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Pitkin County Environmental i.,!alth Department
Onsite Wastewater Treatment System (OWTS) USE PERMIT
Permit for Continued Use of an Existing OWTS
76 Service Center Road, Aspen, CO 81611
Phone: 970-920-5070 Fax: 970-920-5374
www.aspenpitkin.com/EHNR
Parcel ID #: 2645-273-00-004
OWTS Use Permit #: I 0006.2014.powu
Date Issued: 3/13/14
Issued By: Bryan Daugherty
Expiration Date: 3/13/15
Owner(s): I Holly McLain
Property Address:
8276 Snowmass Creek Rd (House)
Legal Description:
Licensed Inspector: Doug Warren
Inspection Date(s): 2/28/14
SYSTEM INFORMATION
Components
Type Capacity/Size
Primary Treatment Unit
2 -compartment concrete 1000 gallons
Secondary Treatment Unit
N/A
Absorption Area
Unknown
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 #: Unknown Date of Issuance: Date of Final Approval:
# of Bedrooms or fixtures permitted by OWTS: System was most likely constructed prior to the departments permitting
program. The system design size is unknown. The system currently serves a 3 bedroom home.
Operational Status: After required repairs to the risers and lids of the tank, the system was functioning appropriately.
The tank was in good condition and the field area did not show any signs of failure.
Inspector Recommendations: N/A
Department Recommendations: The department recommends adding an effluent filter to the outlet of the 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
VM
Pitkin County Environmental i —alth Department
Onsite Wastewater Treatment System (OWTS) USE PERMIT
Permit for Continued Use of an Existing OWTS
76 Service Center Road, Aspen, CO 81611
Phone: 970-920-5070 Fax: 970-920-5374
www.aspenpitkin.com/EHNR
Parcel ID #: 2645-273-00-004
OWTS Use Permit #: I 0006.2014.powu
Date Issued: 3/13/14
Issued By: Bryan Daugherty
Expiration Date: 3/13/15
Owner(s): I Holly McLain
Property Address:
8276 Snowmass Creek Rd (Barn)
Legal Description:
Licensed Inspector: Doug Warren
Inspection Date(s): 2/28/14
SYSTEM INFORMATION
Components
Type Capacity/Size
Primary Treatment Unit
2 -compartment concrete 1000 gallons
Secondary Treatment Unit
2 -compartment concrete 1250 gallons
Absorption Area
Unknown
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 #: Unknown Date of Issuance: Date of Final Approval:
# of Bedrooms or fixtures permitted by OWTS: This system serves the barn.
Operational Status: After required repairs to the risers and lids of the tank, the system was functioning appropriately.
The pump was functioning. The tanks were in good condition and no surfacing effluent or other signs of failure were
observed.
Inspector Recommendations: N/A
Department Recommendations: The department recommends adding an effluent filter to the outlet of the 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
Pitkin County Environmental Health Department
4u IN Onsite Wastewater Treatment System (OWTS)
G111 USE PERMIT APPLICATION
UN It 76 Service Center Rd
<�) Aspen, CO 81611
Website: www.aspenpitkin.com/ehnr/
Ar�v�lin.�tinr� fnr f`rnntiniiinrl I Ica of nn FxiCtinn OWTS
Parcel ID# (available from the Pitkin County Assessor's Office
970-920-5160 or at AV w.pitkinassessor.orgl:
Purpose of Use Permit:
[� PROPERTY TRANSACTION ❑ REMODEL/ADDITION
Property Address:
Z -) u S t\ trw �XAOSs
G lc ,` ��lO�jJr`C\LCSS , C
Lot: Block:
Filing: Subdivision:
Residences:
# of Bedrooms:
Other
fixtures/uses:
Prop�(rty Ot iner(s)`: �r-� ` Email Address:
i• ")1L 1 1 ,C�\G` \---, c�C1oGs�1'UY� 5� t'tS CIS�Y
Owner's Mailing Address: City, State, Zip: p
0-0
Home Phone: , n Business Phone:
•-nnmrr Information must be provided for the owner signing this application.
Prim ry C`o` JnJt''act Person/Appliciant (if not owner):
Company: ^� -
f-�\Ca 1s71 1 r 7�Gx�1e�C`-
LW rx-
Contact/Applicant Mailing Address: ,y
City, State, Zip:
0-0 `avo-QL�
Cell Phone:
q
Business Phone:
°I�o q�� 3k
Fax Number:
Email Address:
Indicate Preferred Method of Permit Receipt: ® Email
❑ Fax ❑ US Mail
Licensed Systems Inspector: Phone Number: Email Address: Fax Number:
)LEASE READ BEFORE SiGNiNG:
certify that the above information Is complete and accurate and that I have provided complete and accurate information in all of the documents
ncluded In my application package. I acknowledge that this department may revoke any permit I am Issued if my application is found to contain any
naccurate, false, or misleading Information.
