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Pitkin County Environmental 4ealth Department
Onsite Wastewater Treatment Syh,em (OWTS) USE PERMI-
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 #: 2729-292-02-011
OWTS Use Permit #: I 0037.2017.POWU
Date Issued: 06/21/2017
Issued By: Bryan Daugherty _
Expiration Date: 1 06/21/2018
Owner(s): I Scott Stegall
Property Address:
440 Crystal Park Drive
Legal Description:
Lot G Crystal Park Subdivision
Licensed Inspector: Jason Daubs
Inspection Date(s): 4/13/2017
SYSTEM INFORMATION
Components
Type
Capacity/Size
Primary Treatment Unit
Concrete two-compartment septic
tank
2000 gallons
Secondary Treatment Unit
Absorption Area
Dry well
1184 ft2
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 #: 07087 Date of Issuance: 11/5/07 Date of Final Approval: 12/3/07
# of Bedrooms or fixtures served by OWTS: System is designed to serve 4 bedrooms.
Operational Status: According to the observation at the time of inspection, the system was functioning as designed.
The tank was in good condition, risers were accessible from grade and tees were in place. The dry well did not have
standing water at the time of inspection and appeared to be in good condition.
Inspector Recommendations: N/A
Department Recommendations: Annual maintenance.
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
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Pitkin County Environmental Health Department
Onsite Wastewater Treatment System (OWTS)
USE PERMIT APPLICATION
76 Service Center Rd
Aspen, CO 81611
Website: www.aspenpitkin.conVehnr/
Annfir_atinn fnr r__AnGnss^rl 11__ —49
jFOR OFFICE USE ONLY I
(Received by EH Staff: Fee & Receipt P Date:
Parcel IDI (available from the Pitkin County Assessors office
970-920-5160 or at www-oitkinassessor
orgl:
of Use Permit:
PROPERTY TRIdiSACTTON
❑ REmoi)EvADomoN
Property Address:
S
Lot Block:
Ing:
bdivlston:
Residences:
O
6 of Bedrooms:
IMMMsrus•
jFOR OFFICE USE ONLY I
(Received by EH Staff: Fee & Receipt P Date:
W 11111110
K ! N Onsite Wastewater Treatment Systems (OWTS) Use
/ Permit Inspection Form
4)'C0tl NT Pitkin County Environmental Health Department
76 Service Center Rd, Aspen, CO 81611
w 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: JCU j r S lie
C
Address:00 Ri ).vrp Y16
Parcel Number: c
Inspection Date:
Inspector's Name:
Business Name: j/�—% ,yi C LL. C.
Phone Number
Email: 11 ' 7 -LI), --
Pitkin
Pitkin County Systems Inspector License Nu ber: C
A cony 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? C E J 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? /j✓fit
RECORDS:
Were system records available from Pitkin County? YE NO
If YES: Permit number: 0 '%L)
Date of Final Approval: l 2 .2ec '7
# 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? JNO
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
E
TANK:
Tank 1
NO
Tank 2
PASS
Tank 3
Does the pump/wiring/dosing siphon appear to be in good condition?
Tank capacity
FAIL
gallons
PASS
gallons
SECONDARY TREATMENT:
gallons
Tank material
C+, �r. .-e 7-?—
NO
UNKNOWN
If YES, does the unit appear to be in good working condition? YES
NO
# of compartments
Does the owner have a current maintenance contract for the unit? YES
NO
UNKNOWN
Maintenance Provider: Phone:
YES
UNKNOWN
Date of last pumping
y R5
NO
Is it level and in good condition?
PASS
FAIL
Lids/risers in good condition
FAIL
PASS
FAIL
PASS
FAIL
Risers to gradeES
NO
YES
NO
YES
NO
Riser height
cP y '1
Riser condition/watertightness
p93 5
Inlet sanitary T/baffle
FAIL
PASS
FAIL
PASS
FAIL
Outlet sanitary T/baffle
W?FAIL
PASS
FAIL
PASS
FAIL
Effluent filter (if part of design)
FAIL
N/A
PASS FAIL
N/A
PASS FAIL
N/A
Condition of tank material
PAS
FAIL
PASS
FAIL
PASS
FAIL
Tank was pumped for inspection
YES
NO
YES
NO
YES
NO
If YES, list the pumping company
If NO, when was the last pumping
71
Scum level (1st compartment)
inches
inches
inches
Sludge level (1st compartment)
inches
inches
inches
Scum level (2nd compartment)
inches
inches
inches
Sludge level (2nd compartment)
inches
inches
inches
Backflow (if pumped)
PAS
FAIL
PASS
FAIL
PASS
FAIL
Midtank baffle
Watertightness
PASS FAIL
ASS
N/A
FAIL
PASS FAIL
PASS
N/A—f
FAIL I
PASS FAIL
PASS
N/A
FAIL
PUMPS/DOSING SIPHONS:
Is a pump or dosing siphon present?
YES
NO
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:
YES
Is a secondary treatment unit present? YES
NO
UNKNOWN
If YES, does the unit appear to be in good working condition? YES
NO
YES
Does the owner have a current maintenance contract for the unit? YES
NO
UNKNOWN
Maintenance Provider: Phone:
YES
UNKNOWN
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?
PAS
FAIL
Evidence of past surfacing?
YES
Surface dampness?
ANO
YES
Excessive odors?
YES
Field location verified by observation ports or probing:
Por
/�
Probing
Liquid in observation port?
YES
If YES, record depth:
ince
Distribution Box or ADV part of original design?
YES
UNKNOWN
If YES, is it accessible from grade?
YES
NO
Is it level and in good condition?
PASS
FAIL
Page 2
Any ;oblems 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? NO YES
If YES, please describe the repairs.
To the best of my knowledge and training, the informa ' n Ilected in this inspection is accurate as of
20IJ .
lice sed 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.
Page 4
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