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HomeMy WebLinkAboutpitkin.eh.264504303001 (2011),l11Txity CoU1vT� Pitkin County Environment-' Health Department Onsite Wastewater Treatment System (OWTS) USE PERMIT 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 www.aspenpitkin.com/EHNR Parcel ID #: 2645-043-03-001 OWTS Use Permit #: I 0017.2011.POWU Date Issued: 4/15/2011 Issued By: Carla Ostberg Expiration Date: 4/15/2012 Owner(s): I Killeen Brettmann (Russell CE Family Trust) Property Address: 0184 Little Elk Creek Ave. Legal Description: Lot 26, Block 1, Filing 1, Little Elk Creek Village Licensed Inspector: Tim Petz 002 Inspection Date(s): March 23, 2011 SYSTEM INFORMATION Components Type Capacity/Size Primary Treatment Unit Concrete single compartment 1000 gallons Concrete single compartment 1000 gallons Concrete single compartment pump chamber 1000 gallons Secondary Treatment Unit n/a Click here to enter text. Absorption Area Sand filter (2') (2) 30'x34' Other System Components pump Click here to enter text. OWTS Use Status: ® In use at the time of the inspection. (not certain) ❑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 #: 04048 Date of Issuance: 7/29/2004 Date of Final Approval: 12/14/2005 # of Bedrooms or fixtures served by OMITS: 4 bedrooms Operational Status: The system appeared to be in good working condition at the time of the inspection. This system was upgraded in 2004 to accommodate an addition to the home and sufficiently addresses high groundwater conditions on the site. Inspector Recommendations: none Department Recommendations: Recommend 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. '?d 17. 2 G) U Pitkin County Environmental Health Department ,ofirKIN Onsite Wastewater Treatment System (OWTS) a C4iEN 7`USE PERMIT APPLICATION '� �0405 Castle Creek Road, Suite 10 • Aspen, CO • 81611 • Phone: 970.920.5070 Fax: 970.920.5077 Website: www.aspenpitkin.com/ehnr Annlica+inn Mr ICnn+inuPcl lJse of an Existina OWTS Parcel ID# (available from the Pitkin County Assessor's Office � � 970-920-5160 or at www.pitkinassessor.org): L Company: Contact/Applicant Mailing Address: Purpose of Use Permit: \— PROPERTY TRANSACTION ElREMODEL/ADDITION Business Phone: J\ Property 1 Address: L(jJ' �IL (', � 1 Il✓ Lot: Block: Filing: Subdivision: Residences:r Other of Bedrooms: L# fixtures/uses: Property Owner(s)*:/ Email Ad ress, '/je2t?P44M,�-�� ) /1- -rn e(-O2AA0V4�r , Owner's Mailing Address: City, State, Zip: I I 1p L7l C Home Phone: Bu iness Phone: q 1 Q - cf L - L4 3L15. *Contact information must be provided for the owner signing this application. Primary Contact Person/Applicant (if not owner): C o' Company: Contact/Applicant Mailing Address: City, State, Zip: Cell Phone: Business Phone: Fax Number: Email Address: Indicate Preferred Method of Permit Receipt: mail ❑Fax ❑ US Mail Licensed Systems Inspector: Phone Number: Email Address: Fax Number: Mailing Address: City, State, Zip: 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 Mnature ui ed)T L , n / A Date: icant Sip ature: Date: Please allow 3-5 business days for processing of Use Permits FOR OFFICE USE ONLY Received by EH Staff: Fee & Receipt #: Date: s 4 eoo 3 o -7,313 PAN LES : Onsite Wastewater Treatment ystems (OMITS) Use Permit Inspecto Form Pitkin County Environmental H alth Department 0405 Castle Creek Road, Suite 10 Aspen, CO 81611 Phone: 970-920-5070 Fax: "GLA 70-920-5077 vim^ Website: www.as en itki .com ehnr Inspection Form for continued use of an existing OV4TS OWNERS Name: Address: Parcel Number: Inspection Date: Records: I LLrC5__Q�5'�>✓�-t iM Ate U. Were system records available from the department? If Yes: Permit number: C?4Q q 9D Date of Installation: (a—VA-0 Ye No Tank siz Absorption area size: Permitted Use: p© r 2� t Is this system permitted for its current use? If no, describe the change in use. If No: Site Conditions: Erosion TANK: Was an As -Built drawing available? -> Is the As -Built Drawing Accurate? Complete a drawing of the system on last page of this possible if as -built was not available or is not accurate. Improper Vegetative cover Evidence of Compaction Improper Discharges High Ground Water Snow Cover Property Vacant P FAIL YES YES AS FAIL N YES NO YES NO YES Was the tank pumped as part of the inspection? If No, skip to TaM If No: When was the tank last pumped? 