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HomeMy WebLinkAboutpitkin.eh.264503201004 (2011)411KIN COUN0, Pitkin County Environmenta, .iealth Department Onsite Wastewater Treatment System (OWTS) USE PERMIT Permit for Continued Use of an Existing OWTS Parcel ID #: 2645-032-01-004 OWTS Use Permit #: I 0033.2011.powu Date Issued: 9/1/2011 Issued By: Carla Ostberg Expiration Date: 9/1/2012 Owner(s): I Bill Sharman Property Address: 201 Capitol Creek Rd Legal Description: Lot 4, Capitol Woods Licensed Inspector: Tim Petz Inspection Date(s): 8/30/2011 0405 Castle Creek Road, Suite 10, Aspen, CO 81611 Phone: 970-920-5070 Fax: 970-920-5077 www.aspenpitkin.com/EHNR SYSTEM INFORMATION Components Type Capacity/Size Primary Treatment Unit Concrete tank, two-compartment 1500 gallon Secondary Treatment Unit n/a n/a Absorption Area 24" Sand filter beds Two 16' x 38' beds 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, itis recommended that the system be re-evaluated when itis in use for a more accurate evaluation of the system. System Records: Permit #: 04002 Date of Issuance: 1/14/2004 Date of Final Approval: 8/9/2004 # of Bedrooms or fixtures served by OWTS: 4 bedrooms (3 bedrooms on lot 4 and 1 bedroom for a future ADU on lot 6) The future ADU would need to install a separate tank and tie into the absorption area on lot 4. Operational Status: This system consists of one 1500 gallon, two-compartment tank and two sand filter beds. The tank was pumped at the time of the inspection and everything appeared to be in good working order. Inspector Recommendations: None. Department Recommendations: This department recommends periodic (yearly) maintenance inspections by a Pitkin County Licensed Systems Inspector of the pump and entire system to assure proper functioning. 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. i Pitkin County Environmental H Ith Department Onsite Wastewater Treatment ystem (OWTS) USE PERMIT APPLIC TION 0405 Castle Creek Road, Suite 10 - Aspen, CO - 81611 Phone: 970.920.5070 Fax: 970.920.5077 Website: www.aspenpitkin.comiehnr Residences: Other # of Bedrooms: �\ fixtures/uses: c Afnr %'r%n+inllArl I ICA of nn FYICiinn OWTS Parcel ID# (available from the Pitkin County Assessor's Office CA�CA<J AGF- -SCJ M 970-920-5160 or atwww.r)itkinassessor.org); CC) ��� Purpose of Use Permit:PROPERTY TRANSACTION ❑ REMODEL/ADDITION ` lz� Property Address: 201 CAP K --\o L- C����, c!:)PA1---,\0 City, State , Zip: Lot: Block: Filing: Subdivision: Cell Phone: -7 4 I ._ 011 Residences: Other # of Bedrooms: �\ fixtures/uses: c Property Owner(s)*: Email Address: \ J� CA�CA<J AGF- -SCJ M Owner's Mailing Address: City, State, Zip: 2-01 upt-VOL- C��- uQ+D kx�MAS CC) ��� Home Phone: Business Phone: lz� Contact/Applicant Mailing Address: I�1L+ e. ��M-Ao A.�� City, State , Zip: 'Gontacr Inrormavon muss oe pruV7Oeu !u/ mu uwflw slynory uua aNNuwuuu. I Primary Contact n/Applicant (if not owner): Company: n N Date: Mailing Address: r� q �` City, State, Zip: J IP2> 2 T C91..EN Ute° co � 1 �L' lz� Contact/Applicant Mailing Address: I�1L+ e. ��M-Ao A.�� City, State , Zip: Cell Phone: -7 4 I ._ 011 Business Phone: c Fax Number: (I c2-7 Email Address: -t-o-kcr—B sON Moe C. <oM Indicate Preferred Methoc of Permit Receipt: mail El Fax ❑ US Mail Licensed Systems Inspector: Phone Number: Email Address: �N1 Fax Number: (k?,)A 3�3 ZI TPi---i-1- Date: Mailing Address: r� q �` City, State, Zip: J IP2> 2 T C91..EN Ute° co � 1 �L' lz� PLEASE READ BEFORE: SIGNING: I certify that the above information is complete and accurate and that I have provided complete and ao curate information in all of the documents included in my application package. I acknowledge that this department may revoke any permit I am ssued if my application is found to contain any inaccurate, false, r misleading information. Owner Signature (Requ ): Date: Applicant Signature: Date: Please allow 3-5 business days for processing of Use Permits. FOR OFFICE USE ONLY Received by EHStaff. Fee & Receipt #: iln.. lam. n moo, r, g�-fnn/n" ,.0- l a&" r Go, GAJ 0033.2JDc[•Powu 3 Dave: Onsite Wastewater Treatment Systems (OWTS) Use Permit Inspection Form Pitkin County Environmental HealtF Department 0405 Castle Creek Road, Suite 10, Asp an, CO 81611 Phone: 970-920-5070 Fax: 970- 20-5077 Website: www.as en itkin.co ehnr Inspection form for continued use of an existing OWTS Owner's Name: 6 j u— SwRP Address: 0( C Jap i -vi L Parcel Number: Inspection Date: Inspector's Name: Z Business Name:EP-LL Phone Number CZ© Cot sz)3 Email: COM Pitkin County Systems Inspector License Number: t1) passes 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? When was the tank last pumped?