HomeMy WebLinkAboutPitkin.EH.264502200005 (2018)Page | 1
Pitkin County Environmental Health 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 #: 2645-022-00-005
OWTS Use Permit #: 0017.2018.POWU
Date Issued: 4/13/18
Issued By: Bryan Daugherty
Expiration Date: 4/13/18
Owner(s): Adelaide Zabriskie
Property Address: 2567 Snowmass Creek Rd
Legal Description:
Licensed Inspector: Jason Daubs
Inspection Date(s): 4/2/18
SYSTEM INFORMATION
Components Type Capacity/Size
Primary Treatment Unit Two-compartment concrete tank
Two-compartment concrete tank
Two-compartment concrete tank
1500 gallons
1000 gallons
1000 gallons
Secondary Treatment Unit
Absorption Area Gravelless chamber trenches 1609ft2
Other System Components N/A
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 #: 08001 Date of Issuance: 1/22/08 Date of Final Approval: 7/24/09
# of Bedrooms or fixtures served by OWTS: This system was designed for 7 bedrooms total, currently serving 5
bedrooms in the main house and 1 in the CDU.
Operational Status: According the inspector’s observations the system was functioning as designed at the time of the
inspection. The tanks were in good, watertight condition with effluent filter in place at the outlet of the last tank in
series. The pump for the CDU was functioning properly and the alarm was audible and visible. The field are did not
show any signs of failure such as surfacing effluent.
Inspector Recommendations: Continue annual maintenance or as needed.
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.
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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:I http
Treatment
I Inspection form for continued use of an existing OWTS j
Owner's Name:
Address:
Parcel Number:
Inspection Date:
Inspector's Name:
Business Name:
Phone Number
Email:
Pitkin County Systems
ZABRISKIE JOHN L JR REV TRUST
2567 Snowmass Creek Rd
Old Snowmass CO
2645 022 00 005
4/2/2018
Jason Daubs
Altitude Septic, LLC
970 471-1330
lAltitudeSeptic@gmaii.com
Inspector License Number:
19
A coon 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
asses or Lails.
QUESTIONS FOR PROPERTY OWNER PRIOR TO INSPECTION:
is the home currently occupied? ®' YES ®NO Caretaker occupied/Main house is not
If NO, how long has the home been vacant?
How many bedrooms are in the home? 17
If secondary treatment is used, who is the
maintenance provider?
RECORDS:
Were system records available from Pitkin County? E]YES ®NO
If YES: Permit number:
Date of Final Approval: 07/2009
# of bedrooms permitted: 0
Was an as -built drawing available? 0' YES NO
Is the as -built drawing accurate? M. MNO
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? ' PASS FAIL
Improper vegetative cover? NO YES
Evidence of compaction such as heavy machinery or livestock? • NO YES
Improper discharges such as straight pipes? PASS FAIL
Evidence of high ground water? M. NO YES
Snow cover present? Me NO YES
Page 1 Effective Date 1/12/2017
TANK:
Tank 1
Tank 2
Tank 3
Tank capacity
1,500
gallons
1,000
gallons
1,000
gallons
Tank material
concrete
concrete
concrete
# of compartments
1
2
2
Date of last pumping
?
?
March 2018
Lids/risers in good condition
Pass
Pass
Pass
Risers to grade
Yes
Yes
Yes
Riser height
12"/12"
18"/18"
24"/24"
Riser condition/watertightness
Good
Good
Good
Inlet sanitary T/baffle
Pass
Pass
Pass
Outlet sanitary T/baffle
Pass
Pass
Pass
Effluent filter (if part of design)
N/A
Pass
ass
Condition of tank material
Pass
Pass
Pass
Tank was pumped for inspection
No
No
No
If YES, list the pumping company
If NO, when was the last pumping
Scum level (1st compartment)
0
inches
0
inches
0
inches
Sludge level (1st compartment)
1
inches
0
inches
0
inches
Scum level (2nd compartment)
0
inches
0
inches
0
inches
Sludge level (2nd compartment)
1
inches
0
inches
0
inches
Backflow (if pumped)
Select One
Select One
Select One
Midtank baffle
N/A
Pass
IlPass
Watertightness
Pass
Pass
IPass
PUMPS/DOSING SIPHONS:
Is a pump or dosing siphon present?
YES
HIPASS
NO Only on CDU
If YES, is the pump/dosing siphon functioning properly?
be in
PASS
FAIL
FAIL
Does the pump/wiring/dosing siphon appear to good condition?
Is the high water alarm working, both visible and audible?
+®PASS
FAIL
SECONDARY TREATMENT:
Is a secondary treatment unit present? DYES
[j] NO QUNKNOWN
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
QUNKNOWN
Maintenance Provider: I
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?
'ASS
NO
NO
NO
'orts
NO
YES
YES
FAIL
YES
YES
YES
Probing
YES
inches
UNKNOWN
Page 2
Effective Date 1/12/2017
There are no issues found with this system.
lease list any recommendations for the continued use of the system:
As always, we recommend that wipes of any type are not used.
Were any repairs done as a result of this inspection? E] NO [:1 YES
If YES lease describe the repairs.
To the best of my knowledge and training, the information collected in this inspection is accurate as of
April 2 2 18
Licensed Systems Inspector Signature: D
waitionai
Clearly label any pictures and attach them to this form.
Page 3 Effective Date 1/12/2017
Pitkin County Environmental Health Department
j-f KIN Onsite Wastewater Treatment System (OWTS)
Co U N ffUSE PERMIT APPLICATION
76 Service Center Rd
Aspen, CO 81611
http://pitkincounty.com/248/Wastewater-Treatment
Application for Continued Use of an Existing OWTS
Parcel ID# (available from the Pitkin County Assessor's Office
970-920-5160 or atF—http://pitkinassessor.org/assessor/search.asp
Purpose of Use Permit:
W PROPERTY TRANSACTION REMODEL/
Property Address:
2567 Snowmass Creek Road, Snowmass, CO
Lot:
=
Block:
Filing:
Subdivision:
Residences:
# of Bedrooms:
I Other
4 +1 CDU fixtures/uses:
Property Owner(s)':
Email Address:
Adelaide Zabriskie
azabr.2567@gmail.com
Owner's Mailing Address:
City, State, Zip:
�7CO
3100 Pearl Parkway Apt: 114
Boulder
80303
Home Phone:
Business Phone:
970-309-0818
`Contact information must be provided for the owner signing this application.
Primary Contact Person/Applicant (if not owner):
Company:
Contact/Applicant Mailing Address:
City, State, Zip:
Cell Phone:
Business Phone:
Fax Number:
Email Address:
AltitudeSeptic@gmail.com
Indicate Preferred Method of Payment Check
Credit/Debit r7 Cash
Licensed Systems Inspector Phone Number: Email Address: Fax Number:
Jason Daubs
970-471-1330
AltitudeSeptic@gmail.com
Mailing Address: City, State, Zip:
P.O Box 1534 jEagle
1CO
181631
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 Signature (Required):
Date:
Applicant Signature:
Date:
Please allow 3-5 business days for processing of Use Permits.
FOR OFFICE USE ONLY
Received by EH Staff: Fee & Receipt #:
Save Form Clear Form Print Form
Date:
Effective Date 1/12/2017
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