Loading...
HomeMy WebLinkAboutSEP2013-00067 ,i a�1 ego k Jefferson County Department of Community Development i^ �, , ,/7 , 621 Sheridan St,Port Townsend WA 98368,(360)379-4450 ,�'p ,,, - �;Af ' ,/ `7 y t SEPTIC PERMIT APPLICATION '�i PROPERTY OWNER O t J A L) 3T A r. E ► ( ( ► ° • Vin. v 1orl. .,• MAILING ADDRESS �' M I k •, ° ' .r'. .1CSEN.. �1�1 0 1 , S b t 3 G ra ni►- r PHONE ( 3 G O ) 3 7q - 11.q o 0 (. -i 3-3 SYSTEM DESIGNER E R I C S C lV 1)E S 1 E1 Designer phone# 36©- 301-03,:).T LEGAL DESCRIPTION: Section 1 Township_3O N Range I \IJ PARCEL# 601 07026 I I+ n , itce Subdivision Name /' Division Block Lot(s) 't'"kp Site address/Directions to site �-G 0 1n"1 l_, MINN i P6R 7 TO t N S EN t S I SOURCE OF SEWAGEIUSE TYPE OF WORK WATER SOURCE Residential ) New Tank/s only Private A Residential ADU Modification X Public Commercial Expansion Community Upgrade Repair SITE SIZE 4,613 Act c SYSTEM TYPE Partial Repair-(tank) (drainfield) Previous Evaluation Conventional X Designate Reserve Area 'X Yes It Seg 610- 760 Alternative Redesign No SYSTEM DETAILS Number of Gallons/day_ 6 t) Soil type 4 (attach soil evai.) Application Rate . 57 gal.isq.ftiday Drainfield Length a.I t:) ft. Trench Width 3 ft Trench/Bed Depth .36-3 L in. Septic Tank size EX 1 156 qal. Pump Chamber size -- gal. ,_ —., TEM of syst m M Ob t f Y EX, S YS EM / DES 1.6 Nit I E 'USE R\1( Mtn 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 futu lication w F will be par ely judged by the rules and laws in effect at that time. CA-14,71 /z�/ 3 party ner Signature Date FOR OFfiCE USE ONLY ) I I X15 PARTIAL ASBUILT ) (PM Fl "CliN ROVED fI �I INSP/PUMP TEST PUD ( ( l ALL HOLD B 2EQ.MET ‘ /... 4.z3_4....-7 J Date —i Fee/ 3 _°, Rec# [ Check# 1 ‘, ( Case#SEP '-3 -3 R:\WER\PDFs\Septic\septic_permd.tapp 2008.DOC 1ySCJA fq , ``` JEFFERSON COUNTY PUBLIC HEALTH 615 Sheridan Street •Port Townsend•Washington •98368 firh« www.jefferson countyp ub lichealth.o rg 1'none 3bU-3tb-9444 Fax 3bU-3/9-4413 I ON-SITE SEWAGE DISPOSAL PERMIT PERMIT#: SEP13-00067 Date Received: 06/05/13 Date Issued: 07/10/13 SITE ADDRESS: 260 MC MINN RD Date Expires: 07/10/16 PORT TOWNSEND, WA 98368 APPLICANT: RONALD STRANGE PHONE: JUDITH A KING 260 MCMINN RD PORT TOWNSEND WA 983689646 LEGAL DESCRIPTION: S7130 R1W TAX 10(LESS CO RD R/W) PARCEL#: 001072014 Section: 7 Township: 30N Range: 01 W DESIGNER: BERNT ERICSEN PHONE: 360-301-0324 293 PINECREST DRIVE PORT TOWNSEND WA 98368 SYSTEM DESCRIPTION: CONVENTIONAL TRENCH No. of Gallons per Day: 360 Type of work: MOD Drainfield Trench Septic Tank Length: 210 feet Width: 3 feet Depth: 30 inches Size: 1,150 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. /7/ Jefferson County En ronmental 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.: SEP13-00067 1.) EXTREME CARE MUST BE TAKEN WHEN REMOVING TREES FROM THE EXISTING DRAINFIELD AREA. SOME TREES MAY NEED TO BE CUT AND LEFT IN PLACE AS COMPLETE REMOVAL MAY DAMMAGE THE DRAINFIELD. CONTACT THE DESIGNER PRIOR. 2.) Risers are required on all openings of the septic tank as well as the new D box. 3.) H -All water lines (existing and proposed) must be 10' or more from ANY septic system component. 4.) 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 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.) When/if designated reserve area is utilized an alternative system providing an additional level of treatment may be required and must comply with code at the time of application for use. 10.) 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. 