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HomeMy WebLinkAboutSEP2009-00044 00 jai+' orPr Jefferson County Department of Community Development f 1+ r 621 Sheridan St,Port Townsend WA 98368,(360)379-4450 8 ` to SEPTIC PERMIT APPLICATION PROPERTY OWNER et t n o c MAILING ADDRESS .)7)1 Fbu,i' C®Yy t t``, i UL SEN •,�' PHONE 060 ), �` '7R i 3 .3 eel' 4,. oe SYSTEM DESIGNER Fri c 3641 911 Designer Phone# ,2)60 3OI°®'�a`i' LEGAL DESCRIPTION: Section .3 Township .30M Range I u) PARCEL# 00 1 '533040 Subdivision Name Division Block Lot(s) 11 Site address/Directions to site I j,2 FG c*- CD rrl 2G6'S -Rd . art TDI,z)yiSP. ,I, 'IA/G1 . q 8 3 6 e SOURCE OF SEWAGE/USE TYPE OF WORK WATER SOURCE Residential y, New Tank/s only X Private Residential ADU Modification x • Public X Commercial Expansion Community Upgrade Repair SITE SIZE 6',6 ai r'c SYSTEM TYPE Partial Repair-(tank) (drainfieid) Previous Evaluation Conventional e( Designate Reserve Area Yes#Sep 84 g' Staff-oz Alternative Redesign No SYSTEM DETAILS `���D Number of Gallons/day 3',b Soil type rt (attach sod eval.) Application Rate 5g° gal/suit/day --- Drainfield Length 210 ik Trench Width 3 ft. Trench/Bed Depth 40 in. Septic Tank size 10 on gal. Pump Chamber size 10 00 gal TYPE of system ?vine -+o lrav x-c t state vi (p g" g6 APR 2 3 2009 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 r/ 5 7lC PARTIAL ASBUIL FINAL'a APPROVED `�(] /`� INSP/PUMP TEa ' " is//7 PUB f q 53l c? ALL HOLD REG.MET Date 4-2,3-6?Fee Off.t Rec# it)32Q0 Check# 030 Case#SEP 0°1-* 44 H:\WEB\PDFs\Septic\septic_permitapp_2008.DOC SEWAGE DISPOSAL PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend WA 98368 (360) 379-4450 PERMIT #: SEP09-00044 Date Received: 04/23/09 SITE ADDRESS: 132 FOUR CORNERS RD Date Issued: 05/27/09 PORT TOWNSEND, WA 98368 Date Expires: 05/27/12 APPLICANT: DAVID A HEROUX PHONE: 360-379-1323 MELODY J HEROUX 131 4 CORNERS RD PORT TOWNSEND WA 98368-9367 LEGAL DESCRIPTION: S33 T30 R1W N1/2 NW SW(E OF HWY)LS TX 10-12,14,15,20&PT TX 3,SUB/EASE PP PARCEL#: 001333040 Section: 33 Township: 30N Range: 01 W DESIGNER: BERNT ERICSEN PHONE: 385-3602 1656 S JACOB MILLER RD 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. 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. 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 syste •d' ied 8.15 amended per ordinance no. 06-0719-07. This permit may not be renewed. / Jefferson County Environm I 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 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. HEALTH DEPARTMENT MUST BE CALLED FOR FINAL INSPECTION. SYSTEM DESCRIPTION: 320-SEPTIC TANK & PUMP CHAMBER TO INDIVIDUAL No. of Gallons per Day: 0 Type of work: NEW Drainfield Trench Septic Tank Length: 0 feet Width: 0 feet Depth: 0 inches Size: 1,000 gallons SPECIAL CONDITIONS APPLY - SEE REVERSE CONDITIONS OF APPROVAL- PERMIT NO.: SEP09-00044 1.) H -The existing residence must be removed from the property prior to final approval of this permit. 2.) H - Permanent barriers are required along/around primary drainfield area to protect from CURRENT parking, driving, prior to final. 3.) A new D box and riser is required in the existing drainfield. 4.) 