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HomeMy WebLinkAboutSEP2010-00151 RECEIVED Jefferson County Department of Community Development 2011 621 Sheridan St., Port Townsend WA 98368, (360)379-4450 OCT 1 0 SEPTIC PERMIT APPLICATION Donald & Gayle Thorne Jefferson Coup,,, PROPERTY OWNER Environmentai 221 Dennis Blvd t ���' MAILING ADDRESS .Port Townsend, WA 98368 446! 4, 51PHONE ( \ Suz; EXPIRES 2i11/t t SYSTEM DESIGNER Suzanne Martin Designer Phone# 554-0224 LEGAL DESCRIPTION: Section 10 Township 28N Range 1W _ PARCEL# 801 105 007 Subdivision Name Mt Townsend Vista Division Block Lot(s) 7 Site address/Directions to site 480 Larson Lake Road SOURCE OF SEWAGE/USE TYPE OF WORK WATER SOURCE Residential ✓ New Tank/s only Private ✓ Residential ADU Modification_ — Public Commercial• Expansion_ _ Community Upgrade. Repair SITE SIZE +/-5.132 ac SYSTEM TYPE Partial Repair-(tank) (drainfield) Previous Evaluation Conventional ✓ Designate RARPrve Area Yes# SEp10-00151 Alternative Redesign ✓ No SYSTEM DETAILS Number of Gallons/day 480 Soil type 4 (attach soil eval.) Application Rate 0.60 gal./sq.ft./day Drainfield Length 267 ft. Trench Width 3 ft. Trench/Bed Depth 12 in. Septic Tank size 1250 min gal. Pump Chamber size 1500 gal. TYPE OF conventional trench with one septic tank @ drainfield &one 1500gal. 2 comp. tank w/pump in second comp. By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner with respect to this application packet may result in this permit being null and void. I further agree to save, indemnify and hold harmless Jefferson County against all liabilities,judgments, court costs, reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application that he or she requires prior notice. Inspections shall occur during regular business hours. Initial here if you require notification before entry Appeal -A person aggrieved of a decision of the Health Officer may appeal. Appeals shall be submitted to the Health Division in writing within fifteen days after receiving written notice of the decision. DISCLAIMER-This application is for an on-site sewage system that meets the state and county standards in effect on the date of application. This application for an onsite sewage system DOES NOT assure you of any other County approvals. For example, it DOES NOT GUARANTEE that you will later obtain permission to build a permanent residence or other structure on this parcel. Any future application will be separately judged by the rules and laws in effect at that time. Property Owner Signature Date FOR OFFICE USE ONLY ii PARTIAL ASBUILT 4/0 11' 7/ FINAL I 11/a l tZ A ROVED INSP/PUMP TEST PUD (Z/ "90152 ALL HOLD REQ. MET p2 /�'�j 2 Date/C-10 -t( Fee { Rec# /o Check# /'7 "�r" Case#SEP 1,0 "L5 r.\ oc„m®nts any Ssttin7Q\a,,,a,,.,e_Y,-,t,,,\nIy r.,,,Dty\7affCc forms\Suz\2008 SPA.DOC JEFFERSON TY PUBLIC HEALTH 615 Sheridan Street •Port Townsend•Washington •98368 www.jeffersoncountypublicheal h.org _Pfione....360=38°58444...........Fax...360-3i9:448T_...._._._................_...................................__. ON-SITE SEWAGE DISPOSAL PERMIT PERMIT #: SEP10-00151 Date Received: 12/07/10 Date Issued: 06/27/12 SITE ADDRESS: 480 LARSON LAKE RD Date Expires: 11/27/12 APPLICANT: DONALD A THORNE PHONE: GAYLE L THORNE 221 DENNIS BLVD PORT TOWNSEND WA 98368-9411 LEGAL DESCRIPTION: MT TOWNSEND VISTA TRACT 7 V10/P91 PARCEL#: 801105007 Section: 10 Township: 28N Range: 01 W DESIGNER: SUZANNE L MARTIN PHONE: 360-554-0224 SEPTICS BY SUZANNE PO BOX 125 CHIMACUM WA 98325 SYSTEM DESCRIPTION: CONVENTIONAL TRENCH No. of Gallons per Day: 480 Type of work: NEW Drainfield Trench Septic Tank Length: 267 feet Width: 3 feet