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HomeMy WebLinkAboutSEP2004-00061 Mascot 615 Sheridan Street PtialPort Townsend,WA 98368 www.ieffersonCountyPublicHealth.org STEVEN R CONSTANTINE December 30, 2015 121 WATNEY LN PORT LUDLOW WA 98365-8500 RE: NOTICE AND ORDER TO CORRECT-Septic System Corrections Required Septic System Monitoring Inspection SITE ADDRESS: 121 WHATNEY LN PARCEL#: 930700008 CASE#: SOM04-00061 Dear STEVEN R CONSTANTINE: On December 23, 2014 a monitoring inspection was completed on the above referenced property. The following issues noted below require correction: 1. There was no effluent getting from the pump chamber to the bio-filter pods and the report indicates that the pump was operating resulting in effluent being discharged to a location other than the approved septic system. You are required to immediately contact a Certified Installer to complete repairs and have a monitoring inspection documenting the status of the system and that corrections are complete. Because the sewage effluent is not being properly treated or disposed of, the observed discharging of sewage to the surface of the ground or to the waters of the State of Washington constitutes a violation of the following section/s of Jefferson County Code 8.15: > JCC 8.15.070 (1) No Discharge to Ground or Surface Jefferson County Public Health hereby gives you notice to correct the violations identified above within thirty days of the date of this notice by doing the following: > Immediately prevent sewage from discharging from the pump chamber; > Hire a Certified Installer to further evaluate the conditions and complete repairs A Have monitoring inspection completed and submit report on system status to OnlineRME; > Contact this office within 7 days, by January 7,2016, at 360-385-9444 to inform me of the actions you are taking. This letter is intended to serve as formal notice that no further approvals shall be granted until corrections are made and approved by Health Department staff. Failure to comply with this notice and order to correct may result in the issuance of a civil infraction notice to you pursuant to section 180 of said regulations. The civil infraction notice may result in a fine of up to$513.00 per violation per day to be assessed to you. The purpose of proper maintenance is so the County, for the benefit and protection of the public's health, is assured by this department that these systems are designed, installed and maintained in a proper manner. We appreciate your prompt attention to this matter and if you should have further questions please contact this office at 385-9444. Please note that pursuant to JC Code 8.15.170 of the above regulations that any person aggrieved by the contents of a Notice and Order to Correct Violation issued under this regulation, or by any inspection or enforcement action conducted by Jefferson County Public Health under this regulation may request, in writing, a hearing before the Health Officer or his/her designee. Such request shall be presented to the Health Officer within 10 business days of the action appealed. Such a hearing, if requested by you, will be your sole opportunity to present live testimony and witnesses in support of your position. Sincerely, Environmental Health Specialist Jefferson County Public Health 360-385-9444 c: File Code References JCC 8.15.060(3) Adequate sewage disposal required. Any new or replacement residence or commercial structure,or any expansion,as that term is defined in Section 8.15.050 of this Code,may be connected to a pre-existing on-site sewage system only when the pre-existing system has hydraulic capacity,sufficient vertical and horizontal separation,an adequate reserve area and satisfies all other requirements to be in compliance with current code. JCC 8.15.080(1) On-site sewage system permit. No person shall install or cause to be installed a new on-site sewage system nor perform any modification,extension,repair,relocation,or connection to an existing on-site sewage system without a valid permit issued by the health officer. JCC 8.15.170(1)Appeal-Hearing. Appeal of Public Health Action-Health Officer Administrative Hearing.Any person aggrieved by the contents of a notice and order to correct violation issued under this regulation,or by any inspection,permit issuance or enforcement action conducted by public health under this regulation,may request,in