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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 #: 2467-212-01-001
OWTS Use Permit #: 0026.2019.POWU
Date Issued: 6/17/2019
Issued By: Bryan Daugherty
Expiration Date: 6/17/2020
Owner(s): Barbara Schutz
Property Address: 703 Holland Hills Rd
Legal Description:
Licensed Inspector: Joe Zamora
Inspection Date(s): 5/24/19
SYSTEM INFORMATION
Components Type Capacity/Size
Primary Treatment Unit Concrete two compartment tank
Single compartment concrete tank
1250 Gallons
1000 Gallons
Secondary Treatment Unit
Absorption Area Pipe and gravel bed 1280 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 #: 02076 Date of Issuance: 11/1/02 Date of Final Approval: 11/12/02
# of Bedrooms or fixtures served by OWTS: System is designed to serve 4 bedrooms
Operational Status: After repairs were made by the inspector the system appeared to be functioning as designed.
Risers were replaced on both tanks to bring access to grade, a broken pipe was also repaired. The tanks were in good,
water-tight condition with tees and baffles in place. An effluent filter was in place. The field area did not show signs of
failure such as surfacing effluent.
Inspector Recommendations: N/A
Department Recommendations: Continue maintenance as needed.
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.
5/30/2019 Pitkin County Mail - Online Form Submittal: Property Sale/Remodel Use Permit Application
https://mail.google.com/mail/u/0?ik=c2c72bb885&view=pt&search=all&permmsgid=msg-f%3A1634824588293997381&simpl=msg-f%3A16348245882…1/3
Bryan Daugherty <bryan.daugherty@pitkincounty.com>
Online Form Submittal: Property Sale/Remodel Use Permit Application
noreply@civicplus.com <noreply@civicplus.com>Tue, May 28, 2019 at 6:36 PM
To: schuyler.clay@pitkincounty.com, ehapps@pitkincounty.com
Property Sale/Remodel Use Permit Application
Please Note: Each OWTS System must be submitted individually. If there are
additional systems on the property, additional applications are required.
Job Parcel ID 2467 212 01 001
Physical Address 0703 Holland Hills Road
Residences 1
No. of Bedrooms 3
Square Footage of each
Residence
2200
Purpose of Use Permit Property Transaction
Closing Date Field not completed.
Lot 42
Block Field not completed.
Filing Field not completed.
Subdivision Holland Hills at Basalt
(Section Break)
Primary Contact Information
Primary Contact First Name Barbara
Primary Contact Last Name Schutz
Primary Contact Email
Address
barbh05@comcast.net
Primary Contact Address 0703 Holland Hills Road
Primary Contact Phone
Number
(970) 927-4370
Primary Contact City Basalt
Primary Contact State Colorado
5/30/2019 Pitkin County Mail - Online Form Submittal: Property Sale/Remodel Use Permit Application
https://mail.google.com/mail/u/0?ik=c2c72bb885&view=pt&search=all&permmsgid=msg-f%3A1634824588293997381&simpl=msg-f%3A16348245882…2/3
Primary Contact Zip 81621
(Section Break)
Owner Information
Primary Contact is Owner?Yes
Indicate Preferred Method of
Payment
Check
Payment Contact Email for
Debit/Credit Payment
barb05@comcast.net
(Section Break)
Licensed Inspector Information
Primary Contact is Licensed
Inspector?
No
Inspector First Name Joseph
Inspector Last Name Zamora
Inspector Email Address gerryzamora@msn.com
Inspector Mailing Address P.O. Box 754
Inspector City Carbondale
Inspector State Colorado
Inspector Zip 81623
Inspector Phone Number (970) 963-1399
Inspector Fax Number (970) 963-1399
(Section Break)
Uploads
Pitkin County Inspection
Form
IMG_0001.pdf
Site Plan IMG.pdf
Floor Plans IMG.pdf
Additional Reports, etc.Field not completed.
Comments or additional
information:
Field not completed.
PLEASE READ BEFORE SELECTING SUBMIT:
By selecting SUBMIT, I certify that I am the owner or representative with the legal
authority to agree to the conditions of this permit, 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
5/30/2019 Pitkin County Mail - Online Form Submittal: Property Sale/Remodel Use Permit Application
https://mail.google.com/mail/u/0?ik=c2c72bb885&view=pt&search=all&permmsgid=msg-f%3A1634824588293997381&simpl=msg-f%3A16348245882…3/3
department may revoke any permit I am issued if my application is found to contain
any inaccurate, false, or misleading information.
Building Permit Instructions
If this application is part of a building permit application, please bring a copy of this
application to your building Pre-Submittal meeting. To get a copy, either enter your
email address to receive a copy of your application, or select "Submit and Print"
below.
Email not displaying correctly? View it in your browser.
oNSTTE WASTEWATER TREATMENT SYSTEM (OUffS)
USE PERMIT INSPECTION FORII/
76 Service Center Rd Aspen CO 8151:
97 0-920-5070 Fax 970-920-5071
www.PitkinCountv.con
lnsoection for Permit Number:POWU
lob Address (orovide proof of application for an address if there is currently no address) Address Apolication
robstreet:l hZ03 Holland Hills Road Job ciry:lgu""lt lJob state:]o | .rob zinl61621
Jwner
)wner First N..",lBafbafa Owner Last Name:Schutz Jwner Corporation Name:
)wner Mailing Address:)703 Holland Hills Roat Owner CitV:lgr"r;1 )wner State: leg )wner zin:1g1621
)wner Phone:
f1g T O\ gZ7 4JT A Owner Cell Phone:970) 618-1131 )wner Email:lgarbh0S@comcast. net
lermit Contact
lontact First N.*"rlBafbafa I Contact Last Name:ichutz ontact Business Name
:ontact Mailing Address:)703 Holland Hills Roac :ontaa CitV:[gUar;1 :ontact State: ICO :ontactzio:fu1621
lontact Phone:
f $7q g274g7O I contact cell Phone:970) 61 8-1 1 31 Contact Email:lgarbh05@comcaSt.net
licensed lnspector
nspector First Name:Ioseph lnspector Last Name: VamOfa tnspector Business Name:lZamora Excavating , lnc.