)caner Signa re (Re V Date:
I C) rC]
kpplicant Signature: Dale:
Please allow 3-5 business days for processing of use Permits.
by EH Staff: Fee & Receipt #: Date:
-1 N Onsite Wastewater Treatment Systems (OWTS) Use
Permit Inspection Form
3U11iT" Pitkin County Environmental Health Department
76 Service Center Rd, Aspen, CO 81611
Phone: 970-920-5070 Fax: 970-920-5374
Website: www.aspenpitkin.comlehnr
Inspection form for continued use of an existing OWTS
Owner's Name:
Address:
Parcel Number: 7,1, y 0000
Inspection Date: Z /q
Inspector's Name: p 40-yr--
Business
u yC—Business Name: ` tri b �1
Phone Number 0 _ /�� � /
Email 1 tYYv` R11YJ (Z9a G' CLrta i Cuv�
Pitkin County Systems Inspe or License Number:
A copy of this inspection report will be remitted to Pitkin County Environmental Health Department 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?
RECORDS:
Were system records available from Pitkin County? YES
NO
If YES: Permit number:
Date of Final Approval:
# of bedrooms permitted:
Was an as -built drawing available? YES
NO
Is the as -built drawing accurate? YES
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 OMITS Use
permit is issued.
SITE CONDITIONS:
Proper grading, no evidence of erosion?
PASS
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?
NO
ffs
Page 1
TANK:
Tank 1
N
Tank 2
YES
Tank 3
If YES, is the pump/dosing siphon functioning properly?
Tank capacity
FAIL
gallons
PASS
gallons
Is the high water alarm working, both visible and audible?
gallons
Tank material
SECONDARY TREATMENT:
Is a secondary treatment unit present? YES
NO
UNKNOWN
# of compartments
Z
Does the owner have a current maintenance contract for the unit? YES
NO
UNKNOWN
Maintenance Provider: _ Phone:
Date of last pumping
7i ZPv /
Lids/risers in good condition
PASS
Al
PASS
FAIL
PASS
FAIL
Risers to grade
YES
NO
YES
NO
YES
NO
Riser height
3 �+-
Riser condition/watertightness
Inlet sanitaryT/baffle
ASS
PASS
FAIL
PASS
FAIL
Outlet sanitary T/baffle
FAIL
PASS
FAIL
PASS
FAIL
Effluent filter (if part of design)
PAS FAIL
/A
PASS FAIL
N/A
PASS FAIL
N/A
Condition of tank material
AS
FAIL
PASS
FAIL
PASS
FAIL
Tank was pumped for inspection
Y
NO
YES
NO
YES
NO
If YES, list the pumping company
� o���
If NO, when was the last pumping
Scum level (1st compartment)
inches
inches
inches
Sludge level (1st compartment)
inches
inches
inches
Scum level (2nd compartment)
q
inches
inches
inches
Sludge level (2nd compartment)
inches
inches
inches
Backflow (if pumped)
P
FAILPASS
FAIL
PASS
FAIL
Midtank baffle
ASS FAIL
N/A
PASS FAIL
N/A
PASS FAIL
N/A
Watertightness
S
FAIL
PASS
FAIL
PASS
FAIL
PUMPS/DOSING SIPHONS:
N
Is a pump or dosing siphon present?
YES
If YES, is the pump/dosing siphon functioning properly?
PASS
FAIL
Does the pump/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
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?
PASS FAIL
O YES
YES
YES
'POFt3— Probing (M
NO YES
inches _
YES N�yN Wf�
YES NO
PASS FAIL
Page 2
Any problems with the system that were not addressed in the inspection checklist?
A'
Please lista reco ndations for
tth71 continued use of th system:
�1 ��G?✓G
Were any repairs done as a result of this inspection? YES
If YES, please describe the repairs.
To the est o my knowledge nd training, the infor, r anion toll d in this inspection is accurate as of
20 -
Licensed Systems Inspector Signature:
Additional Notes:
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 diagram 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.
J
........................... . ................
Page 4
0
Moon Run Ranch
8276 Snowmass Creek Road
c/o Holly McLain
Snowmass CO 81654
Quote
Roto Rooter Plumbing
P.O. Box 1800
Glenwood Springs CO 81602
970-945-5519 FAX: 970-243-8794
Quote #
365717
Date:
03/10/14
Page #
1 of 1
Service At:
Moon Run Ranch
8276 Snowmass Creek Road
c/o Holly McLain
Snowmass CO 81654
Job # 274820
OUR PLEDGE TO YOU: IF OUR PLUMBERS SMOKE OR SWEAR IN YOUR HOME, ARE NOT DRUG FREE, DO NOT WEAR
SHOE COVERS, OR LEAVE WITHOUT CLEANING UP- YOU DO NOT PAY.
Description
Excavate the septic tank at the main house and the outlet side of the tank on the upper tank of the barn and replace the old concrete
risers and replace with new plastic lids and risers so that the tanks are water tight from any outside water source. We will then back
fill to proper compation and rough grade. Roto Rooter is not responsible for finish landscaping.
Proposed Work Quantity Unit Price Extended Price Tax
INSTALL 9 RISERS AND 3 LIDS 1 $2,994.00 $2,994.00
Total Quote $2,994.00
THIS REPAIR OR REPLACEMENT COMES WITH A WORRY FREE WARRANTY FOR THE PERIOD OF YEARS. ANY
PROBLEMS OR CONCERNS AND WE WILL RESPOND QUICKLY TO RESOLVE ANY AND ALL ITEMS.