writing,a hearing before the health officer or his or her designee.The appellant shall submit specific statements in writing of the reason why error is assigned to the decision of public health.Such request shall be presented to the health officer within 10 business days of the action appealed;except in the case of a suspension,the request for a hearing must be made within five business days.Upon receipt of such request together with hearing fees,the health officer shall notify the person of the time,date,and place of such hearing, which shall be set at a mutually convenient time not less than five business days nor more than 30 business days from the date the request was received.The health officer will issue a decision upholding or reversing public health's action.The health officer may require additional actions as part of the decision. WAC 246-272A-0200 Permit Requirements. Prior to beginning the construction process,a person proposing the installation, repair,modification,connection to,or expansion of an OSS,shall report the following and obtain a permit from the local health officer: (a) General information... (b) The soils and site evaluation as specified under WAC246-272A-220 (c) A dimensioned site plan... (d) A detailed design... JCC 8.15.150 Operation,Maintenance and Monitoring (1) Responsibility of Owner(s). The owner of every residence,business,or other place where persons congregate,reside or are employed that is served by an OSS,and each person with access to deposit materials in the OSS shall use,operate,and maintain the system to eliminate the risk to the public associated with improperly treated sewage. Owners'duties are included, without limitation,in the following list: a. They shall comply with the conditions stated on the on-site sewage permit. b. They shall employ an approved pumper to remove the septage from the tank(s)when the level of solids and scum indicates that removal is necessary. The septic tank shall be pumped when the total amount of solids equals or exceeds one-third(1/3) the volume of the tank. The pump and/or siphon chamber(s)shall be pumped when solids are observed. c. They shall not use water in quantities that exceed the OSS's designed capacity for treatment and disposal. d. They shall not deposit solid,hazardous waste,or chemicals other than household cleaners in the OSS. e. They shall not deposit waste or other material that causes the effluent entering the drainfield to exceed the parameters of residential/household waste strength. f. They shall not build any structure in the OSS area or reserve area without express,prior consent of the Health Officer. g. They shall neither place nor remove fill over the OSS or reserve area without express,prior consent of the Health Officer. h. They shall not pave or place other impervious cover over the OSS or reserve area. i. They shall divert drains,such as footing or roof drains away from the area of the OSS. j. They shall comply with inspection requirements in JCC 8.15.150 and WAC 246-272A k. They shall complete maintenance and repair of the OSS as recommended by the monitoring entity. 1. They should not dispose of excess food waste via a garbage disposal. m. They should not drive,park or store vehicles or equipment over the drainfield or reserve area. n. They should not allow livestock access to the OSS area or reserve area. o. They shall comply with WAC 246-272A-270. (2) Breach of Owner's Responsibilities. An owner's or occupier's failure to fulfill any of the responsibilities in 8.15.150(1) shall be a basis for a Notice of Violation and for the Health Officer to decline to issue approval for further development on the parcel. \\tidemark\data\forms\F_SOM_surf_sew_vio.rpt 12/30/2015 11/2/2015 Enviro Check, LLC 1612 Hastings Ave. West 360-379-9400 Port Townsend, WA 98368 PROPERTY INFORMATION • House Location:121 Whatney Ln Port Ludlow Tax ID:930700008 Mad To: Steven Constantine 121 Whatney Ln Use:Residential,Single Family Port Ludlow,WA System Design Flow:240 98365 GENERAL SYSTEM TYPE:Glendon Bio-Filter Owner:Steven Constantine ON ID:SOM04-00061 Fold — ON-SITE WASTEWATER TREATMENT SYSTEM INSPECTION REPORT Fold Here Here Inspected:12/23/2014 - Inspection Type:ROUTINE - Correction Status:Some Corrections Made Company. Work Performed By: Submitted 01/07/2015 by: Enviro Check, LLC Dale Wurtsmith Dale Wurtsmith This report does not assure approvals by Jefferson County Public Health for ANY future building permits or development. COMMENTS&GENERAL INSPECTION NOTES Deficiencies Noted:deficiencies must be corrected to ensure proper longevity of the Onsite Sewage System. 