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HomeMy WebLinkAboutSEP2014-00006 Jefferson County Department of Community Development ` 621 Sheridan St., Port Townsend WA 98368, (360)379-4450 0 SEPTIC PERMIT APPLICATION PROPERTY OWNER 4//1/--Z- 7/1— /1/36 'T//, M4- 1.136 MAILING ADDRESS ZG 63 Z /�f �o7t .136P9 /-? /500 %!/`e c449 PHONE ( 7/7 ) '— 6' 9 /+ SYSTEM DESIGNER f� L' '3'/7 Designer Phone# 3 6'0 "-C>�3C—b 300 LEGAL DESCRIPTION: Section Z /--Township 3 Range 2 PARCEL# QO O r T` Subdivision Name Division Block Lot(s) Site address/Directions to site 2_® Z® ''y/ Q , ... A'C'C/t /50 SOURCE OF S WAGE/USE TYPE OF WORK WATER SOURCE Residential /.'I New Tank/s only_aG Private Residential Al Modification_ Public �. Commercial Expansion Community Upgrade Repair SITE SIZE SYSTEM TYPE Partial Repair-(tank) (drainfield) Previous Evaluation Conventional Designate Reserve Area Yes# 5 105 Alternative ,41V- Redesign No DETAILS Number of Gallons/day Soil type ///' ' (attach soil eval.) Application Rate al./sq.ft./day Drainfield Length 6Z3 . Trench Width t ft. Trench/Bed Depth _in. Septic Tank size /COO gal. Pump Chamber size Pal. TYPE of system 1J7'2 - 729/14 /Y20 Pt//77P V Y/L/ • 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 f e application will be eparately judged by the rules and laws in effect at that time. e4YY)40 e(11-0A/ri&- it/I11.1 Property Owner Signature Date FOR OFFICE USE ONLY PARTIAL ASBUILT 1 FINAL ;PJ fC/ APPRO D 1 INSP/PUMP TEST L�20/, / PUD (1(21C ALL HOLD REQ. MET /- p Date I/S 1,4 Fee / Z 1 O° Rec#I `7 IP 7,--C3 Check# q�O q Case#SEP H:\WEB\PDFS\Septic\septic_permitapp_2008.DOC JEFFERSON COUNTY PUBLIC HEALTH 615 Sheridan Street•Port Townsend•Washington •98368 www jeffersoncountypublichealth.org F'tlone 3t3U-Mb- 444 Fax :3bU-3/V-4413 I ON-SITE SEWAGE DISPOSAL PERMIT PERMIT#: SEP14-00006 Date Received: 01/07/14 Date Issued: 03/24/14 SITE ADDRESS: 2020 GARDINER BEACH RD SEQUIM, WA 98382 Date Expires: 03/24/17 APPLICANT: DENNIS R HECKARD PHONE: 717-926-6914 BARBARA S HECKARD 20632 JEFFERSON BCH RD NE KINGSTON WA 983469178 LEGAL DESCRIPTION: S28 T30 R2W TAX 4&6(LESS TAX 17,18,23)SUBJ/REST COVT#562073 PARCEL#: 002283004 Section: 28 Township: 30N Range: 02 W DESIGNER: ERIC HIBBARD PHONE: 360-683-6300 SOILS APPLICATION INC. P. O. BOX 1120 CARLSBORG WA 98324 SYSTEM DESCRIPTION: SEP TANK/PUMP CHAM TO IND SYS No. of Gallons per Day: Type of work: MOD Drainfield Trench Septic Tank Length: feet Width: feet Depth: inches Size: 1,000 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. /14(7 '& Jefferson County Environmental Health Specialist This permit with conditions must be onsite during all phases of construction ALAET E P AC INSPECTION. SPECIAL HETH DEP CONDITIONS RTMNT MUS APBLY CONT- SEE TED ADDITIONAL FOR FINAL PAGES CONDITIONS OF APPROVAL-PERMIT NO.: SEP14-00006 1.) H THE EXISTING WATER LINE MUST BE RE-ROUTED 10' FROM ANY SEPTIC COMPONENT. A CONFLICT EXISTS W/THE APPROVED BUILDING PERMIT BLD13-344 APPROVED PRIOR 2.) Pump vault shall be water tight and equipped with a control panel outside within line of sight of the pump vault. The panel shall have an audio and visual alarm, and a cycle counter. The vault shall be on the DOH list of Approved Septic tanks. 3.) H -This septic tank must be water tight tested by the designer prior to final approval of the septic permit. Doccumentation must be provided on the record drawing 4.) Health Dept. required to observe pressure test with system designer when system fully installed/complete, 48 hours notice to be provided for scheduling. 5.) 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. 