11.) 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. 12.) Divert all sources of drainage, including roof drains away from septic tank and drainfield area. 13.) 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. 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. SEP13-00067 Page 2 of 2 \\tidemark\data\forms\F_SEP_Permitmod.rpt 7/10/2013 CONVENTIONAL SYSTEM ASBUILT INSPECTION REPORT INSTALLER Grt c e i r: . ( To,b.e1 ) ham ) PARCEL# 00 107 2-0 I Li- Permit Owner den4d 3 rafiey,j J(.1.6611 16 ng Permit # Sev 13- Co 7 ABSORPTION AREA: DRAINFIELD TRENCH TRENCH „ TANK #OF #GAU LENGTH a.1 WIDTH 3 DEPTH .3 d SIZE EY. (ISO BEDRMS ,3 DAY 346 Tank Shroud/ IF PUMP AND PUMP CHAMBER REQUIRED: Size Screen 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 I CERTIFY THIS ONSITE SEWAGE SYSTEM WAS INSTALLED AS DESIGNED, PER PLAN APPROVED 1--/0- 13 6xr144 ��L��-l 11- DATE APPROVED `Ds jncr SIGNATURE DATE gee a f et c4 L .►'Rear t "?raitOtif NOV 1 42014 o 13 at "0 U-OZZZ -' X C-rX'c_r- c co as rnD vID tt tt II II H H i m NIU"N-► ._a 3 _aO -:CAW 0 '^ c3 of A CD .11•a) = o r y+l7�'7 Q j V�1 iQ t_ Ca) CO m ro 3 a-a I : ,/ r.' - m � D amp a a ° 73 K• ' ' v v 1 mom ao \/' ' "' -4i' (D3- zr O o -1 - D Z -' (� /o 5" ,, T' '' /' `' a w R �'•`^o // I -' ay CO O 's 1 Is) IL,.- r \ J �Y v o � t i o) na N� j' ha Q-X10 is ° tw z Q.m CO_ t - ' - '� C: ® _ m g N CA)• i co 7CG c2 �m N' N ND t/ i r 1 70, 1 a� 0 869 CO oD o tr.) :'!�/�1i .. Qi' = m x r 1 I -� 0 n 4'°m 9 \\cn !/ o N A 0 o to °tlt°o �` ~ \\<\ _mil @ W fn A�1 - 0• r-N :� ;mss.,. .�or ITT tntn a' .6 i o I -I/' -CI `,l w _ / r ''. 4z, allIllIllIllMMM-D. 313.07` / CA= / S 1"54'06*W C. 4 //\ v KMKKKKK DAADDDAK m Q 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ° `? 1 I0mm000 =Gmm0OW c ea o 3 c N (� i{ it 11 II II II II 11 tl 11 II 11 II li m l�6 a _ �V\ CJ 3_t024 co.o) (aW-�� iro N IL} / ) Z mil, iC m tD o ' "''„ C�iv comet ! E : : o ..t m , " vi -' to on,9 9 a . m o xr 0 co' I w �0 c— CO W -, 'T � • ° a) 6. m w� O /••. s W -n D Z m m m O n O O .. = . m E xmv +sue' 1I 0.' 3° ; � :U � v — . 1 . _§.Qo St 07om !J!x \ 'i 1 �,` t; a) m" m Z m iL'i ' Q• ` om r ` vJ _ _ m t t £ m = • Z:x \ G) _ _ i I EZ- m Riz • W ° - - �D 1 t-0 t J m co X Nma - �.F"3 -° 0 3-E t iO 17 l m •< Q co °• A_ k _ m O F.O N_O ^ ,, I \111 R- ��m Cl- in a � �n cu m t t ' , t � W o i ZD i 1 O % -0 0 i t r Z w � S - m m ° �� Co ow W �� = i t^ C C .o O°7 1 C (n - V N ~O @ W *SQ p_7 O O V e m O m t O . t t L��,_1�J�-� N n� _ _ c 1 C,J t � ,?y'�. ffi AN IV�� t co c t t w� � t r - t m t W vi Iv t 7 = , t Z3 m - m _ I r x CO II 0 6 n 6 K cn $ �iI• ,'\ m g m - x" m o us 0) —moo• ni w .° t Ii- /v 60. to a v °- 7`?7. w 0,t , ® 1; (rim O w § 0 ■ 1 'D ,_ _,,�,r >�►" 3ar go li I 1254. 0 f®`~� 9, o Allillik �� •�� 313.OT i-1 n 0ca c 0i S 1°sacs°w • t/► �° KKKKKKKM DDDDDDDDDm . , C spy 0. 66606660 66 ° ° 6 ° 660 m 0 0 °I rC_mo_nme W rC_] G?�tmrJn W 44* M3 elk a II u u II II II rt a It n II II it II n II m U'1 � � � '' C31CY10� jj1cp3ODODN-' .+(�� .. 0) N N OOOCflN •1O5OU7 m oi = _ 03 a3 1 teaLrn (n - op O n3 r- -I o m = mX D * Ct t t v -;10,11, �`Yr lii Ica x_. Sr'. •rtt . Q 0 �� • x D z W a - "1 M w' �1 y-i m Q �' 0 � (n (A p ,ate K 0 j m m D z A W Z C L 1S 'AGE DISPOSAL DESIGN Approved or Construction 0 n 1•3 Z ,-,c) Date oa 0 f s ` c? N A N Q too -0 y _� / o 0 CD CD 1 Fes// / / '''--\\ X al Oa CD /J cam X I (ID N I i O i / IK ■ • / 313.4T f \■ / S 1°54'06°W '� (7 m / O O \ / (� N 3 \ - --- O O N Q. Air�ail I. JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT +ems of .';.)ai 621 SHERIDAN ST.,PORT TOWNSEND.WA 98368, (36D) 379-4450 / ,� der "� s d.. SOIL EVALUATION _ �?