nspector Mailing Address'l lp.O. BOX 754 nspector city:lCarbOndale lnspector State: ICO lnsnector zin:161623
nspector Phon",l1SZ0; 963-1 3gg rnspector cell nnone: 11970) 379_7 17 1
lnspector Email:fo erryzamora@msn.com
nspector's License lvumber: h 3263lTC
rarcel lD 2467 212 01 001
-esal Descriotion -ot 42 Holland Hills Basalt
\ copy of this inspection will be remitted to Pitkin County Environmental Health Department by the Licensed Systems lnspector within 60 days of the
nspection regardless of whether the system passes or fails
luestions For Property Owner PRIOR To lnspection:
s the home currently occupied?lf N: How long has it been vacant?
{ow many bedrooms are in the home? m
RECORDS
Were system records available from Pitkin CountV?JYes L:N
lf Y: Permit Num Date offinal approval:1totto2 No. of bedrooms permitted:
Was an as-built drawing arailabl"l@$
ls the as-built drawing ,..rrrt"?GH
lf N: Complete and upload a drawing of the system as accurately and possible fl
Describe chanee in use/differences:
'ITE'CONDITIONS\ny questions marked FAIL or N0 will require correction before an OWTS Use permit is issued,
)roper grading no evidence of "rorion, @l Proper vegetation cover: @
\O evidence of compaction such as heavy machinery or livesto.tt Fi6--l
)roper discharges (no straight pipesl:lffil No evidence of high ground *rt"r,lM-l
inow cover is NOT pr"r"nt,lM-l
iite Conditions P"rr/f
"il, lffil
rANK(S)TANK 1 TANK 2 TANK 3
l-ank Caoacitv {eallons)1250 500
l-ank Material Concrete Concrete
\umber of compartments 2 1
)ate of last pumpine 711116 7t1116
Lids/risers FAIL FAIL AIL
Risers to srade NO NO !o
iiser heieht 12"7"
Riser condition/water tightness Fail Fail
lnlet Sanitarv TlBaffle )ASS rASS AIL
Cutlet Sanitarv T/Baffle ]ASS )ASS AIL
Effluent Filter {if oart of desien)]ASS N/A v/A
Condition of Tank Material ]ASS )ASS AIL
[ank was pumped for inspection rES rES \o
lf Y: List Pumping Company lndependent Environmental Serv.
lf N: Date of last oumoins
Scum level (1st compartment) inches 1"3',
Sludge level (1st compartment) inches 10"12"
Scum level 2nd comoartment) inches 1"
lludee level 2nd compartment) inches 2"
]ackflow {if pumped}AIL AIL AIL
Vlidtank Baffle \/A !/A N/A
l\Iater Tightness AIL AIL AIL
,UMPS/DOSING SIPHONS
s a pump or dosing siphon present? lf Y: ls the pump/dosing siphon function properly?
)oes the pump/wiring/dosing siphon appear to be in good condition?
s the high water alarm working; both visibly and audibly?
rumps/Dosing Siphon Pass/Fail:
Tank 1000 gallons,
confirmed with
Inspector
a secondary treatment unit present? @l lf Y: Does the unit appear to be in good working condition? lNo ]
the owner have a current maintenance contract for the unit? @l
there is no maintenance contract, a contract must be in place prior to oecupancy of the home. A copy of the contract-must be submitted to Pitkin
Environrnental Health Department
Evidence of past surfacing?
xcessive ooorrllfr-l
ield location verified by observation ports or probing: FHm
in observation port?1il;6--l f v: RecordelDepth (inches)
stribution Box or ADV part of original Design? lNo I
Y: ls it accessible from gr"o"lJffi-l rtilt level and in good condition INO I
problems with the system that were not addressed above?
risers and lids need to be replaced on the first tank and the main tank. Outlet pipe to the leach field needs to be repaired.
any recommendations for the continued use of the system:
any repairs done as a result of this inspection?
lids and risers on the first and main tank were replaced and brought to ground grade. The outlet pipe to the leach field has
Notes:
is visible and is functioning well. No surfacing was observed, There are no inspection ports in the leach field.
label any pictures and upload them.
'o the best of my knowledge and training the information collected in this inspection is accurate.
Print this formReset this formSave Form for Submittal
May 24,20L9
Joseph B. Zamora
P.O. Box 754
Carbondale, Colorado 81623
Re: OWTS lnspection Report
0703 Holland Hills Road
Basalt, Colorado 81621
Disclaimer: This inspection is intended only as an evaluation of the present condition of the OWTS
based upon what was observed and the Licensed lnspecto/s expertise in onsite
wastewater technology. The inspector has not been retained to warrant or guarantee
the proper functioning of the system for any period of time in the future. Because of the
numerous factors which may affect the operation of an OWTS, as well as the inability of
the inspector to supervise or monitor the use or maintenance of this OWTS, this report
shall not be construed as a warranty by the inspector that the system will function
properly for any pafiicular prospective buyer, and the inspector disclaims any warranty,
either expressed or implied, arising from the inspection of the OWTS or this report. The
evaluation does not ascertain the impact the system is having on groundwater.
Please feel free to contact me at (970) 379-7L77 if you should have any questions.
Sincerely,
-f*"fu #€"?,*,rv
)6seph B. Zamora
NAWT Certified lnspector
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