-�V Name of pumping company: If secondary treatment is used, who is the maintenance provider? 0 RECORDS: Were system records available from Pitkin County? ES NO If YES: Permit number: G`{©CN?— Date of Final Approval: oLi # of bedrooms permitted: z Was an as -built drawing available? NO Is the as -built drawing accurate? YES NO If NO: Complete a drawing of the system on lost page of this form as possible. Any question marked FAIL will require correction before an OWTS U SITE CONDITIONS: Proper grading, no evidence of erosion? Improper vegetative cover? NO Evidence of compaction such as heavy machinery or livestock? NO Improper discharges such as straight pipes? Evidence of high ground water? N Snow cover present? Page 1 a%OAT. - is �) Lely as permit is issued. FAIL YES YES FAIL YES YES TANK: Tank 1 Is a pump or dosing siphon present? Tank 2 If YES, is the purnp/dosing siphon functioning properly? Tank 3 Does the pump/wiring/dosing siphon appear to be in good condition? Tank capacity 60(o gallons SECONDARY TREATMENT: gallons Is a secondary treatment unit present? gallons Tank material cc—, NI -11 Does the owner have a current maintenance contract for the unit? YES Maintenance Provider: K)5)N Phone:_ If there is no maintenance contract, a contract must be in place prior to occu # of compartments ABSORBTION AREA: Effluent surfacing? FAIL Evidence of past surfacing? YES Date of last pumping ~ '30T Excessive odors,? YES Field location verified by observation ports or probing: Probing Lids/risers in good condition ASS FAIL PASS FAIL PASS FAIL Risers to grade ES)NO FAIL YES NO YES NO Riser height 2 Riser condition/watertightness Inlet sanitary T/'baffle FAIL PASS FAIL PASS FAIL Outlet sanitary 17/baffle PASS FAIL PASS FAIL PASS FAIL Effluent filter (if part of design) P FAIL N/A PASS FAIL N/A PASS FAIL N/A Condition of tank material PSFAIL PASS FAIL PAS FAIL Tank was pumped for inspection YES NO YES NO YES NO Scum level (1st compartment) " inches inches inches Sludge level (1st compartment) 1�1�lJf% inches inches inches Scum level (2nd compartment) inches inches inches Sludge level (2nd compartment) inches inches inches Backflow (if pumped) ASS FAIL PASS FAIL PASS FAIL Midtank baffle PAS FAIL N/A PASS FAIL N/A PASS FAIL N/A WatariiohtnPcc ASS FAIL PASS FAIL PASS FAIL PUMPS/DOSING SIPHONS: �1 Is a pump or dosing siphon present? If YES, is the purnp/dosing siphon functioning properly? Does the pump/wiring/dosing siphon appear to be in good condition? Is the high water alarm working, both visible and audible? SECONDARY TREATMENT: Is a secondary treatment unit present? YES If YES, does the unit appear to be in good working condition? YES Does the owner have a current maintenance contract for the unit? YES Maintenance Provider: K)5)N Phone:_ If there is no maintenance contract, a contract must be in place prior to occu copy of the contract must be submitted to Pitkin County Environmental H ABSORBTION AREA: Effluent surfacing? FAIL Evidence of past surfacing? YES Surface dampness? tN YES Excessive odors,? YES Field location verified by observation ports or probing: Probing Liquid in observation port? YES If YES, record depth: inches Distribution Box or ADV part of original design? YES Ao—) If YES, is it accessible from grade? YES `v& Is it level and in good condition? PASS FAIL Page 2 N0 �1 FAIL FAIL FAIL (Z) UNKNOWN NO NO UNKNOWN of the home. A Department. NKNOWN R1Z� 7�w Any problems with the system that were not addressed in the inspection chec [� Please list any recommendations for the continued use of the system: Were any repairs done as a result of this inspection? NO YES If YES, please describe the repairs. To the best of my knowledge and training, the information collected in this inspec ion is accurate as of 20 Licensed Systems Inspector Signature: Additional Notes: �j Kbo Clearly label any Pictures and attach them to this form Page 3 If no as -built drawings exist for this system or the as -built was inaccurate, please iagram 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 X_�cosa &NgXS Te NK Page 4 J 1 .0 0 .06 a