6.) Notification of the start of construction shall be faxed or emailed to Jefferson County Public Health ONE WORKING DAY prior to start. 7.) H -An asbuilt drawing and certification of completion by the designer is required prior to final approval. 8.) 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. 9.) 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. 10.) 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. 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. SEP14-00006 Page 2 of 2 \\tidemark\data\forms\F_SEP_Permitmod.rpt 3/24/2014 . J s CONVENTIONAL SYSTEM ASBUILT INSPECTION REPORT INSTALLER 71/6<i PARCEL# Z ' 2 3 _CEO Permit Owner 00071.0..`-Z /f 4T/7Q Permit # / 000-0C ABSORPTION AREA: 00 751 ENEL TRENCH /// TANK E � G LLGTH WIDTH � DEPTH "//7 SIZE BEDRMS AY Tank r,^-p/ Shroud/ IF PUMP AND PUMP CHAMBE REQUIRED: Size '7(/ Screen / ' W Float Arrangement o�/�c/ A2V-Al High water float-distance to top of tank/emergency storage / 60 t/ JCL U,0 FLQW 1/at-- Dose drawdown (#of inches) i' #Gallons/Dose Al 7' Timer/Dose Counter info a 2/Z_ Pump Size/Manufacturer ---273C)r5 r% 1/2/ff' I CERTIFY THIS ONSITE SEWAGE SYSTEM WAS INSTALLED AS DESIGNED, PER P ~`� PPROVED 5 IS 8�F ` r N I# ` DATF INSTALLER SIGNATURE DATE INSTALLED `f 411448„, •I ��a ; ,I , A 40, EXPIRES 11-18-20 / f7 t2osc c a' 7Z V)9i 44060 7 ' C ari/77ld el' / !/& iict/S-6- 70 5-#77:2--5,c-X 46-Y0‘,/_277(5)777 6777737 1P6 65.5V/3 - .277ze 6 -277/70 /'U'7-7 /7 C/ /77/56-13 MGC 679 mss' iP E7r /70fA,MO/ eel, -sue /0/5,9 - F ' , L-2---7-1174 6 `'l '9C/:2-- /? , /,/, _ _ 6.66'0 RS ,- S.Z --,09PG y ,L,civ," 5—7 0 -7 SI kqy r 6'2 0ift ASBUILT CONVENTIONAL FRM_05-10-04.pdf 1 . v v / 1 . 4 v c„ ma Z ;22 $za82 §"cA 0 I 0 yz,1A�o 73x.0.1 r�D _l—N Z 2cr.Ic�cn CO O (D OD-y1 m04'. m AA_ zAA G,m /\/\\, J,_ ` X-I °_yD tvZ 0 \/'7�_ 1l �.. 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A L 320' a f yQ GARDINER BEA CH ROAD `a� O fl rt A• Z CD rn 2 3 ti Q. • SI a • °Z "RECORD DRAWING" Z z -1 m n - TAX PARCEL 002-283-004 SOILS A PPL I CA TION, LW. C.rri o nN°• ° 0 53 TIMBERLINE DR �' zi go m PRESSURIZED SYSTEM FOR SEQUIM, WA 98382 �' rn N HECKARD PH (360) 683-6300 E-MAIL SOILSAPP@GAMIL.COM / SOILS APPLICATION LLC Eric Hibbard Designer(360)683-6300 863 Carlsborg Road,Suite A,Sequim,WA 9838 Scope of Work: To whom It may concern, RE: Jefferson County Parcel#002-283-004 This property is located at 2020 Gardiner Beach Rd Existing SEP# 10-00092 Soils Application has been contacted by Owner Dennis Heckard. The objective of the permit is to allow for a new MAIN HOUSE 3 Br SFR(2 BR ADU already EXISITNG). All the sewage generation will take place on the above mentioned county parcel. The original permit allowed for a 2 Br ADU and a 3 Br Main house to be constructed and connected to a common set of septic tanks and drain field. The 2 br adu has been constructed and the location of new proposed 3 br main house will not allow enough fall to gravity into the existing septic tank that was set during the original installation. We are proposing to move the existing septic tank to the new position shown on the plan. The new placement will not allow enough fall to transport sewage to existing tanks by gravity. A small effluent pump in an Orenco pump vault will be added to transport effluent through a new 1.25"transport line and connect to existing pump chamber. This design includes: 3 Plan pages 1 Permit page 1 Scope of work If you have further questions please call the office. 360-683-6300 Sincerely, Eric Hibbard Washington State Septic Designer Soils Applications LLC. 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R.• C3- d ~ L \mti ` 1 n o .