10' separation required between a Water line and all portions of the onsite sewage system; effluent transport line, tanks, treatment and disposal components. 5.) On existing tanks as well as new tanks, 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. 6.) 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 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.) Divert all sources of drainage, including roof drains away from septic tank and drainfield area. 12.) 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. 13.) Health Dept. required to observe pressure test with system designer when system fully installed/complete, 48 hours notice to be provided for scheduling. 14.) Any portion of transport line under a driven way is to be sleeved/cased or equivalent. 2 of 3 11/22/19 I:\F_SEP_Permitmod.rpt 15.) 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. 16.) This system as designed and approved is sized for only one single family residence. It is not sized for an Accessory Dwelling Unit(ADU). The minimum daily design flow per residence is 240 GPD. 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. 3 of 3 11/22/19 I:\F_SEP_Permitmod.rpt s JEFFERSON COUNTY PUBLIC HEALTH,615:SHERIDAN. PORT TOWNSEND WA 98368. ASBUILT INSPECTION REPORT For RECORD DRAWING Designer EIZ I C.$E N D E.S 1 e/I∎ Permit# SEP 01-4 Installer ..,EF (-.-RA\IES Parcel# OnI353040 7; - Electrician 1)POI 1 T H ER O U K (3til N EK) Design Flow 3 L 6'I b Property Owner $ v t * i1 EL6)Y H E1R b v X Site Address I a. FOUR CCFW Efts Rt. ?OK I' TO J N SE t iD, WA. Answer MI questions or indicate NA DATE Tanks, Pumps and Controls INSP. Tank (manufacturer, size, baffles) 1000 6 A L. .PE N. TANS l o-9-09 Pump chamber(manufacturer, size) `` � • Screen(s)and/or Pump Shroud (type, location) OUTLG T BfF1=LE F1 ITER 4- - 4 I4I DoTN SE'PTic T hIJks. &URDUD W kJm P TioK Were Tanks tested onsite for water tightness? C)/No Panel Model AQUA \AIo-RX SIB. IPC$0 - 09 cooq n Pump 1 — Man./Model ZOELLE1? T N IS B Flow Rate IS apm Pump Location(i.e_ garage, treatment unit, basement) 'P U MV TA 0 k Float/transducer settings Inches Timer from bottom of tank- On/off- 020/2 in. Functions: On 66 in Veto- 39 in_ Off- .24o a- ( hr Alarm - 3q k in Veto On- min Storage Above High Water Alarm 3t.Q gal. Veto Off- I$b sec nJlhr Dose Counter Reading 1 #gallons/dose 45 gal. Elap.Time Meter Reading 2;,2o:04 II/m/5 Pump Throttled? Yes CD Dose Drawdown (in inches) A.yµ in_ Pump 2— Man./Model Flow Rate qpm Pump Location(i.e. garage, treatment unit, basement) Float/transducer settings inches Timer from bottom of tank- On/off- in. Functions: On sec/min Veto- in. Off- sec/min/hr Alarm - in. Veto On- sec/min Storage Above High Water Alarm gal_ Veto Off- sec/min/1w Dose Counter Reading #gallons/dose gal. Elap. Time Meter Reading minihrs Pump Throttled? Yes I No Dose Drawdown m inches) in. H additional pumps-complete the info In this table (i for each and attach. Other Timer functions & settings(e.g. override on/off) Z B- O 4, AUTO CL E-AT I bb5c \JETo rs?S = 7l UET°/1-1*1 = IR H:%WEB1ONSITE\AsbuiIt_Report Fann.des 04/28/10page t of 2 V 0 r y ZI co 03 0 <... w A `�tt i s W g 1IJ u (N o o m n e- W Ii L ? � W ; S� /g _\4. '( • W Uh k (12 w W NU) , 0 •0 J 0. w m w 0 E " Q °6 or .L£'OLZ �d, Y27 t c CqI- t, 4 JQUu' mo .ti0"09Z [W1 [W1 [W 1 [W 1 Ce m co E— wc)I 0 a Cr --J Nr co 1 1 i rn , a N 0 0 co a a c X w w p W cn cn 0 x N L W LL 7 — t< 0 7 l O Y O ^ ,`, LL W W VJ X A W I /O w wQ 0 .64'49S rit [WI [W] [wl [w] [W] [W]- O o I } a) d M 0 m E LL/ _ 0 � N — o� W W oai ip ; Q i W O re a) x • m c=i� a w°M° 2 b�W o� cx w aa1.