HomeMy WebLinkAboutSEP2006-00356 Jefferson County Department of Community Development \-(( ) °,)� A
621 Sheridan St., Port Townsend WA 98368, (360)379-4450
SEPTIC PERMIT APPLICATION OCT ,
PROPERTY OWNER C/)r s ght4,- T►Ca C[[� f l p�
MAILING ADDRESS u)GD14,rui -v • JEFFF SII 1;1111 V ifl
--rifunv,e4 `1Oa , gg36g
PHONE • ( )Gb ) .3 8 c' 3 �
SYSTEM DESIGNER ler rut fAft CS iel Designer Phone# b66- 1 O 3 A-
LEGAL DESCRIPTION: Section ,2.7 Township 10A) Range L u) PARCEL# q9 q 00 10 S
Subdivision Name t)Ott I/144., 14 (IS Division ) Block Lot(s) 5'
Site address/Directions to site
SOURCE OF SEWAGE/USE TYPE OF WORK WATER SOURCE
Residential yt New Private
Residential ADU Modification %A CTratA s IfN.t., Public X
Commercial Expansion
Community Upgrade
Repair SITE SIZE cj 641 QdrC>
SYSTEM TYPE Partial Repair-(tank) (drainfield) Pre •ous Evaluation
Conventional Designate Reserve Area t# 3T d - 13'7
Alternative ) Redesign No
SYSTEM DETAILS E`i i'se"9
Number of Gallons/day 3 GO Soil type 4- (attach soil eval.) Application Rate . 6 gal./sq.ft./day
Drainfield Length X00 ft. Trench Width 3 ft. Trench/Bed Depth in.
Septic Tank size i OOO gal. Pump Chamber size lb-00 gal.
TYPE OF SYSTEM I?rc.-5 s(.4..4-I2-e-e t 514) Ore n a
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. l 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 (�� )(11 !d' 7
/ _ 4 y.� PARTIAL
.�1! ASBU{LT d � FI
'PROVED ��ob
INSP/PUMP TEST C1i •
ALL HOW REQ.MET �NI�
Date 021106 Fee Ca Rec# )A3 Check# 5 L \ I Case#SEP
SEWAGE DISPOSAL PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend WA 98368 (360) 379-4450 (800) 831-2678
PERMIT #: SEP06-00356 Date Received: 10/27/06
SITE ADDRESS: 1673 WOODLAND DR Date Issued: 11/06/06
PORT TOWNSEND, WA 98368 Date Expires: 11/06/09
APPLICANT: CHRISTOPHE R AFRICA PHONE: 360-385-5342
1673 WOODLAND DR
PORT TOWNSEND WA 983682594
SUBDIVISION: WOODLAND HILLS#2 PHASE 1 DIV BLOCK: LOT: 5+
PARCEL#: 999900105 Section: 27 Township: 30N Range: 01 W
DESIGNER: BERNT ERICSEN PHONE: 385-3602
2281 HASTINGS AVE W
PORT TOWNSEND WA 98368
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.
Permit issued to CONSTRUCT,ALTER, REPAIR OR MODIFY AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM IN
JEFFERSON COUNTY,WASHINGTON
Thls 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 , ems, codified 8.15 amended per ordinance no. 08-0921-00.
This permit may not be renewed.
A GARDNER, Je'erson County Environmental Health Specialist
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 ortank 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.
HEALTH DEPARTMENT MUST BE CALLED FOR FINAL INSPECTION.
SYSTEM DESCRIPTION: 130-PRESSURIZED TRENCH
No. of Gallons per Day: 360 Type of work: MOD
Drainfield Trench Septic Tank
Length: 220 feet Width: 3 feet Depth: 6 inches Size: 1,000 gallons
SPECIAL CONDITIONS APPLY - SEE REVERSE
CONDITIONS OF APPROVAL- PERMIT NO.: SEP06-00356
1.) 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.
