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Pitkin County Environmental ,_,ealth 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 #: 2643-213-01-005
OWTS Use Permit #: I 0043.2013.powu
Date Issued: 09/16/2013
Issued By: Bryan Daugherty
Expiration Date: 9/16/14
Owner(s): I OWB Reo, Inc
Property Address:
250 Upper Ranch Rd
Legal Description:
Lot 6, Block 1, Filing 2, Brush Creek Village
Licensed Inspector: Carla Ostberg
Inspection Date(s): 9/12/13
SYSTEM INFORMATION
Components
Type
Capacity/Size
Primary Treatment Unit
Concrete 1 -compartment tank
Concrete 2 -compartment tank
1500 gallons
1000 gallons
Secondary Treatment Unit
Absorption Area
Gravelless Chambers
1185 ftz
Other System Components
OMITS 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 #: 06079 Date of Issuance: 10/12/06 Date of Final Approval: 5/5/08
# of Bedrooms or fixtures served by OWTS: 4 bedrooms + 1 bedroom CDU
Operational Status: The inspector indicates the system is functioning properly and there is no indication of failure.
Both tanks were in good working condition after repairs, the inlet and outlet tees were present in the tanks with an
effluent filter in the outlet of the 1ST tank. An extended handle was made for the filter so it is accessible. These tanks
flowed to a distribution box at evenly distributed effluent to 5 gravelless chamber trenches. There were no signs of
failure in the field area.
Inspector Recommendations: N/A
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.
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Pitkin County Environmental Health Department
` t ' Onsite Wastewater Treatment System (OWTS)
USE PERMIT APPLICATION
76 Service Center Rd
Aspen, CO 81611
Website: www.aspenpitkin.com/ehnd
Annlication for Continued Use of an Existina OWTS
Parcel IDN (available from the Pitkin County Assessor's Office
v
q � _ } -?7_ O _ r 0 5
970-920.5160 or at www.aitkinassessor.orn):
t .
Purpose of Use Permit: PROPERTY TRANSACTION ❑ REMODELJADDTTION
Property Address:
51 � U. +zc. %\. N
4, -Pk v) CC) lC
Lot:Block: Filing:
Subdivision: (f
r,
Cell Phone:
VA 4-x'1`7
.VL
Residences: Other
Fax Number.Email
# of Bedrooms: Ll-}- D Ll xhuestuses:
Property Owner(s)': Email Address:
Owner's Mailing Address: City, State, Zip:
> Z
Home Phone: Buoess Phone:
'ConiacF irrcimaVon must be proviaeu fur the owner signing this appiicauon.
Primary Contact Person/Applicant (if not owner):
Company
T-�j -)--,v-i D1 kw -
-meAJ
1
Contact/Applicant Mailing Address:
City, Stale, p:
Cell Phone:
VA 4-x'1`7
Business Phone:
q
v -C 3 Zz JrJ
Fax Number.Email
Address:
indicate Preferred Method of Permit Receipt:
Erroll
El Fax ❑ U5 Mail
Licensed Systems Inspector. Phone Number: Email Address: Fax Number.
0-3041-quaS`i 00,fux,u A (L L _ 07-N
Mailing Address: Cay.zip:
�:3 �a r ry ft.' . c+tr ' a v �e Qj 91 tot 'J
PLEASE READ BEFORE SIGNING:
I eerft 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.
owner Si re (Requ r Date:
t7i 13
Applicantr V Date:
Please allow 3-5 business days for processing of Use Permits.
FOR OPFICa USE NL.Y
Received by EH Staff: Fee & Receipt #: Date:
A
September 13, 2013
CBO Inc.
33 Four Wheel Drive Road
Carbondale, CO 81623
cell) 970-309-5259 office) 970-704-0484
carla.ostberq(&gmail.com
Tom DiMercurio
Tom. dimercurio(c)themercuryalliance.com
Onsite Wastewater Treatment System (OWTS) Use Permit Inspection
250 Upper Ranch Road
Pitkin County, Colorado
Mr. DiMercurio,
As requested, CBO Inc. performed an Onsite Wastewater Treatment System (OWTS) Use Permit
inspection at 250 Upper Ranch Raod, Aspen, Colorado on September 12, 2013.
The permit and record drawing was provided by Pitkin County Environmental Health Department
(Parcel ID # 2643-213-01-005). The subject OWTS consists of one 1500 -gallon, single -
compartment concrete septic tank with an effluent filter on the outlet tee, followed by a 1000 -gallon,
two-compartment concrete tank. Effluent is distributed through a distribution box, accessible from
grade, to five gravelless chamber trenches. Each trench has 24 `Quick 4' Infiltrator® chambers for a
total of 120 chambers and 1185 square feet of absorption area.
