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Home My WebLink AboutPitkin.EH.264316401010 (2017)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: 970-920-5077 www.aspenpitkin.com/EHNR Parcel ID #: 2643-164-01-010 OWTS Use Permit #: 0072.2017.POWU Date Issued: 11/1/2017 Issued By: Bryan Daugherty Expiration Date: 11/1/18 Owner(s): John Beetham Property Address: 109 S Little Texas Lane Legal Description: Licensed Inspector: Jason Daubs Inspection Date(s): 10/12/2017 SYSTEM INFORMATION Components Type Capacity/Size Primary Treatment Unit Concrete two compartment tank 1250 gallons Secondary Treatment Unit Absorption Area Engineering Mound 650 ft2 Other System Components Automatic Distribution Valve 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 #: 90009 Date of Issuance: 6/29/90 Date of Final Approval: 6/11/91 # of Bedrooms or fixtures served by OWTS: System is designed for 3 bedrooms Operational Status: According to the inspector’s observations during the inspection, the system appeared to be functioning as designed. The field area did not show any signs of failure such as surfacing effluent. Inspector Recommendations: Add effluent filter to outlet of tank to prevent solids from entering the field area. 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 fx'KIN Onsite Wastewater Treatment System (OWTS) "`�C AU 1v USE PERMIT APPLICATION T"� 76 Service Center Rd a_ ..... 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 10072.2017.powU 970-920-5160 or atFhttp://pitkinassessor.org/assessor/search. asp Purpose of Use Permit: PROPERTY TRANSACTION REMODEL/ Property Address: S. Littid Texas Lane Lot: 3 Block: Filing: Subdivision: Residences: Other # of B Brooms: fixtures/uses: Property Owner(s)": Email Address: John Beeth m johnbee am@comcast.net Owner's Mailing Address: City, State, Zip: po box 148 Woody Creek, Co. 1656 Home Phone: IBusiness Phone: 970-94 4418 'contact information must oe provioea Tor me owner wymoy trns dNNiwauun. Primary Contact Person/Applicant (if not owner): John beetham Company: Contact/Applicant Mailing Address: po box 148 Woody Cre k, Co. 81656 7 City, State, Zip: 1 1 1 Cell Phone: 970.9 .4418 - Business Phone: johnbeetham@comcast. et Fax Number: Email Address: Indicate Preferred Method of Payment ■ Check Credit/Debit Cash Licensed Systems Inspector: Phone Number: Email Address: Fax Number: Jason Daubs 970.471.1330 Mailing Address: City, State Zip: 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): Signature: Date: 10/20 2017 Date: r — Please allow 3-5 business days for processing of Use Permits. Save Form Clear Form Print Form FOR OFFICE USE ONLY Received by EH Staff: Fee & Receipt #: Date: Owner's Name: Address: Parcel Number: Inspection Date: Pitkin County Systems Inspector License Number: 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? RECORDS: Were system records available from Pitkin County?YES NO If YES:Permit number: ___________ 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: 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?NO YES Snow cover present?NO YES Any question marked FAIL will require correction before an OWTS Use permit is issued. If secondary treatment is used, who is the maintenance provider? Complete a drawing of the system on last page of this form as accurately as possible. Email: Inspector's Name: Business Name: A copy 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 passes or fails. Onsite Wastewater Treatment Systems (OWTS) Use Permit Inspection Form Inspection form for continued use of an existing OWTS Website: Pitkin County Environmental Health Department 76 Service Center Rd, Aspen, CO 81611 Phone: 970-920-5070 Fax: 970-920-5374 Phone Number Page 1 TANK: Tank capacity gallons gallons gallons Tank material # of compartments Date of last pumping Lids/risers in good condition Risers to grade Riser height Riser condition/watertightness Inlet sanitary T/baffle Outlet sanitary T/baffle Effluent filter (if part of design) Condition of tank material Tank was pumped for inspection If YES, list the pumping company 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)inches inches inches Sludge level (2nd compartment)inches inches inches Backflow (if pumped) Midtank baffle Watertightness 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 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 NO UNKNOWN Maintenance Provider:_______________________________________Phone:________________________ ABSORBTION AREA: Effluent surfacing?PASS FAIL Evidence of past surfacing?NO YES Surface dampness?NO YES Excessive odors?NO YES Field location verified by observation ports or probing:Ports Probing Liquid in observation port?NO YES If YES, record depth:inches Distribution Box or ADV part of original design?YES NO UNKNOWN If YES, is it accessible from grade?YES NO Is it level and in good condition?PASS FAIL 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. Tank 1 Tank 2 Tank 3 Page 2 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?NO YES If YES, please describe the repairs. Licensed Systems Inspector Signature: Additional Notes: To the best of my knowledge and training, the information collected in this inspection is accurate as of __________________, 20____. Clearly label any pictures and attach them to this form. Page 3 Permit Receipt Date:Name: Project Address: 10/24/2017 Permit Number Fee Description Amount checkType:# 1189 RECEIPT NUMBER 00043247 109 LITTLE TEXAS LN John Beetham PITKIN COUNTY COMMUNITY DEVELOPMENT 0072.2017.POWU OWTS Use Permit Fee 100.00 100.00Total: