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Owner Name:
STREET ADDRI
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Pitkin County Environmental Health Department
Individual Sewage Disposal System Inspection Report
Parcel ID #: 4- 6
INSPECTOR'S NAME
Phone #:
Except for system components, unless a section has been checked NA, ALL ITEMS in that
section must be completed. Items marked with an asterisk (*) are minimum approval criteria
items. Any such item marked FAIL means the system cannot qualify for a use permit. All other
NO / YES items are for information only and will be so noted on the use permit. NP means not
present.
SYSTEM COMPONENTS (mark only 1 for each category — mark NA if not applicable)
Primary Treatment Unit NA [
Septic Tank , Gray Water
Tank is _ gal. Tank Material
Size of Field ft2 Units
Technology
11, Aeration Tank
❑ Tank Lids Within 6" of
Finished Grade
Lineal ft.
❑ There is a `T' that goes down 14 inches in the inlet and outlet of the tank
❑ There is a "T" that goes up to with in 1" of the underside of the tank lid.
❑ Tank has two compartments with the larger compartment closest to the house
❑ Cleanout is installed in between tank and house (+ 1/100 ft)
❑ There is an effluent filter on the outlet pipe
❑ The effluent filter is easy to remove for cleaning
Se dar Treatment Unit NA
❑ Sp
CQ -sorption / Evaporation System NA ❑
❑ Chambered System ❑ Drip Irrigation ❑ Seepage Bed*
❑ SeepagePit ❑ Seepage Trench ❑ ET bed
❑ Other * includes unknown type of seepage bed
❑ Inspection at the end of each trench, or at corners
❑ Proper distance to setbacks
G:\isds\templates, forms\inspection.Report-Engineer.doe
a
NA ❑
❑ CVical ilet ❑ Composting Toilet ❑ Incineration Toilet
Sucharge ❑ Holding Tank ❑ Black Water Vault
Liquid in obs. / vent pipe? ❑ NONE
1"-6"
Alte
❑ NP
❑ NP
❑ NP
Less than 1"
Greater than 6"
NA ❑
Functio
❑ PASS
[j
FAIL
❑ Othe (sp ify)
❑ YES
❑
NO
E
Other Components:
NA ❑
❑ Electri ump (lift) Station ❑
Chlorinator
❑ Other_
SITE, WEATHER AND OCCUPANCY CONDITIONS DURING INSPECTION
*Erosion?
❑ PASS
❑
FAIL
*Improper Discharges?
❑ PASS
❑
FAIL
Improper Vegetative Cover?
❑ NO
❑
YES
Subject to Compaction?
❑ NO
❑
YES
Snow Cover?
❑ NO
❑
YES
Property Vacant?
❑ NO
❑
YES
ABSORPTION / EVAPORATION
NA ❑
Visible Components
*Vent / Observation Pipe
❑ PASS
❑
FAIL
D-Box/Valve Box
❑ PASS
❑
FAIL
Operational Status
❑ PASS
❑
FAIL
*Sewage Surfacing?
❑ NO
❑
YES
Evidence of Past Surfacing?
❑ NO
❑
YES
Surface Dampness?
❑ NO
❑
YES
Excessive Odors?
❑ NO
❑
YES
Liquid in obs. / vent pipe? ❑ NONE
1"-6"
Alte
❑ NP
❑ NP
❑ NP
Less than 1"
Greater than 6"
NA ❑
Functio
❑ PASS
[j
FAIL
%Os?
*Exce siv
❑ YES
❑
NO
&\isdsVemplates, four " Zspection.Report-Engineer.doc
9
Pitkin County Environmental Health Department
Contact Log Sheet
Page 1 of 1
Nancy Mackenzie
From: Jim Austin
Sent: Tuesday, February 06, 2007 7:38 AM
To: Nancy Mackenzie
Subject: RE: 670 Johnson Drive
They just had a rough framing inspection on Jan 25 so still a ways from CO. Contact is Mark, 923-4411.
Jim Lewis? I feel slighted.
From: Nancy Mackenzie
Sent: Monday, February 05, 2007 4:30 PM
To: Jim Austin
Cc: Jim Lewis
Subject: FW: 670 Johnson Drive
This was supposed to go to Jim AUSTIN, not LEWIS! — stupid computer!
From: Nancy Mackenzie
Sent: Monday, February 05, 2007 3:40 PM
To: Jim Lewis
Subject: 670 Johnson Drive
Hi Jim,
Any idea what is happening with this one. They were supposed to have the septic system check before CO. Who
is the contact?
Nancy MacKenzie
970-920-5076
Sr. Environmental Health Specialist
Pitkin County
Environmental Health & Natural Resources Department
2/6/2007
�97�A
To: Mark 411 From: Nancy MacKenzie
Fax: 923-4414
Pages: 5 including cover sheet
Phone: 923-4411 Date: 4/7/2006
Re: Allen - 670 Johnson Dr CC:
❑ Urgent x For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle
Mark,
Attached is the limited information we have on file for the septic system for the above property.:
Septic permit
Sketch of location of the septic tank which indicates that the flow from the tank goes into a
distribution box that equally distributes it to two drywells.
Sample, generic Inspection Report
I have contacted the building dept that the building permit for the remodel/addition can be issued since
the system is sized for the remodel based on the bedroom count.
Because the system is — 17 years old, we will be referred at time of CO. By that time the septic system
will need to be pumped and inspected to be sure the components of the system have good integrity
and are functioning as designed. You can use the Inspection Report as a guideline for what to look for
during the inspection.
In addition we now require an effluent filter on the outlet flow from the septic tank. The filter catches
larger particle so they do not flow into the seepage pits. This prevents clogging in the pits and extends
the life of the system. The filter requires monitoring and cleaning, usually every two years depending
on use.
Call if you have any questions,
Nancy 920-5076
■EN 091'25/2009
00:01 9636070
■ ■
B & R Septic Service,
• •
Rooter & Jetting Service
Video Tnsvection Service
0603 Handy Drive
Carbondale, CO 81623
Bill To
Mark Allen
1969 Shore Oak Dr.
Decatur, IL 62521
Quantity
Pump septic tank @ 0670 Johnson
side was not accessible
800 I Dump Fee
Sales Tax
E R SEPTIC
P.O. No. I Terms
PAGE 01
Invoke
Date Invoice #
9/3/2009 3008
Due on receipt
Rate
- could only pump solid side, water1 280.00
0.15
3.90%
Thank you for your business. ondale Aspen. Fax
[(9370)963-381 (970) 920-2059 (970) 963-6070 Total
Project
Amount
280.00
1.20.00
0.00
$400.00
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