5-ZIE `t© If the tank has not been pumped in more than 2 years, please attac for justification. Information to be included in justification : Dept of sludge layer and/or Verification of limited occupancy If Yes: Pumping Company: Discharge/leakage PASS FAIL Infiltration PASS FAIL Back flow after pumping NO YES A L as accurately as eop'1_00 Components. i additional information i of scum layer, Depth It t, Tank Components: Tank 1 ( bC — — k ib Y\ Lids '5NGLE Tank Integrity Mid -Tank Baffles Sanitary Tees / Inlet & Outlet Baffles Effluent Filter/Screens Water Tight Pump/Dosing Siphon Tank Material Pump Alarm Tank Components: Tank 2 Lids S\ Tank Integrity Mid -Tank Baffles Sanitary Tees / Inlet & Outlet Baffles Effluent Filter/Screens Water Tight Pump/Dosing Siphon Tank Material Pump Alarm © FAIL �-� FAIL PASS 6 FAIL PASS FAIL PAS FAIL PASS FAIL PASS FAIL Yes No L1. o Mechanical Systems PASS FAIL ASS FAIL PASS 6 FAIL FAIL PASS FAIL ASS FAIL PASS FAIL Tesp FAIL Media Condition No If additional tanks are present, include reports for each. SECONDARY TREATMENT: Is a secondary treatment unit part of the system design? NO If Yes: Make/Model: Yes Distribution Box Lids PASS FAIL Tank Integrity PASS FAIL Media Container PASS FAIL Media Condition PASS FAIL Mechanical Systems PASS FAIL Controls/Alarms PASS FAIL Maintenance Agreement PASS FAIL Provider Name Provider Phone Nurr ABSORBTION AREA: Distribution Box Accessible from grade? Yes Distribution Box PASS ADV Accessible from grade? Yes Automatic Distributing Valve (ADV) Observation Ports Yes Effluent Surfacing ASS Evidence of Past Surfacing N Surface Dampness NO Excessive odors Liquid in observation port NO No FAIL No FAIL No FAIL YES YES YES NP NP NP Expires: r 4NN NP NP 'WP k IL' i. Tank Components: Tank,t? l ,1-1L1 Ejv w M Lids FAIT Tank Integrity PAS FAII Mid -Tank Baffles PASS FAIT Sanitary Tees / Inlet & Outlet BafflesAS Effluent Filter/Screens ASS Water Tight Pump/Dosing Siphon PASS Tank Material Pump Alarm es Tank Components: Tank 2 Lids PASS Tank Integrity PASS Mid -Tank Baffles PASS Sanitary Tees / Inlet & Outlet Baffles PASS Effluent Filter/Screens PASS Water Tight PASS Pump/Dosing Siphon PASS Tank Material PASS Pump Alarm Yes If additional tanks are present, include reports for each. SECONDARY TREATMENT: Is a secondary treatment unit part of the system design? If Yes: Make/Model: No FAIL FAIL FAIL FAIL FAIL FAIL FAIL FAI L No Lids PASS FAIL .Tank Integrity PASS FAIL Media Container PASS FAIL Media Condition PASS FAIL Mechanical Systems PASS FAIL Controls/Alarms PASS FAIL Maintenance Agreement PASS FAIL Provider Name Provider Phone NunI ABSORBTION AREA: Distribution Box Accessible from grade? Yes No Distribution Box PASS FAIL ADV Accessible from grade? Yes No Automatic Distributing Valve (ADV) PASS FAIL Observation Ports Yes No Effluent Surfacing PASS FAIL Evidence of Past Surfacing NO YES Surface Dampness NO YES Excessive odors NO YES Liquid in observation port NO i NP NP NP NP NP NP NP NP NP NP Expires: )er NP NP NP NP NP Any problems with the system that were not addressed in the inspection ch �vCl\l� cklist? Please list any recommendations for the system to continue its current usag . Were any repairs done as a result of this inspection? NO J. YES If Yes, please describe the repairs. To the best of my knowledge and training, the information collected in this ii Inspector's Signature: Business Name: U evgcc � Phone Number Rio (of 8-, Address: 00 ispection is accurate as of lroLZ f -o �- / 34 pROP�R1,� �1N� N 28. 45 WP�R L1NE W �W �O Z j Z 2 V.......... B & R Septic Service, Inc. Rooter & Jetting Service Video Inspection Service 0603 Handy Drive Carbondale, CO 81623 Bill To Killeen Brettmann 0184 Little Elk Creek Snowmass, CO 81654 AV Invoice { Date Invoice # 5/28/2010 i 4366 P.O. No. I erms Project i i Due n receipt i Quantity Description Rate Amount s pump 1st septic tank & skimmed 2nd tank260.00 260.00 I 1,3001 Dump Fee Sales Tax 0.151195.00 3.90% 0.00 Thank you for your business. Carbondale Aspen I Fax --- - ----- Total $455.00 I (970) 963-38...' (970) 970) 963- 070 Lo 00 0 W 4� co 00 NT 0 0Z (1) 0 Sr N 28'45 34 W 208-80 LITTLE ELK CREEK AVENUE Lf 3: U, SUMMARY SQ. '=T. ARE -A PERIMETER ' AREA CALCULATION DETAILS Living Area First Floor First Floor 2019 254 20.5 x 33.0 = 676.5 Second Floor 765 111 30.0 x 44.0 = 1320.0 Total 2784 365 4.5 x 5.0 = 22.5 Total 2019.0 Second Floor 25.5 x 30.0 = 765.0 Studio Studio 335 69.9 22.8 x 14.7 = 335.0