The septic tanks appeared to be in good condition. There was minimal accumulation of sludge and
scum in the septic tanks. Pumping at this time is not required. The tee on the inlet pipe of the 1St
tank was missing. There was an effluent filter on the outlet tee; however, it was accessible only by a
rope. All manhole lids were accessible from grade, with the exception of the outlet lid of the 1000 -
gallon tank. The distribution box was also accessible from grade. The absorption area showed no
signs of saturation, and had no indication of failure. Observation ports were present. This evaluation
is not a guarantee of future system performance. This inspection is good for one year.
Required repairs:
• An inlet tee must be installed on the first tank.
• A handle extension must be put on the effluent filter in place of the rope.
• A 1 -foot riser must be installed on the outlet of the 2nd tank.
• The lid on the outlet of the 1 St tank must be replaced.
**Excavation Services has been contracted to perform these repairs on September 16, 2013**
This report will be submitted to the Pitkin County Environmental Health Department in order to
obtain a Pitkin County OWTS Use Permit.
Please call with questions.
Sincerely,
(!alt
Carla Ostberg, MPH, REHS
NAWT Certified Inspector
Certification # ITC 11042010 Exp. 2014
Cc: Craig and Deborah Mulligan (drsmulligan(a)charter.net)
Susan Lodge (susanlodgeCa)me.com)
Missing tee on inlet
LWLVIRUMIGWA
Lcilm WTI cffluent filter (needs extension handle)
Inlet tee on 2nd tank (tee was also present on outlet)
Distribution box (very deep / no baffle or angled inlet pipe)
- a Q
Absorption area — observation ports present
,0prK11N Onsite Wastewater Treatment Systems (OWTS) Use
Permit Inspection Form
""COUNTI`� Pitkin County Environmental Health Department
76 Service Center Rd, Aspen, CO 81611
Phone: 970-920-5070 Fax: 970-920-5374
Owner's Name:
Inspection Date: (7
Inspector's Name:
Business Name:
Phone Number 64 o
Pitkin County Systems Inspector License Number:
A My Qofthig inspection !Le-gort will be remitted to Pitkin CoYntv EnM"o M -ental Health Deourtment by
the Licensed SMems in Ector Within 60 days of the inspection regardless of whether the system
PASsts or fails.
QUESTIONS FOR PROPERTY OWNER PRIOR To INSPECTION:
bthe home currently occupied?
IfNO, how long has the home been vacant? — V 12 1(00- 1,1, '� x
How many bedrooms are inthe home?
|fsecondary treatment i,used, who iothe �------- - - -
maintenance provider? r
RECORDS:
Were system records available from Pitkin County?
��
If YES: pennunombrr: `----~-
FinalDate of
Approval:
#ufbedrooms permitted: I Vo"p,U 0,_--�w�.'�r7
Was onas-built drawing available? NO
|sthe as -built drawing accurate? {YES� NO
If NO: Complete odrawing 4/the system onlast page nythisformosaccurately os
possible.
Any question marked FAIL will require correction before anOMITS Use permit isissued.
SITE CONDITIONS:
Proper grading, noevidence oferosion?
FAIL
Improper vegetative cover?
YES
Evidence ofcompaction such asheavy machinery or|ivpstock?YES
Improper discharges such osme
—{�h�pipp�� -
FAIL
Evidence ofhigh ground water?
YES
Snow cover present7NO
YES
0
TANK:
Tank 1
Tank 2
Is a pump or dosing siphon present?
Tank 3
Tank capacity
gallons
•, z gallons
FAIL
gallons
Tank material
FAIL
Is the high water alarm working, both visible and audible?
PASS
FAIL
# of compartments
T i
Is a secondary treatment unit present? YES
NOS
Date of last pumping(}
If YES, does the unit appear to be in good working condition? YES
NO
f
Lids/risers in good conditionASS
FAIL
PASS FAIL _
-- -PASS
FAIL
Risers to grade
ES NO
YES ---WO O
YES
NO
Riser height
Riser condition/watertightness
Inlet sanitary TJbaffle
PASS FAIL %
PASS FAIL
PASS
FAIL
Outlet sanitary T/baffle
PASS FAIL
C PASS _) FAIL
PASS
FAIL
Effluent filter (if part of design)
: RAS FAIL N/A
PASS FAIL ` NZ6D
PASS
FAIL N/A
Condition of tank material
PASS FAILP
FAIL
PASS
FAIL
Tank was pumped for inspection
YES NO`
YES _ NO `',
YES
NO
If YES, list the pumping company
if N0, when was the last pumping
Scum level (1st compartment)
E inches
t° inches
inches
Sludge level (1st compartment)
" inches
inches
inches
Scum level (2nd compartment)
rr inches
inches
inches
Sludge level (2nd compartment)
i inches
inches
inches
Backflow (if pumped)
-PASS---^a--FAA
PASS
FAIL
Midtank baffle
PASS FAIL) � NTA
FAIL N/A
PASS
FAIL N/A
Watertightness
--- PASS- FAIL
vF'7�55 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:
Is a secondary treatment unit present? YES
NOS
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: Phone:
If there is no maintenance contract, a contract must be in place prior to occupancy of the horne. A
copy of the contract must be submitted to Pitkin County Environmental Health Department.