� ' PROPERTY OWNER 'IR an Q t k Si-rail e/ i L -iK n5u t ,i 44 SOIL *+� . SYSTEM DESIGNER 6 rI C, 1 1)-e5511 :.�$�"1♦��►i\1 .0,0.\\m., LEGAL DESCRIPTION: Section 7 Township 5/)1Q Range (k) Parcel # QO i 07.1014 1 -3-I3 Subdivision Name Division Dock Lot(s) Date Logged: 9 g_ I '� Logged By: T;n. - Eric-5e4 Include soil textural characteristics and the depths at which significant changes occur. Be sure to include depth where mottfmg or impermeable layers occur. SOIL LOG #1 SOIL LOG #2 0 to 10 in. IA L 4 (-•i itvi1 6 to g in. 75R L S 1 b to 4 in. TA FM—e25 Sii7 T.143 S to lv 7 in. TN; FN Skip 7'`f to 8g in. TA) 67W. -C-R'S SAlb ( .2. to in. to in. iAli rhi 71 Le.NStS to in. Anticipated water table? in. c, c ( t5 Anticipated water table?!v J in. to ✓) Roots '`�� inches 6-"9-(2-.Z'aV1N ,; Roots to 6� inches Health Dept'Cominents �' )� Health Dept. Comments 1 .50(3 SOIL LOG #3 IAA/\ SOIL LOG #4 0 to it in.1)K 13R Si_ 1�" , t to 3 in.'b K 'BR SL if to 1a_ in. -6-K U5 Tit 3 to g in. iN LS 1 l to 4 3 in. / A) f i t) S i■J D V to G U, in. !A) F -MO S 1Si) T Lf 4S' to 1 7 in. 71L F 1J- L 1 5 SO T J' to in. - Anticipated water table.777 in. Anticipated water table 7i,6 in. Roots to 41-81 inches Roots to ci-C, inches Health Dept Comments Health Dept. Comments SOIL LOG #5 SOIL LOG #6 0 to 7 in. bA i31'/) .SL to in. 7 to '/I in.- i AtJ (rAJ- 1vE SAM -1-41. to in. " - 45 to 71 in. 1 s f M Q i . to in. to in. to in. Anticipated water table-7 71 in. Anticipated water table in. Roots to -Q inches Roots to inches Health Dept. Comments Health Dept. Comments H:VNFOHLTHISOIL.FRM 1 I00 � SEWAGE DISPOSAL DESIGN Approved f• Construction �; BCt fERICSN . 1 .. eemt kr.»..�.NIWIAmia, Date 41'3-J3 Ronald Strange I Judith King 001072014 Project Description Modify existing system.( SEP 90 — 700 ) by replacing approximately 10' of perforated pipe where less than 10' from foundation of proposed New 2 bedroom home with solid pipe, install Bentonite Dam and add 10' of drainfield to end of Line 3. Replace existing "D" Box, install risers. EES An EES was done a n d s ubmitted 5 — 9 — 2013. Septic Tank needs pumping and risers. Existing L3 was exposed at beginning and end of line. No ponding found. Drainfield appears to be functioning well. Recommend removing young trees from last 20' of drainfield. See EES and plot plan. Septic Tank Existing1150 gallon two compartment septic tank to be used. Install water tight risers to grade on all tank lid openings. Install outlet baffle filter ( Orenco FTiP 0418-W ) or equivalent. Transport Line Install 4" 3034 sewer pipe from "New" building stub out to septic tank @2% minimum grade. Delete existing sewer line from existing residence to SEP 90 — 700. I "D" Box Replace existing "D" box and install riser to grade. Install speed-levelers and water level prior to designers "as built" inspection. Drainfield Replace approximately first 10' of perforated pipe and replace with solid pipe, where lees than 10' from foundation, install Bentonite dam, and add 10' of perforated pipe to end of Lateral 3. See Plot Plan. Water Lines Maintain 10' minimum separation of water and sewer "stub outs" at new building. Existing water line route from well to existing residence was not found. If water line is encountered take measures to obtain minimum 10' separation from septic components where possible. Water line was exposed 16' from faucet at RV site and appears to be heading