1-The septic tank was flooded and needed to be pumped and was by Enviro Check,LLC. 2-At the time of this inspection the permit had not been"Finaled"but has now been"Finaled". 3-What I observed was consistent with"Record drawing". 4-It appears the pump is working but there is no effluent getting from the pump chamber to the bio-filter pods.The owner disconnected the union and the pump was turned on and it appeared to be flowing at an adequate rate.The owner said there have been large trucks driving over the line between the pump tank and the pods and he will try to locate any break in the line or any other reason the flow is not getting to the bio-filter pods. GENERAL SITE&SYSTEM CONDITIONS The General Site and System Conditions were: Fully Inspected All Components accessible for maintenance,secure and in good condition: NO-See Comments Surfacing effluent from any component(including mound seepage): NO Components appear to be watertight-no visual leaks: NO-See Comments Improper encroachment(roads,buildings,etc.)onto component(s): NO Component settling problems observed: NO Abnormal ponding present for one or more of the disposal components: NO Subsurface components adequately covered YES Owner compliance issues noted NO 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, NO 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) YES ONSITE SEWAGE SYSTEM INSPECTION DETAIL TANK:Septic Tank-2 Compartment 1150 Gal This component was: Fully Inspected Component appears to be functioning as intended: YES Effluent level within operational limits(if NO explain in comments): NO See Comments 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): 2 Effluent filter/screen needed cleaning on arrival NO Compartment 1 Sludge accumulation(Inches,if other specify): 18 Compartment 2 Scum accumulation(Inches,if other specify): 0 ReportlD:416089 View inspection reports online at www.onlinerme.com Page 1 of 2 Compartment 2 Sludge accumulation(Inches,if other specify): 8 Pumping needed: YES See Comments Approximate Gallons to be pumped(if needed)by Certified Pumper: 1150 TANK:Pump Tank 1150 Gal This component was: Fully Inspected Component appears to be functioning as intended: YES Compartment 1 Scum accumulation(Inches,if other specify): 0 Pump vault screen needed cleaning on arrival N/A Compartment 1 Sludge accumulation(Inches,if other specify): 2 Pump Vault Filter cleaned(N/A=not present): N/A Pumping needed: NO Approximate Gallons to be pumped(if needed)by Certified Pumper: 'anel:Control-I Pump,Manufacturer=Aquaworx-Aquaworx Manufacturer:Aquaworx Model:Aquaworx This component was: Fully Inspected Panel functioning(including alarm): YES Pump 1:on minutes(override in parentheses-if present): -Proprietary- Pump 1:off hours(override in parentheses-if present): -Proprietary- Pump 1:gallons per dose(override in parentheses-if present): -Proprietary- Pump 1:ETM hours(override in parentheses-if present): 155:43:38 Pump 1:Cycle Count(override in parentheses-if present): 15253 V-51,778 'ump:Effluent Pump This component was: Partially Inspected Component appears to be functioning as intended: YES Controls functioning: YES Dose setting different than original(If YES,detail in comments) NO Dose setting adjusted to meet as-built/record drawing specifications(by the O&M Specialist) NO Tested gallons per minute flow: edia Filter:Bio filter,Manufacturer=Glendon BioFilter Technologies,Inc.-M-31 W/B Pod Manufacturer:Glendon BioFilter Technologies,Inc. Model:M-31 This component was: Partially Inspected Component appears to be functioning as intended: Equalized dosing: Slope integrity maintained: YES Sludge accumulation(Inches,if other specify): 0 Pumping needed: NO Approximate Gallons to be pumped(if needed)by Certified Pumper: Effluent level within operational limits(if NO explain in comments): YES edia Filter:Bio filter,Manufacturer=Glendon BioFilter Technologies,Inc.