Depth: 12 inches Size: 1,250 gallons DISCLAIMER-This approval is for an on-site sewage system that meets the state and county standards in effect on the date of application. This approval for an on-site sewage system DOES NOT assure you of any other County approvals. For example, it DOES NOT GUARANTEE that you will later obtain permission to build a permanent residence or other structure on this parcel. Any future application will be separately judged by the rules and laws in effect at that time. All construction and development activities must comply with all permit conditions, state and local codes, and Recommended Standards and Guidance documents in effect when the permit is issued. The property owner is responsible for the accurate location of all property lines.Any removal of or major disturbance of soil in the primary or reserve drainfield area may create site conditions that are unacceptable for the installation of a sewage disposal system. Any change in drainfield or tank location may invalidate this permit unless prior approval is obtained from the Jefferson County Environmental Health Division. If during excavation or development of the site an area of potential archeological significance is uncovered, all activity in the immediate area shall be halted, and the UDC Administrator shall be notified at once. Permit issued to CONSTRUCT, ALTER, REPAIR OR MODIFY AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM IN JEFFERSON COUNTY, WASHINGTON This permit is issued for a period of three years (unless otherwise stated above) in accordance with Jefferson County Rules and Regulations for On-Site Sewage Systems, codified in JCC 8.15 as amended. This permit may not be renewed. / Jefferson County Enironmental Health Specialist This permit with conditions must be onsite during all phases of construction HEALTH DEPARTMENT MUST BE CONTACTED FOR FINAL INSPECTION. SPECIAL CONDITIONS APPLY - SEE ADDITIONAL PAGES CONDITIONS OF APPROVAL - PERMIT NO.: SEP10-00151 1.) This permit was issued to correct a violation of WAC 246-272A. The permit must be completed within 150 days of the date of issuance. 2.) MAXIMUM (and minimum ) TRENCH DEPTH 12 INCHES 3.) H - AS PER WAC 246-272A AND JEFFERSON COUNTY CODE 8.15 ALL ONSITE SEWAGE SYSTEMS REQUIRE THAT A RESTRICTIVE COVENANT REGARDING THE MONITORING OF THE ONSITE SEPTIC SYSTEM BE RECORDED TO THE PROPERTY TITLE. THE PROPERTY OWNER SHALL ASSURE THAT MONITORING IS PROVIDED BY AN APPROVED ENTITY AT THE FREQUENCY DEFINED PER STATE WAC 246-272A AND JEFFERSON COUNTY CODE 8.15 AS ADOPTED OR AMENDED. A COPY OF THE RECORDED OPERATIONS AND MONITORING AGREEMENT IS REQUIRED PRIOR TO FINAL APPROVAL OF THE SEWAGE DISPOSAL PERMIT 4.) Designer must be contacted prior to start of construction and for inspections during installation. DESIGNER IS REQUIRED TO DO A PRECOVER INSPECTION ON ALL TYPES OF SYSTEMS. 5.) Notification of the start of construction shall be faxed or emailed to Jefferson County Public Health ONE WORKING DAY prior to start. 6.) Setbacks to all wells- 100' required from drainfield and reserve areas. 50' required from tanks and effluent transport lines. 7.) Distribution boxes shall be fitted with a riser to grade, constructed of durable materials and a secured lid, adequately sized to allow visible inspection of the liquid level in the box. 8.) 10' separation required between a Water line and all portions of the onsite sewage system; effluent transport line, tanks, treatment and disposal components. 9.) H - An asbuilt drawing and certification of completion by the Designer is required prior to final approval. 