ASSORBTION 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?
--
No
FAIL
YES
YES
YES
Probing
YES
inches
YESNO
YES�~•'' NO
. PASS-� FAIL
Page 2
UNKNOWN
Any problems with the system that were not addressed in the inspection checklist?
Please list any recommendations for the continued use of the system:
Were any repairs done as a result of this inspection?
If YES. please describe the repairs_
7o the best of my knowledge and training, the information collected in this inspection is accurate as of
x y 2 I
Licensed Systems inspector Signature:
Additional Notes:
Cieariy label any pictures and attach them to this form.
Page 3
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Pitkin County Environmental Health & Natural Resources Department
Permit for an Individual Sewage Disposal System
0405 Castle Creek Road, Suite 10, Aspen, Colorado 81611
Phone 970-920-5070 / FAX 970-920-5077
Permit # 06079 Parcel ID # 2643-213-01-005
Type of permit New(X) Repair() Addition/Remodel to House( )
Name of Owner Doug Raines
Street Address 250 Upper Ranch Road
Property legal description
Size of lot 2.23 acres
Lot 6, Filing 2, Brush Creek Subdivision
Water source Brush Creek Metro District
Total square footage of the house
3,600
# of bedrooms in house 4 # of offices, lofts & similar sized rooms in house
Caretaker unit Detached Total square footage of the caretaker unit
# of bedrooms in caretaker unit
Designed for what # rooms (list)
1,000
# of offices, lofts & similar sized rooms in caretaker unit
FIVE = 4 bedrooms main house + 1 bedroom CDU
Permit information
Designed by All Service Septic
Mailing Address P.O. Box 2844, Glenwood Springs, CO 81602
\ ,� 5 .�- %���?a�=2 ice►---T.�C
Perc rate 44 Profile hole depth 21ft Depth to groundwater or bedrock
Minimum Septic tank capacity 2500 gallons Minimum Absorption area
Comments
31 ft
2322sf / 50% reduce=1160sf
Septic permit approved per compliance with the engineer design and specifications dated September 7, 2006.
Any changes must be approved by this department and the design engineer prior to them being made.
Minimum horizontal distances between components of the system and physical features shall conform to the Pitkin
County ISDS regulations.
Design is for one 1500 gallon single -compartment concrete septic tank with an effluent filter on the outlet followed
by a 1000 gallon, two-compartment concrete septic tank with an effluent pump. Effluent is pumped through a 2 inch
line to a concrete distribution box with a baffle with equal distribution to 5 trenches, each with 24 Quick4 gravelless
chambers for a total of 120 chambers. Trenches are to be a maximum of 3 ft deep with a minimum of 6 ft of
undisturbed soil between the trenches.
This department does not endorse any brand of products. This permit must be kept on-site during installation.
The engineer must do a final inspection of the installation and submit an as -built letter to this department. This
department must also be called for an inspection with a minimum of 48 hours advanced notice.
The owner has the responsibility that all components are inspected and maintained on a regular basis by qualified personnel.
Revegetation over the area of the field is very important for the functioning of the system. Pitkin County has guidelines that must be
followed to assure the plants that are introduced are appropriate for the conditions of the area. The use of native plants is strongly
encou
Permit approved by: 16 /f -L -
Date: ! 4 / 2— v�
Plans and specifications of the prop ed individual sew6lge disposal system have been reviewed and are considered
satisfactory. Permission is hereby gYanted to the owner or the agent to perform the work indicated in accordance with the Pitkin
County ISDS Regulation in effect at the time of issue. This permit becomes invalid 6 months from the date that the permit was
issued unless system construction has commenced or an extension has been approved in writing by the Department.s-_built
drawings must be included with this permit before the final approval will be issued. E piration Date: Z
Installer: License Number: [ �—
Final approval: Date: D Y" , r� I b �✓
"9�-- -"A- _/ Iku, & �"rt., �