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HomeMy WebLinkAboutpitkin.eh.272929203003 (2017)Pitkin County Environmental Health 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: 970-920-5374 www.aspenpitkin.com/EHNR Parcel ID #: 2729-292-03-003 OWTS Use Permit #: I 0033.2017.POWU Date Issued: 06/12/2017 Issued By: Kurt Dahl Expiration Date: 1 06/12/2018 Owner(s): I Jack and Linda Goldman Property Address: 189 Beaver Drive Legal Description: Lot A-3 Redstone Ranch Ac. Licensed Inspector: Jason Daubs Inspection Date(s): 5/19/2017 SYSTEM INFORMATION Components Type Capacity/Size Primary Treatment Unit Concrete two-compartment septic tank 1250 Gallons Secondary Treatment Unit Fiberglass dosing tank 500 gallons Absorption Area Sand filter soil treatment beds (2) 23' x 22' (1012 ft2 total) Other System Components 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 #: 08047B Date of Issuance: 10/03/2008 Date of Final Approval: 12/10/2008 # of Bedrooms or fixtures served by OWTS: System is designed to serve 3 bedrooms. Operational Status: According to the inspectors observation the system was functioning as designed at the time of inspection. An effluent filter was installed on the outlet of the septic tank. Inspector Recommendations: None. Department Recommendations: Annual maintenance. 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. Page 1 1 3r. ?Gi . II�OLjL) Pitkin County Environmental Health Department }; Onsite Wastewater Treatment System (OWTS) USE PERMIT APPLICATION 76 Service Center Rd ' Aspen, CO 81611 Website: www.aspenpitkin.com/ehnr/ Aoolication for Continued Use of an Existina OWTS Parcel ID# (available from the Pitkin County Assessors Office G `% Q 970-920-5160 or at www.pitkinassessor.orgi: 2-7 L J � 797- LLG--��� G t (_ Purpose of Use Permit: [� PROPERTY TRANSACTION ❑ REMODEL/ADDMON Property Address: �9 1 C-Ift I Ic k C141 (P— rN, Lot: Block: Filin vision: Residences: Other V r # of Bedrooms: 3 fixtures uses: Property Owner(s)': 71il Address: A aAE Owner's Mailing Address: City, State, Zip a 10� Z12 COS Home Phoneme Bu mess Phone: `J(/ 'Contact information must be provided for the owner signing this application Primary Contact Person/Applicant ( oder): 1V C. Contact/Applicant Mailing Address:--Iity, n, -n n Sta , Z'p: o�Omn Cell Phone:Business �JMAVI DIV- ?"d I (a Fax Number: Email Address: t Indicate Preferred Method of Permit Receipt: mail ❑ Fax ❑ US Mail .icensed Systems Inspector: one Num Emafl Address: Fax Number: I �e--j Maio, CQ!4 Aailing Address: City, Stale, Zip: DLEASE READ BEFORE SIGNING: certify that the above Information is complete and accurate and that I have provided complete and accurate information In all of the documents ncluded in my application package. I acknowledge that this department may revoke any permit i am Issued If my application is found to contain any naccurate, false, or misleading information. Please allow 3-5 business days fkr processing of Use Permits. FOR OFFICE USE ONLY Received by EH Staff: Fee 8 Receipt #: Date: Onsite Wastewater Treatment Systems (OWTS) Use (� Permit Inspection Form Toulvlr* Pitkin County Environmental Health Department 76 Service Center Rd, Aspen, CO 81611 Phone: 970-920-5070 Fax: 970-920-5374 Website: I http:tlpitkincounty.com/248/Wastewater•Treatrnent Inspection form for continued use of an existing OMITS Owner's Name: Address: Parcel Number: Inspection Date: Inspector's Name: Business Name: Phone Number Email: Pitkin County System! C v : l y c" 1--y -30 — 00 3 v J /a,v f Yv 3'f C L4.G.. 7 -? Ol i 4 ,6 � 0 '''": C Inspector License Number: 1cl 771 A copv of this inspection report will be remitted to Pitkin Countv Environmental Health Department b 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? YES ©NO 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? RECORDS: Were system records available from Pitkin County? YES N0 If YES: Permit number: Date of Final Approval: # of bedrooms permitted: Was an as -built drawing