���_ Y ix \ _.....„„*„.....,=, 56 M Z w `i9�,1 Q > °� E= O W W N cO!_5 L w ca co} Q cc;1 w — 3 a \1 c,v a) 0 0 0 v rt - % w Bch >L e a) cn 0 v 0 ch M O 0 O w N 1 O Y W 2 O E 0 0 .O`-. 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O W OD I- OI -1 Y Cj 0 0 0 0 0 0 0 2 2 2 2 a) mmmmmmm liu-tits E 0 (2t::: �i N CO +i NNO � O � 4.?".... 1ON ,-N �.s COI II II II 11 11 II 11 11 II II II Awl ", ,• 0000000 00 _00 a.,,4 c¢ / CO „ ` � o QQQQQQQ wwww ; flO' Q± a LLI u) \i, 1 I r©Wr �o r i f hers list # 13r N 427°4 7' b t , 1 ( Owner. uu e 1 9 --->- ✓ 4 X Meier Parcel# 00 t 3 35 0 i0 Designed by:trt.Gser, (den I Scale i'`- 60` G% GE�Y' SA� ..00 I i SAS .. forj ` f 4 Contact designer prior to construction 'ate Stele- L Cast+'9 hex,l --ti � - `Y- 1� 1)6 Fbu`(aJ.14ei'S a l4 v.„, d �; a 1;50 aerok, 'MP. i N-a 9- sw A- � rio 4,z,azeAodzr OeSS ie- nsoy allouu41 CC lc'min stPew:Aim1 s\ke, CP°6 6101 �( 40 d OC ald1}x' S\et" 01 fie,Aelle s�n e 0.01 Ex►S i d r,ve,,huts 9 deter gee3� Shoo, 1�c,F RcsP,ve . 04111,41154 Q re i'. i�? ei of`,.../Cd, , ,I 4 �/ 5 .J,259 F . r� , is BERNT PAUL ERICSEN 1 ? i".t�il s ' LICENSED DE IGNER i EXP!•ES 02/11/ f tr e , ..„...,...• 0, ,. .., ..,...,„ .....„,.• , r--:: . 1 i ..---. ...,.. , • .4.. ,,,,„ so : , fs,,.. . k — — _ _ __ ......r".,,.• . r0 ,- ;. 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V ■.... ; 8117.1 IN CLEANOUT 0 64o e-- r 4 0 S.PAI'vI , . ai , i --..---- -le VJOrkt9 VOlarne.- • ... - ../ mi ••■ re I 4. 3470 eill . Min. • 7urr 1 1=1 it 1 1 1 *'*-- 11111 IOR.ET 11111111 '-' PROW I II. ) - ,,,,- HOUSE •\-' II, I I ? .-. (4)4 11:76411/11: ■•., ...111 IS Crl k i 4 r'"...: r''"'C"'-'"*..C.4 f r r:c-, - ,i _ _ . ----_,--. . . .."- vt-,-.4_ t....- ---- ,L,......,',-;,i .--- ...•.-...-.., - 1 4---. - -* t-.--- --• Apreseoc^r on-a. .-..,..,./i co PUMP tl ?ic\ 0/ a) MOW HOLE (,) e vi; CHECK VALVE (4) a PVC UNION td,J :-... (s) - ,_ PVC EViii. VALVE (6) v PVC TRANSPORT LINE (7) AQUAVIT:1RX TRANSDUCER , (1) SPLICE ROX (R) 18' MIA. ,a- 0- 4 • R sEcnor, war a mnR Vow ir ,"1. badiva. tutted- 464$ - ON ROTTEN, AS PUMP SHROUD. - w) Il$e etraL. Woo.74 - FINNED gREE -•••• i Z. 11-...11 ..... INONWWWIWWWNNIWIWW ...... : ** — ?...-.• —ii —iii;'"'i 1.•-•''- RR TRENCHES=WSW DOWN Prr- II it. swam WACO . r tXUSED SURFICING VP couRsru- II RUNE RACKRIE, ORME TV PER IMS11001.51.1 9-01fICTX I OW WOW ROPONNYS Ir Gale. -' Pet WOW • ft SA 9-0110. 0 . .0,0, It' arazuveY,U),, Wien- U MONDE SOL AO PVC " 0 ENDOWENT WIER'ROWNOS , Viliarof 1.)• -• A WI RIM MOUNT AND ORR= 111`.■ ''''' I II ML O A ARENS USE PIPE REDO=PER A. •I 0: 4.104isi.,_\ t, 1119)070,154 9-41,1K CONSTRUCT , '-'1%.;11;8 - ..-,ri`51-;-.4.-i. : .. _ n J.., z•so4b..4". • ..: -It ............-WINOS ANO MOIL EWE MR WEV Aol'°&* r ' 'II , 4 . .. ., b . .4' , ---0 v ,---,,iliti-VMME' AMIN 7•47.1 OF MOE=NFU 0/#4. . g ..at,.,0 " . . • ilk iric-Ax Less.7.2„ownErc=10401141%ce 0 • - - .41 MEN Mar RPE W CP. FOR ARWS r, ... ' ''.. SI At • * '- .;illittiN wawa ARMS USVAer VMS i •- 10021C __ _ 0",,ii, WOW MEWL or WRAC WORM 11 e I:0 i T,' ' ERICSEN . 