I HEREBY AGREE TO THIS PROPOSAL. I UNDERSTAND THAT PAYMENT WILL BE AS FOLLOWS: PRIOR TO
STARTING AND REMAINING UPON COMPLETION. (ALL BIDS GOOD FOR 30 DAYS)
Acceptance (Customer) Date Approval (Company) Date
%jrKIN
y
COUNT''
Owner's Name:
Address:
Parcel Number:
Inspection Date:
Inspector's Name:
Business Name:
Ins
•
Onsite Wastewater Treatment Systems (OWTS) Use
Permit Inspection Form
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
form for continued use of an existing OWTS
Phone Number 9 P - &IT — SS/ 7
Email: i , , Fo A0 0
Pitkin County SystemsInln p or License Number:
A copy of this inspection report will be remitted to Pitkin County Environmental Health Department by
the Licensed Systems Inspector within 60 days of the inspection regardless of whether the system
gasses or fails.
QUESTIONS FOR PROPERTY OWNER PRIOR TO INSPECTION:
Is the home currently occupied? a 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?
RECORDS:;
Were system records available from Pitkin County? YES
If YES: Permit number:
Date of Final Approval:
# of bedrooms permitted:
Was an as -built drawing available? YES NO
Is the as -built drawing accurate? YES NO
If NO: Complete a drawing of the system on last poge of this form as accurately os
possible.
Any question marked FAIL will require correction before an OWTS Use permit is issued.
SITE CONDITIONS:
Proper grading, no evidence of erosion?SS " FAIL
Improper vegetative cover? Q YES
Evidence of compaction such as heavy machinery or livestock? 0 YES
Improper discharges such as straight pipes? PASS FAIL
Evidence of high ground water? 0 YES
Snow cover present? NO YES
Page 1
X
TANK:
Tank 1
Tank 2
Effluent surfacing?
Tank 3
FAIL
Tank capacityL%FSG
Evidence of past surfacing?
gallons
S
gallons
Surface dampness?
gallons
Tank material
(6"Vv
Excessive odors?
YES
r
Field location verified b observation ports or robin
Y P probing:
# of compartments
Z
, �--,�'c, TT -C! cl,�`«`'°i
Liquid in observation port?
NO
YES
Date of last pumping
inches
Distribution Box or ADV part of original design?
YES
Lids/risers in good condition
PASS
FAIL
PASS
NO
PASS
FAIL
Risers to grade
ES)
NO
6S
NO
YES
NO
Riser height
Z i U6 t -e_ -s
Riser condition/watertightness
Inlet sanitaryT/bafFle
FAIL
FAIL
PASS
FAIL
Outlet sanitaryT/bafFle
FAIL
FAIL
PASS
FAIL
Effluent filter (if part of design)
PASS FAIL
PASS FAIL
N/
PASS FAIL
N/A
Condition of tank material
FAIL
FTZS71FAIL
PASS
FAIL
Tank was pumped for inspection
S
NO
E
NO
YES
NO
If YES, list the pumping company
v l
If NO, when was the last pumping
Scum level (1st compartment)
Q
inches
inches
inches
Sludge level (1st compartment)
tff
inches
36
inches
inches
Scum level (2nd compartment)
inches
/
inches
inches
Sludge level (2nd compartment)
,
inches
i L—
inches
inches
Backflow (if pumped)
PASS
FAIL
PASS
FAIL
PASS
FAIL
Midtank baffle
FAIL
N/A
<94§91> FAIL
N/A
PASS FAIL
N/A
Watertightness
FAIL
S
FAIL
PASS
FAIL
PUMPS/DOSING SIPHONS: Law„y
Is a pump or dosing siphon present?NO
If YES, is the pump/dosing siphon functioning properly? A S ' FAIL
Does the pump/wiring/dosing siphon appear to be in good condition? eVA'SS, FAIL
Is the high water alarm working, both visible and audible?PEAS FAIL
SECONDARY TREATMENT:
Is a secondary treatment unit present? YES NO NKNOWN
If YES, does the unit appear to be in good working condition? <15 NO
Does the owner have a current maintenance contract for the unit? YES NO N N W
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?
AS
FAIL
Evidence of past surfacing?
YES
Surface dampness?
YES
Excessive odors?
YES
r
Field location verified b observation ports or robin
Y P probing:
Ports
Probing
g
, �--,�'c, TT -C! cl,�`«`'°i
Liquid in observation port?
NO
YES
If YES, record depth:
inches
Distribution Box or ADV part of original design?
YES
(�g
UNKNOWN
If YES, is it accessible from grade?
YES
NO
Is it level and in good condition?
PASS
FAIL
Page 2
err
•
•
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? XO YES
If YES, please describe the repairs.
To the b ' t of my knowledge and training, the in mation colle in this inspection is accurate as of
20/.
Licensed Systems Inspector Signature:
Additional Notes:
Clearly label any pictures and attach them to this form.
Page 3
0
if no as -built drawings exist forth is system or the as -built was inaccurate, please diagram 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.
Page 4