°z ■ •G 111 ..:. \ x—24"t y fi GI it z \,,.:.:........ ....jr--____ IA.__ ax-vgl r-- 1 II 1.m O nzay v r, r 0 141 D ' n�D-0 z A o rr,lihED ol O z o tt Z —I I 10'MIN A. ;% O4y+.,I z 0 r,," om m r* ) , , ., Z 1'.0 °° . 0 • ..' /0 ,� m N I. 2 m ON—SITE WASTEWATER PLANS \ z z m o c !. TAX PARCEL #002-283—004 SOILS A PPL I CA TI CN, L L C. o ao •n O •m A• N 53 TIMBERLINE DR 03�' r0 w SYSTEM MODIFICATION FOR SEQUIM, WA 98382 CA HECKARD PH (360) 683-6300 E-MAIL SOILSAPPOGMAIL.COM GENERAL CONSTRUCTION NOTES SYSTEM CALCULATIONS o Li o 1. Construction materials and procedures shall be as set forth herein and in Original Design Flow: 600 GPD PEAK/420 AVERAGE WILL NOT CHANGE ...•J conformance with: SYSTEM INFORMATION&SPECIFICATIONS •••..I 6 • applicable Washington State Department of Health(WSDOH)Technical Z N a Review Committee(TRC)publications, © Q e0 t • WSDOH TRC Pressure Distribution Standards(2007). Septic tank: Move existing 1000 gallon two compartment tank with `y?. . j o • Washington Administrative Code chapter 246-272A,On-Site Sewage 2 risers to grade. `; ~ Z o� Systems(2007) Septic tank risers: 24"0 water tight,sealed to tank,equal to Orenco model `' Q • applicable portions of the Standard Specifications for Road, Bridge,and RR24 with FL24G un-vented lids with gasket ®, ', v W 3 Municipal Construction(Washington State Department of Effluent filter: 1/16"mesh rated for 500 gallons per day equal to Zabel `• ('' ---.i CO W Transportation/APWA,current edition), Model A1800 Q., O • National Electrical Code(NEC),(current edition), Pump Vault: 24"Orenco pump vault riser material w/lids affixed to top CI. I'- S PI • Jefferson County Regulations,chapter 8.15,for On-site Sewage and bottom approx 140 Gallons ' 0 `O Disposal Systems, Pump chamberriser: EXISTING LO 0 PI • Jefferson County Division of Environmental Health Policies, Gravity pipe: 4"0 ASTM D-3034 PVC `o o • along with all other applicable national,state and county codes. Transport line: 1.25"0 sch 40 PVC �•�." Anti-siphon valve: 1.25"0 Orenco,product#051 HVAS200 or equal Q 2.Any inconsistencies,errors,or omissions in the Plans or the Specifications Effluent Pump: Non-clogging submersible pump rated @ 5 gpm @ 20' - Cej a which in the opinion of the Contractor,may reduce the quality of the wastewater TDH,able to handle household solids and safe in the system shall be reported to the Engineer prior to construction. areas of explosive gases. Y P 9 Control panel: .-IC Demand control with on/off float and high level alarm and ✓ (I) 3.The Contractor shall be knowledgeable and experienced in the construction of dose counter mounted on a post in a NEMA 4 enclosure. \\I�V�yyP�``�� g P P rod V"'' Z this type of wastewater system,and shall hold a valid certificate from the - euuLfa Q Jefferson County Division of Environmental Health. The following notes, disclaimers, and instructions are binding upon the on- g J site system designer, the installer,and the property owner or grantor of the a_ '4' 4. Backfill shall be native material,free of organic matter. Compaction shall be to property for which this design is intended. No substitutions of material or 90%of maximum dry density as per ASTM D 1557. procedures may be made without approval of the system designer: is o - W 5.The pump shall be installed in the pump chamber as per WAC 296-46A-500, • The site plan map does not represent a survey of the property in question,nor I-- oNO O Installing Electric Wires&Equipment,On-Site Sewage Disposal Systems. does it profess to illustrate all easements or encroachments.Any that may exist Q N I I":" p are the responsibility of the property owner and are the owner's liability. 