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HomeMy WebLinkAboutpitkin.eh.272929202019 (2017),Opr IN Pitkin County Environmental^walth Department Onsite Wastewater Treatment Syst.011n (OWTS) USE PERMIT COU NT Permit for Continued Use of an Existing OWTS 76 Service Center Road, Aspen, CO 81611 Phone: 970-920-5070 Fax: 970-920-5077 www.aspenpitkin.com/EHNR Parcel ID #: 2729-292-02-019 OWTS Use Permit #: I 0023.2017.POWU Date Issued: 4/13/2017 Issued By: Bryan Daugherty Expiration Date: 4/13/18 Owner(s): I Steve and Terri Hess Property Address: 425 Crystal Park Drive Legal Description: Lot 21, Second Filing, Crystal River Park Licensed Inspector: Doug Warren Inspection Date(s): 3/30/17 SYSTEM INFORMATION Components Type Capacity/Size Primary Treatment Unit Concrete two-compartment septic tank 1250 gallons Secondary Treatment Unit Absorption Area Dry Well 1050 ft2 (15'x15'x14') Other System Components ❑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 #: 96041 Date of Issuance: 6/5/96 Date of Final Approval: 7/12/96 # of Bedrooms or fixtures served by OWTS: 3 bedrooms Operational Status: The inspector indicates the system is in good condition and there is no evidence of failure. The tank was pumped as part of the inspection. Dry well did not have any standing water at the time of inspection. Inspector Recommendations: Continued maintenance, install risers to grade for access to tank at outlet side. Department Recommendations: N/A 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. Pitkin County Environmental Health Department : Onsite Wastewater Treatment System (OWTS) USE PERMIT APPLICATION 76 Service Center Rd Aspen, CO 81611 Website: www.aspenpitkin.com/ehnr/ Aunlication for Continued Use of an Existina OWTS Parcel ID# (available from the Pitkin County Assessor's Office Company: i ' 970-920-5160 or at www.aitkinassessor.orgi: City, t\te, Zi _ Purpose of Use Permit: PROPERTY TRANSACTION ❑ REMODEUADDIIION Property Address: Indicate Preferred Method of Permit Receipt mail El Fax ❑ US Mail q Val, 'V Lot: B o 4 fling: Su 'vision: Residences: Other \\ # of Bedrooms: fixtures/uses: ^ Property Owner(s)': Email Address: Owner's Mailing Address: City; State, Zip: a c Home Phone: ,\ 1 - Business Phone: -7 :3�e 6 i On 'Contact information must be provi ed for the owner signing this application. Primary Contact Person/Applica f ho owner): Company: i ' Contact/Applicant Mailing Addre City, t\te, Zi Cell Phone: _ - Busin hone: I Fax Number:9w y `ll ` II 9 Email Address: J Indicate Preferred Method of Permit Receipt mail El Fax ❑ US Mail Licensed Systems Inspector: Phone Number. Email Address: Fax Number: 4 - Mailing Address: ' r y City, State„,ZiR: PLEASE READ BEFORE SIGNING: 1 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. (Required): r Please allow 3-5 business ys foh processing of Use Permits. FOR OFFICE USE ONLIh�� Received by EH Staff: Fee & Receipt #: Date: M 1 k ,a h IN Onsite Wastewater Treatment Systems (OWTS) Use # ' Permit Inspection Form CO11;tji'7'1 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: address: Parcel Number: Z 7 L — ZY Z- 0 2- B! Inspection Date: _O $ 'lit Inspector's Name: Business Name: Phone Number 76 - yl-- MI Email: " r tk I f Pitkin County Systems Inspe or License Number: A cagy of this inspection report will be remitted to Pitkin -County EnvirparnentolHealth Deportirum by the Licensed Svstems Inspector wfthin 68 days of the inspection regardless of whether the system posses or hails. 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? If secondary treatment is used, who is the maintenance provider? RECORDS: © Were system records available from Pitkin County? NO If YES: Permit number: %OT 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 lost 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? ASS FAIL Evidence of high ground water? YES Snow cover present? YES Page 1 Scanned by CamScanner TANK: Tank 1 Tank 2 Tank 3 YES Tank capacity 7_1jV gallons FAIL gallons PASS gallons Tank material CeMGre- FAIL SECONDARY TREATMENT: o Probing Is a secondary treatment unit present? YES # of compartments UNKNOWN If YES, does the unit appear to be in good working condition? YES NO inches Does the owner have a current maintenance contract for the unit? YES NO Date of last pumping Maintenance Provider: Phone: YES NO is it level and in good condition? PASS FAIL Lids/risers in good condition AS FAIL PASS FAIL PASS FAIL Risers to grade ES NO YES NO YES NO Riser height QA Riser condition/watertightness D Inlet sanitary T/baffle ASS FAIL PASS FAIL PASS FAIL Outlet sanitary T/baffle FAIL PASS FAIL PASS FAIL Effluent filter (if part of design) Condition of tank material PASS FAIL S FAIL PASS PASS FAIL N/A FAIL PASS FAIL PASS N/A FAIL Tank was pumped for inspection NO YES NO YES NO If YES, list the pumping company 1,r' 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) PASS FAIL PASS FAIL PASS FAIL Midtank baffle ASS FAIL N/A PASS FAIL N/A PASS FAIL N/A Watertightness I PASSidl PASS FAIL PASS FAIL PUMPS/DOSING SIPHONS. N Is a pump or dosing siphon present? YES FAIL 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: o Probing Is a secondary treatment unit present? YES UNKNOWN If YES, does the unit appear to be in good working condition? YES NO inches Does the owner have a current maintenance contract for the unit? YES NO UNKNOWN Maintenance Provider: Phone: YES NO If there is no maintenance conbaM a contrast must be in place p w to occupancy of the horn. A Cg" of the Contract arAg be submitted ao Wilkin Courcy En— oau+u"Ital Health Department. ABSORBTION AREA: Effluent surfacing? FAIL Evidence of past surfacing? YES Surface dampness? YES Excessive odors? YES Field location verified by observation ports or probing: o Probing Liquid in observation port? YES If YES, record depth: inches Distribution Box or ADV part of original design? YES OD If YES, is it accessible from grade? YES NO is it level and in good condition? PASS FAIL Page 2 UNKNOWN Scanned by CamScanner n 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?'9J YES If YES, please describe the repairs. To the Pest of my knowledge and training, the info ation col ed in this inspection is accurate as of 2011. Licensed Systems Inspector Signature: Additional Notes: Clearly label any pictures and attach them to this form. Page 3 Scanned by CamScanner E Scanned by CamScanner T d / J i Scanned by CamScanner A0 -.ft �Cyc l a � ower L cYcl