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Home My WebLink Aboutpitkin.eh.264522400021 (2017)TA jtxxin COUNT4 Pitkin County Environmentallth Department Onsite Wastewater Treatment Sys (OWTS) USE PERMIT Permit for Continued Use of an Existing OWTS Parcel ID #: 2645-224-00-021 OWTS Use Permit #: 0038.2017.POWU Date Issued: 06/23/2017 Issued By: Bryan Daugherty Expiration Date: 6/23/18 Owner(s): I LinRoc LLC, #17 Property Address: 487 Shield O Road Legal Description: Lot 20, Shield O Terrace Licensed Inspector: Doug Warren Inspection Date(s): 6/13/17 76 Service Center Road, Aspen, CO 81611 Phone: 970-920-5070 Fax: 970-920-5374 www.a npitkin.com/EHNR SYSTEM INFORMATION Components Type Capacity/Size Primary Treatment Unit Concrete two-compartment tank 1000 Gallons Secondary Treatment Unit Absorption Area Deep Gravel Trenches 1650 ft' 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 #: 81061-R Date of Issuance: 08/04/1992 Date of Final Approval: 08/23/1992 # of Bedrooms or fixtures served by OWTS: System is designed to serve 3 bedrooms. Operational Status: According to the inspector's observation the system was functioning as designed at the time of inspection and there was no evidence of failure. Inspector Recommendations: Annual maintenance or as needed. Department Recommendations: Add effluent filter to outlet of tank to prevent solids from reaching the field area. 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 00A<9 ,'DO Pitkin County Environmental Health Department f Onsite Wastewater Treatment System (OWTS) USE PERMIT APPLICATION 76 Service Center Rd p Aspen, CO 81611 http://pitkincounty.com/248ANastewater-Treatment A....I:��:fir (`r%ntinrrnrl I Ica of nn FXi-z inn OWTS 101 Parcel ID# (available from the Pitkin County Assessor's Office [-U�52 OD®7G-li 970-920-5160 or at httessor.or /assessor/search. asp Purpose of Use Permit: PROPERTY TRANSACTION ®REMODEL/ Property Address:Ij ,� • � ` �` V)Q Lot: - Block: Business Phone: Filing: Fax Number: Subdivision: Email Address: Indicate Preferred Method of Payment Check Credit/Debit Li Cash Residences: Other # of Bedrooms: fixtures/uses: Property Owner(s)': Email Address: _ i F, Owner's Mailing Address: City, State, Zip: V Ucivrjjj-'Y�+. Home Phone:Business Phone: 3-7 *Contact information must be provided for 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 Payment Check Credit/Debit Li Cash Licensed Systems Inspector: Phone Number: Email Address: �.)5 ,JaorIG- 95�- S/ -ii, I agQ!b s�C,,-,. Mailing Addregs: city,State Zip: �, I car wW.i ber: 2- - O 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. Owner Signature (Required): Date: Applicant Signature: Date: Please allow 3-5 business days for processing of Use Permits. Save Form Clear Form Print Form FOR OFFICE USE ONLY Received by EH Staff: Fee & Receipt #: Date: Effective Date 1/12/2017 / T Onsite Wastewater Treatment Systems (OWTS) Use Were system records available from Pitkin County? YES Permit Inspection Form COUNTS Pitkin County Environmental Health Department Date of Final Approval: 76 Service Center Rd, Aspen, CO 81611 ----'- CPcv Phone: 970-920-5070 Fax: 970-920-5374 Was an as -built drawing available? YES Website: www.as en itkin.com ehnr Inspection form for continued use of an existing OWTS Owner's Name: &C kg possible. Address: Gig'7 Sbiltiol 0 IN Parcel Number: Inspection Date: / f? inspector's Name: Business Name: o± -e/" Phone Number _Cft/S � $ _ Email: �J ja?fE.n., ro io Pop kq&I 1.Co Pitkin County Systems InspeHor License Number: _ A con' of this inspection report will be remitted to pitkin county Environment Hea�ortment by the Licensed Systems inspector within 60 days of the inspection regardless of whether the system Passes or fails. QUESTIONS FOR PROPERTY OWNER PRIOR TO INSPECTION: Is the home currently occupied? 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? kal0 9-6-A Tcq- RECORDS: Were system records available from Pitkin County? YES NO If YES: Permit number: �0 Date of Final Approval: # of bedrooms permitted: Was an as -built drawing available? YES NO Is the as -built drawing accurate? YES NO If N0: Complete a drawing of the system on Iasi page of th/s 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? FAIL Improper vegetative cover? YES Evidence of compaction such as heavy machinery or livestock? YES Improper discharges such as straight pipes? FAIL Evidence of high ground water? YES Snow cover present? Nr YES Page 1 0 TANK: Tank 1 Tank 2 YES Tank 3 If YES, is the pump/dosing siphon functioning properly? Tank capacitygallons FAIL Does thepump/wiring/dosing siphon appear to be in good condition? PASS gallons Is the high water alarm working, both visible and audible? gallons Tank material SECONDARY TREATMENT: Is a secondary treatment unit present? YES -(0) UNKNOWN p of compartments NO Does the owner have a current maintenance contract for the unit? YES NO UNKNOWN Maintenance Provider: Phone: Date of last pumping Lids/risers In good condition FAIL PASS FAIL PASS FAIL Risers to grade NO YES NO YES NO Riser height Riser condition/watertightness Inlet sanitary T/baffle 5 FAIL PASS FAIL PASS FAIL Outlet sanita T/haffle 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 NO YES NO YES NO If YES, list the pumping company�- If NO, when was the last pumping Scum level (istcompartment) Z- Inches Inches Inches Sludge level list compartment) inches Inches inches Scum level (2nd compartment) inches Inches Inches Sludge level (2nd compartment) Inches inches Inches Backgow (If pumped) PASS FAIL PASS FAIL PASS FAIL Midtank baffle FAIL N/A PASS FAIL N/A PASS FAIL N/A Watertightness CWSV FAIL PASS FAIL PASS FAIL PUMPS/DOSING SIPHONS: Is a pump or dosing siphon present? YES If YES, is the pump/dosing siphon functioning properly? PASS FAIL Does thepump/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 -(0) 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 home. A copy ofthe 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? a 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? FAIL YES YES Ad YES o Probing 0 YES Inches YES A<2 KNOWN YES rVjO PASS FAIL Page 2 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? "C( YES If YES, please describe the repairs. 7o the be s of my knowled a and training, the infor tion ected in this Inspection Is accurate as of 20�. License Systemslnspector Signature: Additional Notes: _aearw label anv otcturas and attach them to this form. Page 3 E