Maintenance Provider: Phone: YES NO Is it level and in good condition? Date of last pumping Unknown Lids/risers in good condition ® FAIL PASS FAIL PASS FAIL Risers to grade ® NO YES NO YES NO Riser height 3 ft outlet 2ft inlet Riser condition/watertightness Good Inlet sanitary T/baffle A FAIL PASS FAIL PASS FAIL Outlet sanitary T/baffle 49&> FAIL PASS FAIL PASS FAIL Effluent filter (if part of design) PASS FAIL PASS FAIL N/A PASS FAIL N/A Condition of tank material FAIL PASS FAIL PASS FAIL Tank was pumped for inspection <:M> NO YES NO YES NO If YES, list the pumping company B&R Septic If NO, when was the last pumping Scum level (1st compartment) inches inches inches Sludge level (1st compartment) inches inches inches Scum level (2nd compartment) inches inches inches Sludge level (2nd compartment) inches inches inches Backflow, (if pumped) FAIL PASS FAIL PASS FAIL Midtank baffle AS FAIL N/A PASS FAIL N/A PASS FAIL N/A Watertightness AS FAIL PASS FAIL PASS FAIL PUMPS/DOSING SIPHONS: Is a pump or dosing siphon present? YES NO If YES, is the pump/dosing siphon functioning properly? PASS 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: Ports robin Is a secondary treatment unit present? YES ® UNKNOWN If YES, does the unit appear to be in good working condition? YES NO inches Does the owner have a current maintenance contract for the unit? YES NO UNKNOWN Maintenance Provider: Phone: YES NO 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? 4g FAIL Evidence of past surfacing? <01 YES Surface dampness? ® YES Excessive odors? NO YES Field location verified by observation ports or probing: Ports robin Liquid in observation port? NO YES If YES, record depth: inches Distribution Box or ADV part of original design? YES If YES, is it accessible from grade? YES NO Is it level and in good condition? PASS FAIL 4 Page 2 UNKNOWN 0 Any problems with the system that were not addressed in the inspection checklist? No problems. Please list any recommendations for the continued use of the system: Install outlet filter. Were any repairs done as a result of this inspection? 0 YES If YES, please describe the repairs. 7o the best of my knowledge and training, the information collected in this inspection is accurate as of February 25 2015 . i ) { Licensed Systems Inspector Signature: Additional Notes: Clearly label any pictures and attach them to this form. i Page 3 J 0 If no as -built drawings exist for this system or the as -built was inaccurate, please diagram the system as accurately as possible. Be sure to document all system components and the location of any well on the property. Using markers such as corners of the house, exact measurements can be used to triangulate the location of the system components for future reference. Garage and is steel Island inI 0 driveway / House Page 4