14 14 - -- • - -- ----- 0 iii- iii;I:*-.....4..-C.:::::076 411111Flii 2*. WEE OF war LARGER VOW VS: a el -'4' "N,,■.4. ■ZIOVIVI 1 C t■ IcHANAIVIONOVIVIgH. N. ze Ma PC PPE ON WOVE=REQUWW9 IND 6 W*ME ...1-717r..3.. .411 I MIES N nif SIVE WWI* WERE SNAIL BE r • WO="CROW&CITNOWCE BETWEEN APES). PVC PIPE TRENCH DETAIL • C 1 , /1 trisi-tut ON SIz a-ttryt i)obt, g.h4evitt• 5 0 ertik faW. - d'e .14-01. (11-4,1°Itil'AL-Celd- 4#),„ k.4 scot to t a La 1 0 6 a 1 relt,-740fi 1 3 2009 4 , 1 A o clock or- use, T44r-rin esieit -fee- 6.1010 c.,.& , 6-0.-tnis.qe,, e 141:444# Ar y v � � �� 1 erg; � ' '-ii O � . s • RFANT„rAUL CSEN Si Heroux 001333040 Tr r Project Description Install new septic and pump tanks, and transport line to existing septic tank ( SEP 89- 88 ) , install new distribution box, risers etc. Septic Tank /Two compartment (1000 gal.) mono-pour concrete, equipped with water and airtight un ented risers to grade. Tank shall be water tight. Outlet baffle filter required. Pump Chamber 1000 gal.) mono-pour concrete, equipped with water and air-tight riser to grade. Tank shall be water tight. 360 gals. min. working volume required above transducer "on". An emergency storage of at least 270 gals. shall exist above high water alarm. Pump Need pump capable of 10 gpm @ 8.5 tdh, installed in shroud. Control Panel The control panel (Aqua Worx IPC-S) is to be mounted outside, within site of the pump chamber on a post or on a wall of building. The designer is to set the timer to provide a pump run time that equals 45 gals. and a pump off time of 4 hrs.( for an average daily loading of 270 gals, or 75% of peak design flow, dosed 6 times per day) Transport Line Install 2" sch. 40 PVC pipe from new pump tank to inlet of existing septic tank. 1 Double case under drive areas with 4"ASTM 3034 D-box Install one new "D" box on poured in place concrete pad on undisturbed soil with riser to grade. Install speed-levelers and water level prior to designers "as built" inspection. Misc. Place barricades at ends of existing drainfield to protect against driving/parking. No water/sewer crossings allowed, 10' min. separation required. General Construction Notes 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. 2 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 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- 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,negligence or improper action on the part of the users could result in the premature failure or malfunction of the system or its components. 3 E 0 z a OE a o a o ?? ll a h ii o c�:77 S`- § o oo a a a am° Nom :-c' W 0 0 E a. to OI 1. P as 0 0 V Q co Z 0 I... 3 1 10 E - o 00 n a a a Ea a a— o c °o a V M M N N r in to lee`(Hai)P° H 3IweuAa IWol 1 0 N .L Q Ch 2 2 UU'i _ c c c Q„ a ® 00000 0 o ' Naa °I"- i r C . ,, O d• O C O o C C o a ow ` q �4 I (v Z N N Z o o •mil ....... . Z: ' 0 ,) n,s C !�"{r _ Z N Z co N j N N d N tll k....sr+?.