available? ®YES 0 NO Is the as -built drawing accurate? ®YES r7NO 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 OMITS Use permit is issued. SITE CONDITIONS: Proper grading, no evidence of erosion? PASS ❑FAIL Improper vegetative cover? NO YES Evidence of compaction such as heavy machinery or livestock? NO YES Improper discharges such as straight pipes? SS QFAIL Evidence of high ground water? Q YES Snow cover present? PNO M YES Page 1 Effective Date 1/12/2017 TANK PUMPS/DOSING SIPHONS: Is a pump or dosing siphon present? YES RNO If YES, is the pump/dosing siphon functioning properly? ASS FAIL Does the pump/wiring/dosing siphon appear to be in good condition? ASS ®FAIL Is the high water alarm working, both visible and audible? ASS QFAIL SECONDARY TREATMENT: Is a secondary treatment unit present? MYES NO ®UNKNOWN If YES, does the unit appear to be in good working condition? YES NO Does the owner have a current maintenance contract for the unit? ®YES ® NO ®UNKNOWN Maintenance Provider: I 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? IT UNKNUWN Page 2 Effective Date 1/12/2017 Tank 1 Tank 2 Tank 3 Tank capacity Tank material # of compartments gallons , r . A r— gallons gallons Date of last pumping t Lids/risers in good condition Select One S Select One 453 Select One Risers to grade Select One Select One 5 Select One Riser height tt Riser co watertightness nlet sanita affle Select One ' Select One Select One utlet sanit baffle Effluent filter (if part of design) Select One Select One �61y Select One Select One Select One elect One Condition of tank material Select One ,� Select One Select One Tank was pumped for inspection If YES, list the pumping company Select One v +. Select One Select One If NO, when was the last pumping Scum level (1st compartment) Sludge level (1st compartment) inches inchesi inches inches inches inches Scum level (2nd compartment) inches inches inches Sludge level (2nd compartment) inches inches inches Backflow (if pumped) Select One ,we- Select One Select One Midtank baffle Select One P&<5 Select One Select One Watertightness Select One Select One �?}�$ Select One PUMPS/DOSING SIPHONS: Is a pump or dosing siphon present? YES RNO If YES, is the pump/dosing siphon functioning properly? ASS FAIL Does the pump/wiring/dosing siphon appear to be in good condition? ASS ®FAIL Is the high water alarm working, both visible and audible? ASS QFAIL SECONDARY TREATMENT: Is a secondary treatment unit present? MYES NO ®UNKNOWN If YES, does the unit appear to be in good working condition? YES NO Does the owner have a current maintenance contract for the unit? ®YES ® NO ®UNKNOWN Maintenance Provider: I 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? IT UNKNUWN Page 2 Effective Date 1/12/2017 Please list any recommendations for the continued use of the system: Were any repairs done as a result of this inspection? 17 NO ,� YES OiL�►(-t-, r/4eR fMA5 A6.4{,0 T-6 '04-e. OL,rl-ei e6 `ro-e TA.,,uk, To the best of my knowledge and training, the information cQjIected in this inspection is accurate as of 200. Lid nse Systems Inspector Signature: Clearly label any Pictures and attach them to this form. U .Clear Form Print Form Page 3 Effective Date 1/12/2017 'i 079771: 7!� niONSITE WASTEWATER TREAT :NT SYSTEM (OWTS) coNSTRUCTION PERMIT 044 Cele Crseit Road, Suite 10 Aspen, CG , 81611 Phare. 870.820.5070 fax` 970 020 6077 080478 toy 2729-292-03-003 Vw„w(a)' ( , roWty Add�yir"�a , Leow f 3 ww p RMAM t l e %)0EVAD=0a Ll WK ONLY OF= aur a ; ' of Lot .65 Rues Acxes'sM Lfrft €�'Ya5 WJ40 Site, of,Bwwk g, low {, Ft We of Accomory Unit 711 LC 2% 2D08 ,-,Mone 0: 34395 (�it,3;aq AdLitess 14eo Lea KH1 Road, E.LJS�ii�R} aCO 0-304 FOX* 303 4434355 Email Addre sw, Perc MAIM 1*0 briar! ;95.t.tt Prott7e Hate Depth' 88 tt. R Depth to Gmundwa#tic or 20" Per ttyrt�ar Minimw Tattle Capadt W g ono k inUnum Absorp5an Area 1000 sq ft *W no redLNcWn CSV m Cottsbrtdtatt Pura a is appfwY an ttt• at mow of awopft" wWj Ute ** W dos4n as rid *0 Hw a PkW6 rt snd UN "KW'� Obd ww 0MVea MUM be eWa od ay that {lyejgi*P* and U» 0091OW Pd- to =wh't6M A 1280 6a Non tank -has atreuady been ktst Ued due -to tonins of the exs� m4W tat* (OWTS Ge:atr JWw pert * Oug?), It shtkl be 1 *0h an affluent filter. A purnp, as qw ffad by the engind&, must be trtdisW In the ging chamber, The tteaid wo OW41A of (2) 23' x 22' sand iter boft. A,Wadsflbh of the Band filter auRWtal, matt whit socoon 6,26.090 8 2 of the i,:fttrt CAu;ty OWTS RVUs A�a, shit! be submitted to INS t to F IIsi. Sand s)u* be at W9 30" In depth (although the wVg w er sp9d$as 24"). The has atso spec W 0 30m4i PVC liner to be instnried MUM We north bed where the depot of s awid mweeds 24". The perimew of the bed(s)"tsave a 31 skgm fix proper drair r. Wk tn'tum sa Macks of 1 W from the Mbit to trio fluid, W from the fidid to the river, and W from any component to the "" tine roust be ma>!n A*d r6Mnrrt 3t► gs A d tAa f ice, *a., kow padad of deme tw baen ww"d up OM in tiw4 MC- This 130outinitMt front Mita fru a" bf the 6W ir"Pedon H If+>tMrte �' d9 horns froVice. trnraxrrttai t3isbMtoos i�h+ean cprrponanta vt the sysken aed ptt}+s" fen hm w wa cw0artn too* Mqu*warft of"* i odn cmmft t wls Posuk►ttom i'dis r'aratk ba coredaion+d upon rf+a Ptop+srty''�°'+rx"i"} paiwtd8q leu ropi�r� InsA+�tia►. Cots* � of the s�er#t by Qua�tfsd r'��ie, �t wWs tha rs� mmow w+dWwo and ilea e # 4f on pain aaarr8 Pott THIS PERKIT 65 "PRSMY CONDMONED UPON COMPLMNCiE:1At" ALL REQUIREMEMM OF THE PfflW COUNTY OWM REGUI ATiON, R CU BUT NOT taWED TO THWE COOMT"S SPECIRED ABOVL Piesis ascisptttit"a xis to the GYM hMn been raviea+md Mead ace co wk*'ed satisfaciary, Prrrntssiat is WC13Y Well to the property MAW 3) fo perforrn the work RowW in woordar" wdh the PKIn Cotmty flW M RegulOm Ttos Potmlt W51 expir$1 year front the doe of dsstarm untm consbuatim an the system► has coavn*rw*d, An "*&-buW df&*UV must be suiondtied and appmed by pfVM before from approval of the syAwn w l be �� ��« � � # �, � �, �. .� r„ _ ;� � � -� � - � � �� .�.F-. ^„ �.. � }i4 �\ °P �k f � 't �. a �a.f � � ��.� s� �.. ��.�`�� -�a,� .�� .,� � ,� ,� -.�. f j i f € l { { ; F *_' � ', . iii � ;� i � jj- }�T^�Y�� 3Y LLL -. aB� _ E F +�� S i 11'k i N Pitkin County Environmental Health Department Onsite Wastewater Treatment System (OWTS) USE PERMIT CHECKLIST Permit for Continued Use of an Existing OWTS 0405 Castle Creek Road, Suite 10 • Aspen, CO • 81611 Phone: 970.920.5070 Fax: 970.920.5077 Website: www.aspenpitkin.com/ehnr Some items listed on this checklist may already exist in the Department files. Please contact this department to collect any necessary documentation, using the parcel ID# to identify the property, priorto scheduling an OWTS Use Permit inspection and/or submitting the OWTS Use Permit application packet. A complete application package must be presented at the time of your pre -application conference for acceptance. To schedule a pre -application conference, please call (970) 920- 5070. PLEASE INITIAL EACH ITEM TO INDICATE COMPLETION Only one copy of each item is necessary. Electronic versions of any or all of the documents identified below may be emailed to ehnr(a)-co.pitkin.co.us before the date of the pre -application conference. OWTS Use Permit Application (completed) Site Plan (11x17) F-_ Should include general location of each OWTS, buildings, water courses, domestic water source(s), and other pertinent information. l Building Floor Plans (11x17) Current floor plans for a property transaction; or Proposed floor plans for an addition/remodel that does not increase potential bedroom count or water usage of the structure served by the existing OWTS. Inspection report by a Licensed Systems Inspector A list of Licensed Systems Inspectors can be found at www.aspenpitkin.com/ehnr An inspection report is good for one year. Z-11 Applicable Fee F OWTS Use Permit: $100 Please make checks payable to Pitkin County Environmental Health Department.