HomeMy WebLinkAboutSEP2014-00083 t
Jefferson County Department of Community Development
621 Sheridan St., Port Townsend WA 98368, (360)379-4450
SEPTIC PERMIT APPLICATION
PROPERTY OWNER The Point Corp (Jack Hensel) JUN 2014 li'.,,��
MAILING ADDRESS PO Box 610 ., '2%:-...,:l�
Port Townsend,WA 98368 5? 2 4
"`v Suzanne L Martin '{I
PHONE ( 360 ) 301-0102 -. .� ,. ..4 ',,
a. .>.Intn9
SYSTEM DESIGNER Suzanne Martin Designer Phone# 554-0224
LEGAL DESCRIPTION: Section 2 Township 29N Range 1W PARCEL# 998 300 018
Subdivision Name Tamarack Division Block Lot(s) 13
Site address/Directions to site 54 Evergreen
SOURCE OF SEWAGE/USE TYPE OF WORK WATER SOURCE
Residential ✓ New Tank/s only Private
Residential ADU Modification_ Public it
Commercial Expansion_
Community Upgrade,
Repair ✓ — SITE SIZE +/-12180sf
SYSTEM TYPE , Repair-(tank) (drainfield) ✓ Previous Evaluation
Conventional Designate RPsArve Area Yes# SEP85-00017
Alternative Redesign No , —
SYSTEM DETAILS
Number of Gallons/day 360 Soil type 4 (attach soil eval.) Application Rate 0.60 gal./sq.ft./day
Drainfield Length 200 ft. Trench Width 3 ft. Trench/Bed Depth 12-24 in.
Septic Tank size 1000 ex gal. Pump Chamber size n/a gal.
TYPE OF conventional trench; drainfield repair only
By signing the application form, the applicant/ownej 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
y= . will later obtain permission to build a permanent residence or other structure on this parcel. Any
f t appli ion w' be s= •arately 'udged by the rules and laws in effect at that time.
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Property Owner Signature Date
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PAR 4 S{-A.t,�� ASBUILT � I FINA� //ly
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forms\Suz\2008 SPA.DOC
JEFFERSON COUNTY PUBLIC HEALTH
615 Sheridan Street•Port Townsend•Washington •98368
gs�it nic
www.jeffersoncountypubficheakh.org
Friona 3bU-:3t3b-9444 Fax MU-3I9-44d I
ON-SITE SEWAGE DISPOSAL PERMIT
PERMIT#: SEP14-00083 Date Received: 06/18/14
Date Issued: 09/02/14
SITE ADDRESS: 54 EVERGREEN LN Date Expires: 12/02/14
PORT HADLOCK, WA 98339
APPLICANT: THE POINTE CORP PHONE:
PO BOX 610
PORT TOWNSEND WA 983680610
LEGAL DESCRIPTION: TAMARACK VILLAGE LOT 18
PARCEL#: 998300018 Section: 2 Township: 29N Range: 1W
DESIGNER: SUZANNE L MARTIN PHONE: 360-554-0224
PO BOX 125
CHIMACUM WA 98325
SYSTEM DESCRIPTION: CONVENTIONAL TRENCH
No. of Gallons per Day: 360 Type of work: REP
Drainfield Trench Septic Tank
Length: 200 feet Width: 3 feet Depth: 12 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.
(/L2
Jefferson County Environmental'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.: SEP14-00083
1.) BOTH ENDS OF ALL EXISTING LATERALS MUST BE LOCATED PRIOR TO INSTALLING THE
NEW LATERALS
2.) This permit was issued to correct a violation of WAC 246-272A FORA FAILED DRAINFIELD. The
permit must be completed within 90 days of the date of issuance.
3.) If the existing tank is kept it must be certified by the designer to meet code in all aspects.
4.) Contact designer prior to installation for staking of drainfield area.
5.) 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.
6.) H - AS PER WAC 246-272AAND 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
7.) 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.
8.) Notification of the start of construction shall be faxed or emailed to Jefferson County Public Health
ONE WORKING DAY prior to start.
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.) Divert all sources of drainage, including roof drains away from septic tank and drainfield area.
14.) 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.