•• y I. as g > a r $ d; 2 IflPi5i1oE: Q W .0 V o o VQ 5' I- m rn y1.i° ?I n o it W o•+ c N = R \a0 V) E it 6 d x ° 2009 Q. d W m co 7 V = Q A C IL ONSITE SEWAGE DISPOSAL SYSTEM DESIGN OOI 330'/O Date o2-a0-o9 Property Owner I)tL1It L iii t6k e.rou. System Designer E(tc,S{P,i1 Dest n Legal Description: Section 3 Township Q30►J Range 11/3 Subdivision Name Division Block Lot(s) I. CALCULATIONS E i t i rtg sq-eg If for residential use: Number of Bedrooms: 3 x 120 G.P.D. = .AO total G.P.D. If for non-residential use, attach calculations used to determine G.P.D. Soil texture waste water application rate t5S G.P.D./ft. squared (see page 214 of the EPA Design Manual) DRAINFIELD SIZING: Absorption area: 30 square feet (total G.P.D. G.P. ft. sq ared) Trench or bed width 3 feet Trench or bed length .2I0 lineal feet (sq. ft. . tre ch or bed width) it. APPURTENANCES Septic Tank Size 1000 gallons Pump Requirements (If Necessary) °°• • Elevation difference in feet t,r-7 2 3 2039 Friction loss Pump capacity should be id G.P.M. at 8.5 T.D.H. Number of doses per day Dosing volume gallons I e! Pump chamber size loon gallons ,do I. ti { H:.home pincntr infohfthtsawdsn 1m► 'i►'s■!a►®�e�►1'r.\iii.7►tsvh`1, j 4e—ts°"! A `''" ,,{ JEFFERSON COUNTY '-' 1-14- f�,^ ��ENT OF CO !yi �!,3� r !t i *. 624 Sheridan Stet•Port Townsoend•Waslrirgton 98368 04> i ,ill - �..,.. ' •36( 379-4454 Fax �a- o w '. � N: 4 Stormwater Calculation Worksheet ,2 el 1 rru►# PROJECTAPPUCANT ut Da-vu 4 Vv`l e do6ti . exou_x DETUfitliG STORIIWATER MANAG INENC REaumanwrik iNs stonnewkw oak:Waken w oricairest should be completed krst to classify the proposal as'small."finedium.*or"sage." The size detonates vat a Sbmnwaler She Plan is requited in conjunction with a stonnweler management peat*applcakon,building pone app,or other land use appnwal applcahon that nwolves donnwaler review. The basic infosmeton WI also be heiptid for canpietg a Shier She Purr,if required. s .,- LABGEL-WgitgaMil Size of parcel 5.' L arses An acre contsrirhs 43.560 square feet- PAdlipty the acreage by this hgtot. Size of parcel in square f .24/) gag-r sift activity is any activity that wafts in movement of earth,or a change in the mdsting soli cover(both vegetative and non-vegetative) and/or the existing soil topography. Land dsturbing activities hhciude, but are not limited to dewing,grading,fif&hg, excavation,and compaction associated with stabilization of structures and road construction. Native vegetation is vegetation comprised on plant species,other than maims weeds,that are Indigenous to the coastal region of the Parma Northwest and which mason*could have been expected to naturally odour on the ale. Examples include species such���a/s Dough kr,western hemlock,weskits red cedes,alder,bitleef maple,and vine m ple;strums such as willow,elderberry,sal onberr and said;herbaceous plants such as shim'fern,'foarn*tower,and lammed. _.__L 1 ��11.-..L" ,'c I11 PI!■ai A"1 ice`i._i'OF x:111 J. r z.l.i!,, ?, ,�-_ • •:-,1 1i Cakwliet the total area to be dewed,graded,Died, Answer the following two questions related to excavated,and/or compacted for proposed development conversion of nerve vegetatl 4 project. include In this calarllion the area to be cleared for: Does the project Corned ii axes or mom of Conebucion site for atrocious sglfi native vegetation to lawn or leashed areas? Drairlleid,septic tang,eta 4 d 0 spa Circle: Yes IC: Wei,utales,etc. sglft Does the project convert 2 Mt acres or more of :native vegetation to pasture? thiveway,poking,etc. luta Ckde: Yes (D Lawn,landscaping,eta luta Other compacted surface,etc. sag/ft a Total Volumes of Proposed - st Cut n _ a t Total Land DDsham wbrce mint fill [over] ir Impervious eurfet,tie Aard surface that either prevents or retards the entry of water into the soil mantle as under natural conditions prior to •= .