HomeMy WebLinkAboutpitkin.eh.264504303001 (2015)N Onsite Wastewater Treatment Systems (OWTS) Use
Permit Inspection Form
111FICOUNT'; Pitkin County Environmental Health Department
76 Service Center Rd, Aspen, CO 81611
Phone: 970-920-5070 Fax: 970-920-5374
Website: www.aspenpitkin.com/ehnr
Inspection form for continued use of an existing OWTS
Owner's Name: Bill Switzer
Address: 184 Little Elk Creek
Snowmass CO 81654
Parcel Number: 2645-043-03-001
Inspection Date: 7/14/2015
Inspector's Name: Jason Daubs
Business Name: D&D Septic Services, LLC
Phone Number 970-471-1330
Email: DDSepticServices@gmail.com
Pitkin County Systems Inspector License Number: 19
A copy of this inspection report will be remitted to Pitkin County Envirom
the Licensed Systems Inspector within 60 days of the inspection reaar(
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? 4
If secondary treatment is used, who is the
maintenance provider? N/A
Nee
0
d�
RECORDS:
Were system records available from Pitkin County? ®
NO
If YES: Permit number: 04048
Date of Final Approval: 12/14/05
# of bedrooms permitted: 4
Was an as -built drawing available? ®
NO
Is the as -built drawing accurate? ®
NO
If NO: Complete a drawing of the system on last page of this 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?
® YES
Page 1
TANK:
Tank 1
Tank 2
Tank 3
®
Tank capacity
1000
gallons
1000
gallons
1000
gallons
Tank material
Concrete
Concrete
Is a secondary treatment unit present? YES
Concrete
UNKNOWN
# of compartments
1
1
NO
1
Maintenance Provider: Phone:
Date of last pumping
Lids/risers in good condition
Risers to grade
r7M
FAIL
NO
PrM
FAIL
NO
PAM
r7m
FAIL
NO
Riser height
Riser condition/watertightness
Good
Good
Good
Inlet sanitary T/baffle
IMM
FAIL
FAIL
FAM
FAIL
Outlet sanitary T/baffle
FAIL
UM9
FAIL
FM
FAIL
Effluent filter (if part of design)
PASS
FAILN A
PASS FAIL
MM
FASS FAIL
N/A
Condition of tank material
FAILFTM
FAIL
ASS
FAIL
Tank was pumped for inspection
YES
rMM
YES
NO
YES
If YES, list the pumping company
If NO, when was the last pumping
Scum level (1st compartment)
1/8
inches
0
inches
0
inches
Sludge level (1st compartment)
6
inches
0
inches
0
inches
Scum level (2nd compartment)
inches
inches
inches
Sludge level (2nd compartment)
inches
inches
inches
Backflow (if pumped)
PASS
FAIL
PASS
FAIL
PASS
FAIL
Midtank baffle
Watertightness
FAIL N/A
FAIL
PASS FAIL
PA7M
FAIL I
PASS FAIL
17M
FAIL
PUMPS/DOSING SIPHONS:
Is a pump or dosing siphon present?
®
NO
If YES, is the pump/dosing siphon functioning properly?
®
FAIL
Does the pump/wiring/dosing siphon appear to be in good condition?
®
FAIL
Is the high water alarm working, both visible and audible?
®
FAIL
SECONDARY TREATMENT:
inches
®
Is a secondary treatment unit present? YES
NO
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 of the 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?
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?
®
FAIL
®
YES
®
YES
®
YES
o -rt s
Probing
NO
YES
inches
®
NO
®
NO
®
FAIL
Page 2
UNKNOWN
Any problems with the system that were not addressed in the inspection checklist?
None
Please list any recommendations for the continued use of the system:
None
Were any repairs done as a result of this inspection? ® YES
If YES, please describe the repairs.
To the best of my knowledge and training, the information collected in this inspection is accurate as of
July 14 , 20 15.
Licensed Systems Inspector Signature:
Additional Notes:
At the time of inspection the system is functioning properly. The first tank had a sludge level of 6"
or 15%. Pumping is done when the sludge level is 30% or greater.
Clearly label any pictures and attach them to this form.
Page 3
IMPROVEMENT SURVEY
LOT 26, BLOCK 1
LITTLE ELK CREEK SUBDIVISION, FILING NO. 1
PITKIN COUNTY, COLORADO
0 10 20 40
1' = 20'
NOTES
1) LEGAL DESCRIPTION:
LOT 26. BLOCK 1 LITRE ELK CREEK SUBDIVISION, FlUNG NO. 1 RECORDED IN PLAT BOOK
4 AT PAGE 130 IN THE COUNTY OF PITKIN, STATE OF COLORADO.
2) BASIS OF BEARING:
ABEARING OF 55715'06"W BETWEEN A FOUND REBAR AND YPC LSj 9184 AT THE
EASTERLY PROPERTY CORNER AND A FOUND REBAR AND ALC LS/ 5933 AT THE
SOUTHERLY PROPERTY CORNER.
3) THIS SURVEY DOES NOT CONSTITUTE A TITLE SEARCH BY THIS SURVEYOR. TITLE
INFORMATION RELIED UPON FOR THE PREPARARON OF THIS SURVEY FURNISHED BY TITLE
COMPANY OF THE ROCKIES, COMMITMENT NO. 0704673—C, DATED 06/30/2015.
4) UNIT OF MEASUREMENT FOR THIS SURVEY IS THE U.S. SURVEY FOOT.
5) POSTED ADDRESS IS 184 LITRE ELIC CREEK AVE.
6) SETBACKS SHOWN HEREON ARE BASED ON PITKIN COUNTY ZONING DESIGNATION R-30
LEGEND
SURVEYOR'S CERTIFICATE
'I, Michael Lafferty, hereby certify to Barbara Lands (buyer) and Title Company of
the Rockies and/or assigns that this Is an improvement survey plat' as defined
by C.R.S. 6 38-51-102(9) and that it is a manumanted land survey showing the
location of all structures, visible utilities, fences, hedges, or walls situated on the
described parcel and within five feet of all boundaries of such parcel, any
conflicting boundary evidence or visible encroachments, and all easements,
underground utilities, and tunnels described in the Title Company of the Rockies
Commitment for Title Insurance Commitment Na, 0704673—C, or other sources as
specified an the knprovement survey plat
MICHAEL P. LAFFERTY PLS. i 37972
• INDICATES FOUND MONUMENT AS DESCRIBED.
RPC RED PLASTIC CAP
YPC YELLOW PLASTIC CAP
ALC ALUMINUM CAP
®
ELECTRIC TRANSFORMER
FENCE LINE
EM
ELECTRIC METER
®
SEPTIC UD
CD
TELEPHONE RISER
4&
CURB STOP
RO
ROOF OVERHANG
SURVEYOR'S CERTIFICATE
'I, Michael Lafferty, hereby certify to Barbara Lands (buyer) and Title Company of
the Rockies and/or assigns that this Is an improvement survey plat' as defined
by C.R.S. 6 38-51-102(9) and that it is a manumanted land survey showing the
location of all structures, visible utilities, fences, hedges, or walls situated on the
described parcel and within five feet of all boundaries of such parcel, any
conflicting boundary evidence or visible encroachments, and all easements,
underground utilities, and tunnels described in the Title Company of the Rockies
Commitment for Title Insurance Commitment Na, 0704673—C, or other sources as
specified an the knprovement survey plat
MICHAEL P. LAFFERTY PLS. i 37972
SITE PLAN
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