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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 #: 2643-341-00-001
OWTS Use Permit #: 0034.2018.POWU
Date Issued: 07/24/2018
Issued By: Kurt Dahl
Expiration Date: 07/24/19
Owner(s): Old Maitland Investments LLC
Property Address: 150 White Horse Springs Ln
Legal Description: Lot 5 Block 2 White Horse Springs
Licensed Inspector: Jason Daubs
Inspection Date(s): 6/19/2018
SYSTEM INFORMATION
Components Type Capacity/Size
Primary Treatment Unit Concrete two compartment septic
tank
1,500 gallons
Secondary Treatment Unit
Absorption Area Gravelless Chamber soil treatment
trenches
109 standard chambers, 4012 ft2
Other System Components Distribution box
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 #: 92058 Date of Issuance: 09/16/1992 Date of Final Approval: 10/05/1992
# of Bedrooms or fixtures served by OWTS: This system was designed for up to 4 bedrooms. However, the existing
residence has 5 bedrooms. The sizing discrepancy shall be resolved when the house is remodeled or the OWTS system is
repaired.
Operational Status: The inspector indicates the system was functioning properly at the time of inspection and there is
no evidence of failure.
Inspector Recommendations: Change risers to bring them down to grade, install an effluent filter.
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.
Pitkin County Environmental Health Department
Vfj7KIN Onsite Wastewater Treatment System (OWTS)
CCU NTi USE PERMIT APPLICATION
76 Service Center Rd
Aspen, CO 81611
hhp //pitkincounty comt2481Wastewater-Treatment
Application for Continued Use of an Existing OWTS
Parcel 10# (available from the Pitkln County Assessor's office
643 341 00 001
k
9711-920-5160 or all hti 11 itkinassessor orglassessor/search asp
Purpose of Use Permit PROPERTY TRANSACTION
F—JREMODEL/
Property Address
150 White Horse Springs Lane
Lot
Block
Filing
Subdivision
hite Horse Springs
Residences
Other
# of Bedrooms
fixturesluses
Property Ovmer(s)'
Email Address
�LD MAITLAND INVESTMENTS LLC
msorensongdsi,biz
Owners Mailing Address
City, State Zip
114225 Ventura Blvd. Suite 100Sherman
Oaks
ICA
V1423
Home Phone
Business Phane
'Contact information must be provided for the owner signing this applicaWn.
Primary Contact Person/Applicant (if not owner)
ILauraGee
Company
seen Snowmass Sotheby's Int'I Realty
Contact/Applicant Mailing Address
kol Midland Avenue
City State Zip
Basalt
O V1
Cell Phone:
1(970)
948-8568
Business Phone
1(970) 273-3045
Fax Number
Emai: Address
la liitudeseptic@gmail.com
Indicate Preferred Method of Payment ■ Check El Credit/Debit
FICash
Licensed Systems Inspector Phone Number Emai Address Fax Number
Altitude Septic, LLC
(970) 471-0913
liitudeseptic@gmail.com
Mailing Address City, Slate Zip
PO Box 1534 Eagle
KO
k1631
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)
�wec%wic�r, C�ii�r
Date
07/ 10/2018
Applicant Signature
Date
1Yjj,1A1 L:
19 201 h
,`+
Please allow 3-5 business days for proses ng of Use Permits. BaVe Form Clear Form Print Fad
FOR Offf[Ci tUSE 0 Y
Received by EH Staff, Fee & Receipt # Date
Effective Date 1/12/2017
0034.2018. POW U
�01'f Onsite Wastewater Treatment Systems (OWTS) Use
-,P,cPermit Inspection Form
DUNT� Pitkin County Environmental Health Department
76 Service Center Rd, Aspen, CO 81611
Phone:970-920-5070 Fax: 970-920-5374
Website: I http://pitkincounty.com/248[Wastewater-Treatment
Inspection form for continued use of an existing OWTS
Owner's Name:
Address:
Parcel Number:
Inspection Date:
Inspector's Name:
Business Name:
Phone Number
Email:
Inspector License Number:
19
Pitkin County Systems
A copy of this inspection report will be remitted to Pitkin County Environmental Health Department by
the Licensed Svstems Inspector within 60 days of the inspection reaardless of whether the system
passes or fails.
QUESTIONS FOR PROPERTY OWNER PRIOR TO INSPECTION:
Is the home currently occupied? ❑YES ONO
If NO, how long has the home been vacant? unknown
How many bedrooms are in the home? 15
If secondary treatment is used, who is the
maintenance provider?
RECORDS:
Were system records available from Pitkin County? AYES ❑NO
If YES: Permit number:
Date of Final Approval: 10/05/92
# of bedrooms permitted:
Was an as -built drawing available? 0 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 OWTS Use permit is issued.
SITE CONDITIONS:
Proper grading, no evidence of erosion? OPASS ❑FAIL
Improper vegetative cover? 0 NO ❑ YES
Evidence of compaction such as heavy machinery or livestock? 0 NO ❑ YES
Improper discharges such as straight pipes? ❑' PASS ❑FAIL
Evidence of high ground water? 0 NO 0 YES
Snow cover present? 0 NO ❑ YES
Page 1 Effective Date 1/12/2017
Page 1 Effective Date 1/12/2017
0034.2018. POW U
TANK:
Tank 1
Tank 2
Tank 3
Tank capacity
1,500 Igallons
gallons
gallons
Tank material
Concrete
# of compartments
2
Date of last pumping
unknown
Lids/risers in good condition
Pass
Select One
Select One
Risers to grade
Yes
Select One
Select One
Riser height
7'
Riser condition/watertightness
Good
Inlet sanitary T/baffle
Pass
Select One
Select One
Outlet sanitary T/baffle
Pass
Select One
Select One
Effluent filter (if part of design)
N/A
Select One
select One
Condition of tank material
Pass
Select One
Select One
Tank was pumped for inspection
No
Select One
Select One
If YES, list the pumping company
If NO, when was the last pumping
unknown
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)
Select One
Select One
Select One
Midtank baffle
Pass
ISelect One
Select One
Watertightness
Pass
ISelect One
Select One
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:
Is a secondary treatment unit present? ❑YES 0 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 H 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
E
NO
❑YES
F.
NO
❑
YES
❑■
NO
❑
YES
❑Ports ❑Probing
NO ❑ YES
inches
❑■ YES ❑ NO
YES ■ NO
PASS FAIL
UNKNOWN
Page 2
Effective Date 1/12/2017
0034.2018. POW U
'lease list any recommendations for the continued use of the system:
I would recommend removing the current risers (See below) that stick up out of the ground and dig
down to the top of the tank to install normal risers for better access. We would also recommend
pumping the tank after construction is finished before anyone moves in. I would also recommend
installing an outlet filter.
Were any repairs done as a result of this inspection? ❑- NO 0 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
June 19 1, Zp 18
Licensed Systems Inspector Signature:
Additional Notes:
Due to the "riser" height and opening size of the "risers", it is difficult to see what the tank material
is and also what the condition of the tank is. Also due to the risers, we are also unable to measure
the sludge level, but we can see a thick scum layer and that is why we are recommending that the
tank be pumped. *Construction on the house in progress, may be a good time to install correct
risers.*
Make note that the "risers" are white pvc 6" pipe.
Clearly label any pictures and attach them to this form.
Save Form Clear Form
Print Form
Page 3 Effective Date 1/12/2017
0034.2018.POWU
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