-•• . A vLsurface area which causes water to ran off the mime in greater quantities or at an increased rate of flow from the flow • -,t!"- •= '111- = conditions prior to development Common krvervious surfaces include,but are not limited to roof tops,walkways V, • - parking lots or storage areas,concrete or asphalt paving,gravel locals,packed earthen materials, and oiled,rql*iciarn = -•— which sindarly bipeds the natural infiltration 9f stonnwater. rty .11°WAM=0tM,--tM122*;.` ,• I oftwreie 3i14)(3- Structures(all roof area) sat Shuctures(alt roof area) eglit Sdevrailcs sqlft Sklewalics sga Patios me Patios sgat Solid Decks sqat Solid Decks sq (without inftrat on bebw) (mahout kdindion below).- Driveway sga Driveway sga Other sga Other _ft Total New sqa Total E3dsting sga TOTAL NEW 4-TOTAL EXISTING* sqlft anis amount vAll be used to check totd tot coverage. The following questions will help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT v.IHNIEVELOPIREINT Divide the total foOkig impervious surface above tr,the dm of the parcel and convert to a percentage: Does the site have 35%or more of sidag inwervious deface? Ckde: Yes No FURTHER INSTRUCTIONS:if the answer is yes,the proposal Is considered redevelopment and the attached Figure 2 should be used to determine the apptcable Minimum Requkemerds. If the answer is no,the proposal is considered new development and the attached Agree 1 should be used. At this juncture,the aprdcemt should refer to the applicable Flow Chart to determine the Minimum Requirements for stcsmwater management. DCD staff wS he verity the classimation of the project and the eqvgcation requirements. For proponents of ' mar projects who must comply only with Minknum Reqdrement-.112,-Conshuction Stormweder Pollution Prevention—an additional subenthal is not reqdred. The proponent is responsible for employing the 12 Elements to control erosion and prevent sedimed and other polkdants from leaving the site during the construction phase of the project. Pick op the Construction Stonuwater Polkdlon Prevention(SWPP)Best Management Practices(BRIM PadaeL Proponents of l'inecturn*projects—those that must meet only Minimum Requkements #1 geough 16—and for large" projects—those that must meet al 10 Minimum Requirements—are required to submit a Stonnwater Sib)Plan. DCD has prepared a submittal template of a Stonnwater Site Pan, prthcipdy for rural re:Mental pmjects. Complete the templets in the Stannwater Sts Plan insbudlons and Submittal Template or prepare a Shxmarabr Site Plan using the step-by-step guidance lithe Sionniveler Management&fennel. APPLICANT SIGNATURE By signing the Mon-matey Calculation Wodcsheet,I as the appthautiowner attest that the infonnagon provided herein is true and correct to the best of my knowledge. I also catty that this application is being made with the full knowledge and consent of all owners of the affected property. (LANDOWNER OR AUTHORIZED IFEPRESINTATIVESIGNMURE) OWE) _ -