-M-31 E/B Pod Manufacturer:Glendon BioFilter Technologies,Inc. Model:M-31 This component was: Partially Inspected Component appears to be functioning as intended: Equalized dosing: Slope integrity maintained: YES Sludge accumulation(Inches,if other specify): 0 Pumping needed: NO Approximate Gallons to be pumped(if needed)by Certified Pumper: 0 Effluent level within operational limits(if NO explain in comments): YES 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 future performance. ReportiD:416089 View inspection reports online at www.onlinerme.com Page 2 of 2 ' Jefferson County Department of Community Development • 621 Sheridan St., Port Townsend WA 98368, (360) 379-4450 ,._ --i SEPTIC PERMIT APPLICATION D F----~ PROPERTY OWNER S-rEw Cia?ISTANTI,LE ` 1�t � � 004 '.,�` f MAILING ADDRESS Bog 232 I. ' Pau t sgo.Wm IA 48310 ;.cT. OF c k; , ., . , t� .ODIti,L r P _ R _i-- PHONE Area Code ( 360 ) 431- 0221 SYSTEM DESIGNER • DAv10 14A2~1111 LEGAL DESCRIPTION: Section 33 Township 27N Range 1E- PARCEL # 136700004._ Rn7 3Qaav 1 7Jxt Subdivision Name WAINEYS SatIL-AuplA Division -• Block -- Lot(s) 8 A&tO`? SITE LOCATION /2/ IA/Ai/Jet 44,1£ PaR4 Lu O14k1 Zip Code 46365 SOURCE OF SEWAGE: Residential X Residential ADU Commercial Community TYPE OF WORK: New 9( • Redesign Upgrade Repair Partial (tank) - (drainfield) Expansion Designate Reserve Area X Conventional Alternative a( Drainfield Length — ft. Trench Width -- ft. Number of Gallons/day 2406QD Trench/Bed Depth in. Number of Lines — Site Size kt$,Q12Ss. Septic Tank size /1Z5 gal. Pump Chamber size /12.5 gal. Water Source: private public K Sbil type 4 (ATTACH SOIL EVAL.) Previous eval: yes / no SEP Application Rate -0-6 gal./sq.ft./day TYPE OF SYSTEM 6 upr.1 (3rccciet Mace.No.14-3 f ucp , • . By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the test of their knowledge. Any material falsehood cr 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 it's employees, representatives or agents for the purpose of application review and any required later inspections. Access and right of entry to the applicant's property or structure shall be requested and shall occur during regular business hours. 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 judg-a , he rul- . and laws in effect at that time. re .Owner Signa ure Date AoM I i�'hk � •r OFFICEUSE O LY C,tuAwv\.pcu% 3 . , 9-3-o PARTIAL `a ASB ILT "Y . 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SEWAGE DISPOSAL PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend WA 98368 (360) 379-4450 (800) 831-2678 PERMIT #: SEP04-00061 Date Received: 03/12/04 SITE ADDRESS: 121 WHATNEY LN Date Issued: 09/03/04 PORT LUDLOW, WA 98365 Date Expires: 12/03/04 APPLICANT: STEVEN R CONSTANTINE PHONE: (360)437-0221 PO BOX 2322 POULSBO WA 98370-0904 SUBDIVISION: WATNEY'S SUNLANDIA BLOCK: LOT: Y PARCEL#: 930700008 Section: 33 Township: 28N Range: 01 E DESIGNER: DAVID MARTIN PHONE: 360-598-3505 MILLER BAY WATER CO PO BOX 138 SUQUAMISH WA 98392 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 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 o ms, codifie 8.15 amended per ordinance no. 08-0921-00. This permit may not be renewed. �( TKIN', Jefferson 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 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: 280-GLENDON BIOFILTER No. of Gallons per Day: 240 Type of work: NEW Drainfield Trench Septic Tank Length: feet Width: feet Depth: inches Size: 1,125 gallons SPECIAL CONDITIONS APPLY - SEE REVERSE CONDITIONS OF APPROVAL - PERMIT NO.: SEP04-00061 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.) This permit was issued to correct a violation of WAC 246-272. The permit must be completed within 90 days of the date of issuance. 3.) 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. 4.) 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 ANNUALLY THEREAFTER. 5.) If west portion of driveway is to be retained it shall no wider than 10' , the area 10 / ,\15 S t 7 surrounding it shall be filled with type 2 or 3 soils and a m ' of 6"of crushe rock jito p!� /!e �( gravel base shall be placed over the driveway. 'l `b -C )/. !'0 6.) Health Dept. required to observe pressure test when system fully installed/complete, 48,101%f. for 171Q- 4` hours notice to be provided for scheduling. / 1Orl Uint, 7.) An asbuilt drawing and certification of completion by the designer is required prior to final // approval. 8.) Permanent barriers are required along/around primary and reserve drainfield areas to)4714y protect from parking, driving, and other land disturbing activities prior to final. 9.) 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. 10.) Setbacks to all wells- 100' required from drainfield and reserve areas. 