10.) Before final approval is given, the designer shall provide an operations and maintenance manual to the property owner and the Health Department. The manual must instruct the owner of the on site sewage system on the ways to properly operate and maintain all components of the system. 11.) Approval/issuance of a sewage disposal permit does not guarantee the approval of other development or a building permit on this site. Compliance with other Jefferson County and Washington State Codes is required. 12.) All construction and development activities must comply with all permit conditions, Washington State and Jefferson County Codes and Recommended Standards and Guidance documents in effect when the permit is issued. 13.) When/if designated reserve area is utilized an alternative system providing an additional level of treatment may be required. 14.) Contact designer prior to installation for staking of drainfield area. 15.) Divert all sources of drainage, including roof drains away from septic tank and drainfield area. 16.) Approval of this sewage disposal permit does not preclude the permit holder from complying with the Unified Development Code for other/future development on the site. 17.) The project shall adhere to the Best Management Practices (BMPs) to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. SEP10-00151 Page 2 of 2 \\tidemark\data\forms\F_S EP_Perm itmod.rpt 6/27/2012 CONVENTIONAL SYSTEM AS-BUILT INSPECTION REPORT Installer: Shold Excavating (Kevin Nutting) Parcel # 801 105 007 Permit Owner: Donald&Gayle Thorne Permit# SEP10-00151 Designer: Suzanne Martin Design Flow: 480 gpd Site Address: 480 Larson Lake Road ABSORPTION AREA: DRAINFIELD TRENCH WIDTH TRENCH DEPTH TANK SIZE #OF BEDRMS #GAL/DAY LENGTH 267 3' 12" 1500 4 480gpd IF PUMP AND PUMP CHAMBER REQUIRED: Shroud/Screen Tank Size: Float Arrangement High water float—distance to top of tank/emergency storage Dose drawdown (#of inches) #Gallons/Dose Timer/Dose Counter info Pump Size/Manufacturer COMMENTS (inspection notes, changes from design or deficiencies installation)Attach additional sheet(s) if necessary Installed 2 compartment, concrete septic tank and distribution box. Risers, clean-out, speed levellers and outlet filter have been installed. All OSS Component installation have met or exceeded State and local codes and regulations. Users Manual Provided to Homeowner 17 November 2012 Date ATTACH ASBUILT DRAWING signed by Designer or stamped/signed by a Licensed Professional Engineer I CERTIFY THE INFORMATION PROVIDED ABOVE WAS VERIFIED BY INSPECTION, THE SYSTEM WAS INSTALLED AS DESIGNED AND APPROVED by JEFFERSON COUNTY (DATE) OR THAT CHANGES HAVE BEEN NOTED AND THIS SYSTEM IS IN COMPLIANCE WITH WAC 346-272 17 November 2012 . +1 Desi er Signature Date .3.1 V `" O/l.C.KJ L i Suz"umrvt5nr$ww' b0/ -1)l/l!/'1 vJWK-( /4/7((i'/ ./(f IV L c/ki WPC/ Gl4c( OS/ai l 7- Iloun4 vZ0I `awl /Oil tua d-t/iv' 77/ l� )/6 (0 !7 Alootwl2/k— lN Z , / . 4 / . , f • . . , , z _ , . _ c> , „ , . . . .,. ' , •=t w ' 03 ' -• 0 CD H 0 -c 0 ., . / Z CD b•4 / / cg.- • . . / • ..4"/ ' / i . ,.•" a. ' , /: \'■ ' / ,' . ' •/ / ••' . 4 4' / , 4•.'' :b. ' ' • ',' , . • / / / • i , • . . . 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SECURED LID WITH GAS TIGHT SEAL 1 ACCESS RISER \II t —,1� \t i FINISH GRADE 17 . lJ \ / Li L d_, J �� \ ,- in1 -- TO PUMP T ! CHAMBER / 1— FROM SEWAGE / SOURCE 1 FLOATING MAT � APPROVED EFFLUENT FILTER SEDIMENTS P�pzon -/---------- -` �__ RECEIVED•• ID S ol S No �^,nn''NCI D Cap OCT 10 2011 SGV" • ed • SEPTIC TANK ° PPS „ �e (TYPICAL) Jefferson County Oa Environmental Health SECURED LID WITH GAS TIGHT SEAL THREADED UNION ACCESS RISER SERVICE FINISH G' ' DE —_ VALVE ' FROM SEPTIC -L ! l s, r --II.TO DRAINFIELD TANK ;�� !