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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 #: 2641-272-00-040
OWTS Use Permit #: 0001.2018.POWU
Date Issued: 01/23/2018
Issued By: Kurt Dahl
Expiration Date: 01/23/2019
Owner(s): Thomas Marsing
Property Address: 8219 Woody Creek Rd
Legal Description:
Licensed Inspector: Jason Daubs
Inspection Date(s): 12/19/2017
SYSTEM INFORMATION
Components Type Capacity/Size
Primary Treatment Unit Concrete two-compartment septic
tank
1,000 gallons
Secondary Treatment Unit
Absorption Area Unknown Unknown
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 #: N/A Date of Issuance: N/A Date of Final Approval: N/A
# of Bedrooms or fixtures served by OWTS: Unknown. The existing structure is 2 bedrooms
Operational Status: This is an undocumented septic system and information was not on file with Pitkin County. When
the system is repaired/modified and/or when the residence is remodeled a more detailed inspection of the OWTS
including: location, size components, and function will be required. According to the inspectors observation the system
was functioning at the time of inspection. The tank appeared in watertight condition. The field area did not show any
signs of failure such as surfacing effluent.
Inspector Recommendations: None.
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.
01/13/2018 09:18 6055841025 TERRY PEAK PAGE 02/02
Pitkin County Environmental Health Department
= t t,► Onsite Wastewater Treatment System (OWTS)
4 USE PERMIT APPLICATION
d } 76 Service Center Rd
Aspen, CO 81611
http:/ipitkincounly,mm/24BIWestewater-Treatment
ADplication for Continued Use of an Existing OWTS
IDS (available from the Pitkin eoun pegessor's Office 2.641 272 00 040
D-5160 or at http'//Ait inaasessor.or J85aeSsortsearch.as
e,of Use Permit; ppROpEPTY TRANSAMON ,17 REMODEU
ty Addraa8: 8219/TBD Woody Creek Road, woody Creek, CO 81656
of Sedrooma: 2 flxturas/u8ea:
Ly ..,,,.\e, .
Thomas Marsing
s Mailing Address:
Terry Peak 21120 Stewart Slaps Rd.
Phone: (605) 580.0031
ict rn►ormation must to provided for the owner.signing this appiicatla
y confic; porsonlAppi;cani (If not ovmer): Mike Carr
Ct1Appl�cans Mailing Address:
555 E. Durant, Ste. 5A
11 r"..."J(970) 319-62203
K Number: (970) 920-4549
Indicate Preferred Method of payment Gheck
LLC
Box1534
471-1
#ne:
@terrypeak.com .
ziSQ
Lead
Pho5) 580-0031
7754
Hathaway HomeServices
CO 181611
(970) 925-5400
�micarr®aspenrei�n►
Cash
CO 81631
pLeASE READ BEFORE SIGNING:
i certify that the above Information Is complete and accurate and that t have provided complete and accurate information in all of the documen
included in my application package. I ecMlowiedgo that this department may revoke any permtt I am Issued If my application le found to contain any
inaccurate, false, or misleading Information.
Date: t .�
Please allow 3-5 business days for processing of Use Peunits. •,;,�,;. „ ,;,Y,.:r,;
;.:..
FOR Of:.FIC??U&E_ NIY.:.. •...' .. Res & Receipt #:
Date:
Effective Date 1/12/2017
Onsite Wastewater Treatment Systems (OWTS) Use
Permit Inspection Form
C1.) K 1 N T Pitkin County Environmental Health Department
76 Service Center Rd, Aspen, CO 81611
Phone:970-920-5070 Fax: 970-920-5374
Webslte: 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:
Thomas Marsin
s
8219 Wood Creek Rd.
Wood Creek CO
2641 272 00 040
12/19/2017
Jason Daubs
Altitude Septic, LLC
970 471-1330
altitudeseptic@gmail.com
Inspector License Number:
19
Pitkin County System
A copyat this ins action re ort will be remitted to Pitkin fount Environ entcal ll r lth Qg2grtmer e
the Licensed Systems Inspector within Fa0 da s of the insertion re ardless ofwvhe�th�r Else syst�rrr
pexsse. car rxits.
QUESTIONS FOR PROPERTY OWNER PRIOR TO INSPECTION:
Is the home currently occupied? DYES [ 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? DYES NO
If YES: Permit number: _
Date of Final Approval:
# of bedrooms permitted:0
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 OWTS Use permit is issued.
SITE CONDITIONS:
Proper grading, no evidence of erosion? PASS FAIL
Improper vegetative cover? ' NOH YES
Evidence of compaction such as heavy machinery or livestock? • NO YES
Improper discharges such as straight pipes? PASS QFAIL
Evidence of high ground water? NO D YES
Snow cover present? NO YES
Page 1 Effective Date 1/1212017
TANK:
Tank 1
Tank 2
Tank 3
Tank capacity
1,000
gallons
gallons
gallons
Tank material
Concrete
# of compartments
2
Date of last pumping
?
Lids/risers in good condition
Select One '�) GS
Select One
Select One
Risers to grade
Select One pct.,
Select One
Select One
Riser height
No risers
Riser condition/watertightness
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
ISelect One
If YES, list the pumping company
If NO, when was the last pumping
?
Scum level (1st compartment)
1
inches
inches
inches
Sludge level (1st compartment)
5
inches
inches
inches
Scum level (2nd compartment)
0
inches
inches
inches
Sludge level (2nd compartment)
0
inches
inches
inches
Backflow (if pumped)
Select One
Select One
Select One
Midtank baffle
Pass
Select One
Select One
Watertightness
I Pass ISelect
One
Select One
PUMPS/DOSING SIPHONS:
Is a pump or dosing siphon present? HPASS
YES 1 0 1 NO
If YES, is the pump/dosing siphon functioning properly? ®FAIL
Does the pump/wiring/dosing siphon appear to be in good condition? PASS MFAIL
Is the high water alarm working, both visible and audible? PASS FAIL
SECONDARY TREATMENT:
Is a secondary treatment unit present? YES [F] NO MUNKNOWN
If YES, does the unit appear to be in good working condition? MYES NO
Does the owner have a current maintenance contract for the unit? MYES 11 NO UNKNOWN
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.
ABSORSTION 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
NO
YES
®'
NO
0
YES
NO
YES
Ports
Probing
NO
YES
inches
YES
NO
YES
NO
PASS
FAIL
Page 2
Effective Date 1/12/2017
-,iease list any recommendations for the continued use of the system:
Were any repairs done as a result of this inspection? EKI NO 0 YES
To the best of my knowledge and training, the information collected in this inspection is accurate as of
December 19 z 17 1.
Licensed Systems Inspector Signature: x' Z»au6d
Additional Notes: .So
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Page 3 Effective Date 1/1212017
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