6.All exposed soil shall be seeded with grass prior to final inspection. Installations • This site map is based wholly or in part on the best information available at the W 0 Y during October through April shall be mulched with 2 inches or more of seeded time from one or more sources such as the latest county assessor's parcel I— p U hay to prevent erosion.Seed shall be spread at an approximate rate of 10 pounds map, or from the owner's or owner's agent location of property lines and (I) W 0 _ per 5,000 square feet. corners.The drainfield and reserve area have been placed accordingly. If this <[ U property line information is inaccurate,then the system designer is not liable ec 7.The designer shall be responsible for periodic inspection to document the for improper placement for those items.A good faith attempt will be made to ki location of visible components.The installer shall be responsible for constructing be as accurate as possible. W the system described within these plans and with the conditions of the permit.The • Final grading must ensure that all surface water is diverted away from the I--. Q j installer shall be fully responsible for the quality and function of the permitted drainfield and reserve areas. (r) I- system for a period of one year after the completion of construction.The installer • Site preparation and drainfield installation are to occur during dry conditions. shall certify that the system conforms to the specifications and performance of the • Vehicles and livestock are to be kept away from the drainfield and reserve permit and WAC 246-272A implicitly by receipt of final payment from the permitee areas. No burning is allowed. Z for construction services.The owner shall be responsible for operating and • This on-site system requires regular maintenance on the part of the owner as 0 maintaining the wastewater. described in the provided manual. The designer and installers are not responsible for system failure due to improper maintenance or diligence by the SCALE: 8.Any deviation from these plans shall be approved by the county and engineer system owner. prior to construction.All changes in location of the system components shall be • No septic system additives are required,nor may they be used. documented by the installer with an"as-built"drawing giving distances to two • The property owner is responsible for damage done by landscapers. DATE: reference points. • Site conditions at the time of system installation may require that a curtain drain 12-19-2013 be built to protect the drainfield even if it was not shown on this design. 9.The installer shall notify the engineer 48 hours in advance to stake the location JOB NUMBER: of the system prior to beginning construction,as needed. 10-086 10. Installer shall finish grade to divert all surface water runoff away from tanks DESIG% DRAWN BY: and drainfield treatment areas. SAGE DISPOSAL ERIC c nstruction 11. After permanent power is connected to the pump controls, the location and ApprOV-a f REVISIONS: operation of the system shall be inspected by the engineer.The installer shall make omit fr` any necessary adjustments. 0 ate / \ 14. After installation but prior to covering,the location and operation of the system #.�.• :ty\ shall be inspected by the county Health Department. Phone 379-4468 to schedule ,/l,�<v:4sAs;$rs,�\ SHEET NUMBER when ready.They have 48 hours or two working days to complete an inspection, /4)...4, eta-2■ after which the installer may cover the system. t� = ,:N_ -,� 5100362 Vq■ 1 OF •gyp?` ERIC W HIBBARD ' ' A. LICENSED DESIGNER EXPIRES 11/18/2014