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HomeMy WebLinkAboutFile Documents.309 Oak Ln.0021-2022-BRES (32) prom rCOVNI4 PITKIN COUNTY SPECIAL WASTE APPROVAL FORM SOLID WASTE CENTER This form is to be used to describe soils and/or cleanup materials which have been contaminated. The material being delivered for disposal at the Pitkin County Solid Waste Center can contain no free liquid and cannot be a hazardous waste under state or federal authority. All of the following information must be supplied: (�� ' Name of Generator: l.Jv'i S GuYT woorke- ask -- 051- Mailing Address: c=oc;k Oqk 11 v Q City: Ave" State:Co Zip: g«/j Address of Contaminated material: 3Cn, Oak. City: /'C'S Telephone:11 R-c9-9 et Fax: Email: ^ 1l Contact Person: C oui h e?'c rill.$ Company: � �'1tx Unvt WO KS Signature: _�: � \ _ Date: tI ($1 �,2 � L . 1 \ Truck company hauling in:Yv41 WK.S Date expected to start haulin I -2:. Charge to Account*: I' ki k/'c • or check* Name on check: *Charge accounts must be set up prior to hauling. Check must be at landfill with first haul but may be left open to run for a week at a time. • ALL materials* must have Analytical Lab Data submitted and approval given before material arrives at landfill. Date submitted: D via email Cathy.Hall@PitkinCounty.com D via f x 970-923-2043 *Soil from the Smuggler Superfund Site does not need labs submitted unless the City of Aspen has r quired additional testing. We require a signed approval copy of COA's "Smuggler Mountain Superfund Site Soil Rem val Permit" Date Received: Volume or Tons of Waste: 9-50 ,, Yards ❑Tons Description of Waste: Erf-sWo•MOIN riiV-¢.t-tau( Date(s)of Waste Generation: Source of Waste: ❑Spill ❑UST ❑AST ❑Non-friable Asbestos ❑Other: If bringing in used Waste Containers have they been triple rinsed; D Yes ❑NA Reviewed and approved by Pitkin County by: Date: Notes/Conditions: • A copy of this approved form will be returned to you. Fax or Email: • 1st Date Accepted at Pitkin County Solid Waste Center: Last Date: Run report for project. Total Tons: RECEIV Copy the report to Tom Dunlop(Pitkin County)and Aaron Red(City of Aspen) RECEI V D 01/19/202 ASPEN BUILDING DEPARTM NT City of Aspen and Pitkin County SMUGGLER MOUNTAIN SUPERFUND SITE SOIL REMOVAL PER IT Building Permit Number:__ No person shall undertake or conduct any activities or development withi i the Smuggler Mountain Superfund Site (Site) involving the excavation or expo.ure of more than one (1) cubic yard (cu yd) or 1.125 tons of soil without first obti fining a permit from the Director of the City of Aspen Building Department or the l irector of the Pitkin County Building Department. They shall be subject to the requirements. set forth in Institutional Controls, Section 7-143 in the City or Section 8-1 i the County.Activities or development involving excavation of less than the amount of soil mentioned above shall also require a permit,but with less handling requirements than soil volume equal to or in excess of 1 cu yd or 1.125 ton.. Contaminated soils removed from the Site may only be taken to the Pitkin ounty Landfill for disposal. Reference the Pitkin County Special Waste Approval Form- attached.The owner or owner's representative must complete Affidavit's 1 and 2 with a notarized signature- attached. Property owner: Chris Campaigne Phone number(s): 719-293-0513 • Mailing address: Contractor name:_SH BUILDING GROUP Describe activity that will take place: Remove existing construction, foundation, fence, shrubs,landscape and gravel. Build a new single family home and landscape Depth of excavation:`t'PSurface area disturbed (cu yds or tons) Cubic yards/tons of material to be excavated: D50\r(.S Cubic yards/tons.of material to be retained on property: 0 •• Cubic yards/tons of material to be disposed of off property: DSO LA) NioS How long will excavated material be exposed on surface? 14 j'- 4 WEEKS r RECEIVE 101/19/202 ASPEN BUILDING DEPARTMENT How will the applicant identify and segregate clean soil (soil with a total lead content of 999 parts per million [ppm] or less) from contaminated soil (soil with a total lead content of 1,000 ppm or higher) during the excavation or development • period? How does the applicant plan to backfill, cover,and re-vegetate contaminated soil left on the property? • I applicant agree to comply with all 'er ormance tan.ards, Sol s esting, an. • Inspection and Maintenance as described in the Institutional Controls adopted by the City of Aspen and Pitkin County:YES X NO • vEHiCLES I Submit an updated version of this entire form complete with • SOIL TO EF affidavit #1 and #2 including signatures and notarization. Please also complete all spaces on page 2 of the submitted application . VEHICLES'.The form can be found on EXACT SIR https://www.cityofaspen.com/DocumentCenter/View/623/Dirt-Movin CONTAMIN g-Permits-PDF?bidld= Director/Manager). •1, Applicant's Signature: Date: l r4 �2— • • RECEIVE ) 61/19/2022 • ASPEN BUILDING DEPARTMENTS