toward front door of existing residence. See plot plan. Water faucet at RV Hookup needs to be moved to obtain 10' minimum from septic tank and transport line. Inspections Designer needs to be contacted for a pre-construction meeting prior to construction to discuss details and to set up schedule for inspections. Designer is responsible for submitting "Record" drawing, and must be called prior to backfilling system.. General Construction Notes 2 • 1. The work described herein consists of construction of an on-site wastewater system. 2. The contractor shall be knowledgeable and experienced in the construction of this type of wastewater system and shall hold a valid certificate from Jefferson County Division of Environmental Health. "Approved" septic plans must be on site during construction. 3. If during the installation of the system the contractor finds soil conditions that may lead to premature failure of the system, construction shall be terminated immediately and the designer notified. Such soil conditions may include groundwater, fill, clay, highly compacted soil, bedrock or excessively permeable soils. a. Any inconsistencies, errors, or omissions that, in the opinion of the installer, would compromise the quality of the wastewater system shall be reported to the designer prior to construction. 4. Backfill in traffic areas shall be pitrun gravel and compacted. All gravity pipe shall conform to ASTM D 3034. All gravity and transport pipe shall be bedded, using native or imported material free of rocks, debris and sharp objects. 5. All exposed soil shall be seeded and mulched prior to the final inspection. Seed shall be spread at an approximate rate of 10 lbs. per 5,000 sq. ft. 6. The installer shall be responsible for constructing the system according to plans and conditions of permit and shall be responsible for its proper operation and function for one year. The owner shall be responsible for operating and maintaining the wastewater system in accordance with 3 WAC 246-272A-0270. 7. Any changes, substitutions, or deviation from these plans shall be approved by the designer and by the Jefferson County Environmental Health Department. 8. The installer shall grade to divert all surface water runoff away from tanks and drainfield/reserve areas. 9. The bottom of the trench or bed may be inspected by the designer prior to placing drain rock and shall not exceed +1- '/2" from level. Place filter fabric over drain rock prior to backfilling. 10. Setbacks to all known water lines shall be a minimum of 10'. No crossing of water lines with any septic component shall be allowed, except as included in septic design approved by Jefferson County Health Department. 11. Setback from the house foundation wall shall be 10' minimum to drainfield, 5' minimum to tanks and 2' minimum to non-perforated sewer pipes. Water saving appliances, fixtures, and practices are to be used. 12. The septic and pump tanks, drainfield and reserve areas are to be protected from vehicular traffic or mechanical disturbance. 13. The designer is to provide the as-built and letter of certification. 14. This system has been designed in accordance with WAC 246-272-A-0270 and the most current Department of Health "Recommended Standards and Guidelines for Pressure Distribution Systems," and has been approved by the Jefferson County Health Department. Nevertheless, 4 negligence or improper action on the part of the users could result in the premature failure or malfunction of the system or its components. 5