SEP14-00083 Page 2 of 2
\\tidemark\data\forms\F_SEP_Permitmod.rpt 9/2/2014
CONVENTIONAL SYSTEM AS-BUILT INSPECTION REPORT
Installer: Shold Excavating(Evan Neville) Parcel # 998 300 018
Permit Owner: Pointe Corp(Jack Hensel) Permit# SEP14-00083
Designer: Suzanne Martin Design Flow: 360 gpd
Site Address: 54 Evergreen Lane-Port Hadlock,WA 98339
ABSORPTION AREA:
DRAINFIELD TRENCH WIDTH TRENCH DEPTH TANK SIZE #OF BEDRMS #GAL/DAY
LENGTH 200 3 24-30" 1000 3 360gpd
IF PUMP AND PUMP CHAMBER REQUIRED: Shroud/Screen
Tank Size: n/a
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 1 October 2014 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 / ?'.,
30 September 2014 5100342 ;: +
Desi er Signature Date License# =� +'+
9 9 �M R '+,
E\Ft M11116
Record Drawing sent to both Point Corp¤t
resident at 54 Evergreen.
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Page 1 of 4; Johnson;
Parcel#998 300 018
JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT
621 SHERIDAN ST..PORT TOWNSEND .WA 98368.(3601 379-4450 t
s.
SOIL EVALUATION .4,^I' I%r''4■
Jim&Laurie Johnson ''4' '� ► i�`+,
PROPERTY OWNER .,. 51.,12 ,
�€ i Suzanne L Martin t#
SYSTEM DESIGNER
Suzanne Martin 2111„5
LEGAL DESCRIPTION: Section 2 Township 29N Range 1W W Parcel # 998 300 018
Subdivision Name Tamarack Division Block Lot(s) 18
Date Logged: 21 May 2014 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 � (f/ SOIL LOG #2
0-11"Dark brown gravelly loamy sand 0-8"Strong brown gravelly loamy medium sand
11-22"Light yellow brown mottled loamy sand 8-25"Yellow brown faintly mottled loamy fine sand
22-37"gravelly medium sand 25-38"Grey medium sand
7-60+"Yel ow brow m dium sand - 38-60+"Yellow brown medium sand
\14 i t �Tll orth side of test pit has dark brown layer, likely a old
1,l ,p / $1.L 5 (�j_ z _ root rotted, soil not indicative of fill soils
Antici•ated water table ni in. 33 `0°fP Anticipated water table n/a in.
Roots to inches Roots to 55 inches 1
Health Dept. Comments Heal De t Cos ents ' 36'"
SOIL LOG #3 SOIL LOG #4
0-7" Dark brown gravelly sandy loam 0-6" Dark brown gravelly loamy sand
7-14"Yellow brown faintly mottled loamy sand 6-14"Yellow brown faintly mottled loamy fine sand
14-21"grey medium sand 14-26"Grey medium sand
21-48+" medium sand 26-48+"Yellow brown fine sand
not excavated further; planned reserve area not excavated further; planned reserve area
Anticipated water table n'a in. Anticipated water table n/a in.
Roots to 42 inches Roots to 32 inches
Health Dept. Comments C Health Dept. Comments -
SOIL LOG #5 ---11413. SOIL LOG #6
. eo- d —f3--.)--7 444°)'/111 73V19.
9-q-,2-1 4 ` Z —C-0 - Si
Anticipated water table in. Anticipated water table in.
Roots to inches Roots to inches
Health Dept. Comments Health Dept. Comments
H:INFOHLTH\SOIL.FRM 1/00
Page 4 of 4;Johnson;
Tank Cross Section-Not To Scale parcel#998 300 018
(For illustrative purposes only, actual tank configuration may vary, tanks must be on list of approved products.)
SECURED LID WITH GAS TIGHT SEAL
ACCESS RISER oiv
FINISH GRADE
C
_
- distribution box
Mar r
DIE
FROM SEWAGE
SOURCE FLOATING MAT
APPROVED
EFFLUENT
FILTER
SEDIMENTS maximum 3/16"filter
recommend smaller filter
SEPTIC TANK Ex.tank to be tested on site to be sure that
(TYPICAL) it is water tight;over night will be sufficient
If it is not it shall be replaced with a state
approved septic tank.
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