2.) H - AS PER WAC 246-272 AND JEFFERSON COUNTY CODE 8.15 ALL SYSTEMS
REQUIRE MONITORING. THIS MONITORING IS PROVIDED BY AGREEMENT
BETWEEN THE JEFFERSON COUNTY ENVIRONMENTAL HEALTH DIVISION AND
THE JEFFERSON COUNTY PUBLIC UTILITY DISTRICT#1. THIS SEWAGE
DISPOSAL SYSTEM WILL REQUIRE AN ACTIVE MONITORING CONTRACT WITH
THE PUD#1 PRIOR TO FINAL APPROVAL OF THE SEWAGE DISPOSAL SYSTEM.
While the County strongly recommends that the property owner allow inspectors to enter
their property to inspect the system in order to insure that the system is functioning
correctly, the property owner always has the right under the Fourth Amendment and our
State Constitution, to refuse the inspectors access to their property. The property owner
never loses the right to refuse access and can do so despite never having refused access
before.
3.) As per Jefferson County Code 8.15 all onsite sewage systems require monitoring.
Monitoring shall be provided by an approved entity. THIS SYSTEM IS REQUIRED TO
BE INSPECTED AT 6 MONTHS, AT ONE YEAR, AND THEREAFTER. TIME OF SALE
INSPECTION IS REQUIRED SHOULD THIS SCHEDULE NOT BE CURRENT.
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.
6.) H -An asbuilt drawing and certification of completion by the designer is required prior to
final approval.
7.) Before final approval is given, the designer shall provide an operations and maintenance
manual to the property owner. 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.
8.) Setbacks to all wells- 100' required from drainfield and reserve areas. 50' required from
tanks and effluent transport lines.
9.) 10' separation required between a Water line and all portions of the onsite sewage
system; effluent transport line, tanks, treatment and disposal components.
10.) Setback to surface waters- 100' required from drainfield and reserve areas. 50' required
from tanks.
11.) All components of the septic system are to be completely protected from vehicular traffic
or mechanical disturbance.
12.) A 30' setback shall be maintained from the disposal component and reserve area to any
downslope footing, curtain or interceptor drain or drainage ditch.
13.) Divert all sources of drainage, including roof drains away from septic tank and drainfield
area.
14.) Any portion of transport line under a driven way is to be sleeved/cased or equivalent.
2 of 3
11/22/19
1:\F_SEP_Permit.rpt
15.) Pump chamber shall be water tight and a minimum capacity of 1,000 gallons. It shall be
equipped with a control panel outside within line of sight of the pump chamber. The panel
shall have an audio and visual alarm, a cycle counter and a riser to grade. It shall be UL
listed and meet L&I requirements.
16.) A screen shall be provided either at the outlet of the septic tank or around the pump or at
both locations. A pump shroud is required if only an outlet baffle filter is used.
17.) Dose counters are required in the control panel for all drainfield components.
18.) Risers are required to grade with secured lids over both compartments and over the
outlet of the septic tank for inspection and maintenance/monitoring. Minimum 20" riser
over inlet.
19.) 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.
20.) 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.
21.) 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.
3of3
11/22/19
I:\F_SEP_Permit.rpt
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10/7/2014
Ericson Design
293 Pinecrest Drive 360-301-0324
Port Townsend, WA 98368
THIS REPORT HAS NOT YET BEEN LOCKED AND IS PROPERTY INFORMATION
SUBJECT TO FURTHER EDITING.
Location:1673 WOODLAND DR 72tr,
Tax ID:999900105 �c el/4
Mail To: CHRISTOPHE AFRICA
Use:
PORT TOWNSEND,WA
983682594
Owner.CHRISTOPHE AFRICA
ON ID:SOM04-00139
Fad ' ON-SITE WASTEWATER TREATMENT SYSTEM INSPECTION REPORT ' Fold
Hem Here
Inspected:10/03/2014 - Inspection Type:ROUTINE - Correction Status:Corrections in progress
Company: Work Performed By: Submitted 10/0612014 by:
Ericsen Design Bernt Ericsen Bemt Ericsen
This report does not assure approvals by Jefferson County Public Health for ANY future building permits or development.
COMMENTS&GENERAL INSPECTION NOTES
Deficiencies Were Noted:Corrections are in progress.
Drainfield flushed and balanced.One minute draw down(1")indicated 20 GPM. On time changed to 2:15(45 Gal.Dose)and off changed to 4
hrs.270 GPD(Veto=3 hrs=8 doses of 45 Gal.=360 GPD)
Outlet baffle filter was cleaned upon arrival.
SEP 04-139 was"finaled"
SEP 06-356 added sewer line to accommodate office was not finaled because of incomplete as built.
New Record Drawing showing components of both permits to be submitted.
GENERAL SITE&SYSTEM CONDITIONS
The General Site and System Conditions were: Fully Inspected
All Components accessible for maintenance,secure and in good condition: YES
Surfacing effluent from any component(including mound seepage): NO
Components appear to be watertight-no visual leaks: YES
Improper encroachment(roads,buildings,etc.)onto component(s): NO
Component settling problems observed: NO
Abnormal pending present for one or more of the disposal components: NO
Subsurface components adequately covered YES
Owner compliance issues noted N/A
Site maintenance required(e.g.Landscape maintenance)If yes,describe in comments: NO
Occupant compliance problem(occupant not operating the system properly). If YES,describe in notes: NO
If deficiencies were identified on last inspection were they corrected before or during this inspection? N/A
(If NO,describe in notes,NA=no deficiencies on last report):
OSS Components,structures and appurtenances located per as-built/record drawing(If NO,describe YES
in notes). If no as-built exists or changes made,state NO and provide record to Health Dept:
Alterations made to the OSS(valves adjusted,timer settings modified,ports installed,etc.)(If YES, YES
describe in notes):
The house/structure was vacant or used infrequently,assessment of the drainfield was not possible. NO
Is the SEP case in a finaled/completed status?(if NO explain in comments) NO-In Progress
ONSITE SEWAGE SYSTEM INSPECTION DETAIL
TANK:Septic Tank-2 Compartment
Manufacturer: Local Manufacturer
This component was: Fufly Inspected
Component appears to be functioning as intended: YES
Effluent level within operational limits(if NO explain in comments): YES
All required baffles in place(N/A=No baffles required): YES
Effluent Filter Cleaned(N/A=Not Present): YES
Compartment 1 Scum accumulation(Inches,if other specify): r
This report indicates certain charaderistics of the onsde sewage system at the time of visit In no way is Nis report a guarantee of operation or future perfoimenca
ReportlD:401344 View inspection reports online at www.onlinerme.com Page 1 of 2
Effluent filter/screen needed cleaning on arrival YES In Progress
Compartment 1 Sludge accumulation(Inches,if other specify): 9"
Compartment 2 Scum accumulation(Inches,if other specify): 0°
Compartment 2 Sludge accumulation(Inches,if other specify):
Pumping needed: NO
Approximate Gallons to be pumped(if needed)by Certified Pumper: g
TANK:Pump Tank
Manufacturer: Local Manufacturer
This component was: Fully Inspected
Component appears to be functioning as intended: YES
Pump vault screen needed cleaning on arrival N/A
Compartment 1 Scum accumulation(Inches,if other specify): 0"
Compartment 1 Sludge accumulation(Inches,if other specify): o"
Pump Vault Filter cleaned(N/A=not present): NIA
Pumping needed: NO
Approximate Gallons to be pumped(if needed)by Certified Pumper. 0
"anel:Control-1 Pump,Manufacturer=Orenco-MVP-S Series
Manufacturer:Orenco Model:MVP-S Series
This component was: Fully Inspected
Panel functioning(including alarm): YES
Pump 1:on minutes(override in parentheses-if present): 2:15
Pump 1:off hours(override in parentheses-if present): 4 tvs
Pump 1:gallons per dose(override in parentheses-if present): 45
Pump 1:ETM hours(override in parentheses-if present): 9464
Pump 1:Cycle Count(override in parentheses-if present): 5640
•rainfield Pressure
Manufacturer:Site Constructed
This component was: Fully Inspected
Component appears to be functioning as intended: YES
Lateral lines flushed: YES
Average squirt height(if performed)(feet,if other specify): 6'
Ponding present?If YES explain in comments: NO
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This report indicates certain characteristics of the onsite sewage system at the time of visit.In no way is this report a guarantee of operation or futum performance.
ReportiD:401344 View inspection reports online at www.onlinerme.com Page 2 of 2
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