/ rii min ,0 gallons I )[ EMERGENC TORAGE ' ANTI SIPHON HIGH WATER ALARM LEVEL 1 I¢ VALVE' �� system to be on demand,on/off NORMAL TIMER OFF LEVEL WORKING VOLUME float,high water alarm,low >n water alarm/pump cut out �/ n `a ENCLOSED P /4 required !1t:; SEDIMENTS."OUD` CHECK VALVE • 4_____ \y 18" ` _ I 4 ,\,,,j ��' or SEDIMENTS SUBMERSIBLE CENTRIFUGAL 4..r PUMP PUMP CHAMBER (TYPICAL) `AS NEEDED Two septic tanks total both equipped with 1/16"outlet filters and risers to the surface. The pump shall be capable of 10gpm @ 30 tdh. The pump shall be equipped with an on/off float and an alarm floats only,it shall be set on demand to the second compartment of the upper septic tank or plumbed into the outfall of the upper tank. Which shall be a minimum of 1250 gallon two compartment tank. Page 5 of 5;Thorne; Parcel#801 105 007 co Effluent Pumps Oren ems° Incorporated 1-800148-9843 100 r... t S -._. Effluent Pumps — 90 f PEF 15U PEF, PKP Series 1/3 hp to 1-1/2 hp 80 f PEF MI • • • • 70 ' 3 ,, _ 4. -w_ .W uN� 60 , - ca (PEF 751 l 0 T 5Qv { • IPEF501 effluent pump 1 I 1 © 40 _ r to Ti 30'of • head —, , 20 10 l I 0 ? € I 1 IPEF33111 1 0 10 9Pm 20 30 40 50 60 70 80 90 Net Discharge,gpm NDW-PC-PEF-1 Rev.5.0.©9/04 Page 1 of 1 Page 1 of 5;Thorne; Parcel#801 105 007 JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 SHERIDAN ST., PORT TOWNSEND ,WA 98368, (360) 379-4450 SOIL EVALUATION 1, PROPERTY OWNER Donald and Gayle Thorne f ..,•,.,,,;mz.. SYSTEM DESIGNER N.. Suzanne Martin �" 5102' .?'.y�� �� Suzanne L Martin ,1{ : `'U w'Ar''N : !1, EXPIRES 2/11/11 LEGAL DESCRIPTION: Section 10 Township 28N Range 1W Parcel # 801 105 007 Subdivision Name Mount Townsend Vista Division Block Lot(s) tract 7 Date Logged: 20 February 2010 Logged By: Suzanne Martin Include soil textural characteristics and the depths at which significant changes occur. Be sure to include depth where mottling or impermeable layers occur. SOIL LOG #1 SOIL LOG #2 0 to 9 in. Dark brown gravelly sandy loam 0 to 4 in.dark brown gravelly sandy loam 9 to 15 in,dark yellow brown very gravelly loamy medium sand 4 to 53 in. dark yellow brown v gray loamy medium 15 to 54+ in. Lt yell brn slightly compact very gravelly loamy med sa 53 to 58 in. dk yel brn v gravelly loamy med sand to in. ‘ in. last layer slightly compact Anticipated water table nia in. 2\ Anticipated water table n/a in Roots to 54" inches ++ Roots to 50" inches Health Dept. Comments /„ Health Dept. Comments 5-� �� SOIL LOG #3 SOIL LOG #4 yq at di 0 to 14 in, brown gravelly loamy medium sand 0 to 4 in. dark brown sandy loam v-iczhti, A1 TOX 14 to 49 in. yellow brown gravelly loamy medium sand 4 to 10 in, dark yellow brown gravelly loamy sand to in. 10 to 42 in. yellow brown gravelly medium sandy to in. 42 to 60+ in.light yellow brown gravelly medium sand Anticipated water table n/a in. Anticipated water table 60+ in. Roots to 48" inches Roots to 53 inches Health Dept. Comments AA 670(---- Health Dept. Comments OK. 5."5 57-55 , ( .. 1 SOIL LOG #5 Z-10 III. SOIL LOG #6 0 to 6 in.dark brown gravelly sandy loam 0 t0 6 jn dark brown gravelly sandy loam 6 to 24" in,yellow brown gravelly loamy sand ,� 6 to 40+ in.Yellow brown gravelly loamy medium sand 24" to 40+ in,yellow brown gravelly medium sand M � to in. to in. soil log #7 to in. Anticipated water table n/a in. 0-20" dk br av s lo Anticipated water table n/a in. Roots to 40 inches 20-32" y Mott SI. comp. Roots to 40 inches gravelly san y oam Health Dept. Comments Health Dept. Comments 32-46+ yb gr loamy med ) 1 COV "" I ■�� sand 6) ZZ Oi ., root to 46" 117,D no signs of groundwater