50' required from tanks and effluent transport lines. 11.) 10'separation required between a Water line and all portions of the onsite sewage system; effluent transport line, tanks, treatment and disposal components. 12.) Dry season installation required. 13.) Setback to surface waters- 100' required from drainfield and reserve areas. 50' required from tanks. 14.) Curtain Drain required a minimum of 10' upgradient of primary and reserve drainfields. 15.) Drainlines are to be installed along the natural contours. 16.) Contact designer prior to installation for staking of drainfield area. 2 of 3 11/22/19 I:\F_SEP_Permit.rpt 17.) Divert all sources of drainage, including roof drains away from septic tank and drainfield area. 18.) Any portion of transport line under a driven way is to be sleeved/cased or equivalent. 19.) Septic tank and pump chamber to be water tight. Extra protection (i.e. Bentonite)to be used around inlet, outlet, and risers due to high water table. 20.) Dose counters are required in the control panel for all drainfield components. 21.) This permit is granted based on the recorded RESTRICTIVE COVENANT combining lots 8 &9, Watneys Sunlandia to meet the minimum land area required under WAC 246-272 Onsite Sewage Code. COVENANT recorded 7/30/04,#487567 22.) 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. 3 of 3 11/22/19 I:\F_SEP_Permit.rpt ,r; 1►' t JEFFERSON COUNTY COMMUNITY DEVELOPMENT 621 SHERIDAN ST, PORT TOWNSEND WA 98368 4/ �J, ASBUILT INSPECTION REPORT County Inspector (to be filled in by County) Date Inspected by County Designer David Martin - MBH2O Permit # SEP 04-00061 Installer Shold Excavating Parcel # 930 700 008 & (009) Electrician Owner Design Flow 240 GPD Peak Property Owner Constantine Site Address 121 Watney Lane - Port Ludlow DATE ITEM SIZE/MANUFACTURER/CLASS/SCHEDULE INSP. Tank (size, baffles, risers, etc) 1150 Gallon Concrete Septic Tank 8/14/06 Pump chamber (size, baffles, risers, g/ inch, etc) 1000 Gallon Pump Tank 8/14/06 Screen(s)/Pump Shroud screen in septic outlet 2/14/14 Float arrangement Pump #1 N/A (transducer) 2/14/14 Pump #2 N/A Emergency Storage Above High Water Alarm (# gallons) 400 Gallons 2/14/14 Pump#1 model& flow rate at time of installation Meyers ME-40 8/14/06 Pump Throttled? YES/NO No Pump #2 model & flow rate at time of installation N/A N/A Pump Throttled? YES/NO Anti-siphon device Backflow preventer 8/14/06 Sandfilter basin high water alarm shuts down pump to Sandfilter.DYes No N/A Dose Counter Reading #1 12040 Elap. Time Meter Reading #1 166H50M 2/14/14 Dose Counter Reading #2 51,366 v-closes Elap. Time Meter Reading #2 N/A N/A Dose Drawdown (in inches) 1st Basin 2nd Basin N/A N/A #Gallons/dose 1st Basin Per GBT 2/14/14 2nd Basin N/A Panel Model Aquaworx Timer Model IPC-1 2/14/14 Other Panel Settings N/A Timer Functions: On time Per GBT Off time Per GBT 2/14/14 Other Timer functions & settings (e.g. override on/off)Start - 0.9, Veto - 8.8 (180 gal.) 2/14/14 HWA- 11.9 (240 gal.). ZB-09. Autoclear - 32 doses Alternative Asbuilt Form_05-10-04_pdf Page 1 of 2 ■ c it b 4 Other components (alternating valves, treatment units, UV light etc.) N/A Transport Pipe Manifold Header 8/14/06 Orifice size Lateral N/A Barrier Material Cover Material/Depth N/A Residual Head (lat.# & ft. Head) N/A Caps for measuring residual head stored (location)- Sand Fill (met ASTM?) Sandfilter Basin N/A Mound/Glendon Site Prep Per GBT guidelines (verified). 8/14/06 Source of Drainrock Cleanliness N/A Drainfield Length ft Width ft Depth inches COMMENTS (inspection notes, changes from design or deficiencies in installation) Attach additional sheet(s) if necessary Users Manual Provided to Homeowner Yes Date March, 2014 Installer Certification attached/signed YES/NO No ATTACH ASBUILT DRAWING signed by Designer or stamped/signed by Licensed Professional Engineer I CERTIFY TOE INFORMATION PROVIDED ABOVE WAS VERIFIED BY INSPECTION, TfEE SYSTEM APPEARS TO t t. HAVE BEEN INSTALLED AS VESIONEV AND APPROVED •:'Al- ,, Uy JEFFERSON COL(NTY9/3/2004(DATh) Er TEAT CHANGES hot Y�;. 4, 4 ,r , . HAVE BEEN NOTED AND THE SYSTEM IS IN COMPLIANCE `'r �r e., w O'`' PANN?WAWA s L{CENSW DESIGNER w, WITH WAC 246-272. %+ ,,r ,r00 :, , erusrr�rsor. �.: . . 1/ -: "* AR) \.i.014 6/ g as Designer Signature Date License ,-, . \a,A.D..,c) ' (fir, . AG‘k tn ►) AA li M ns \\ -kL -ktio. 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L,"%% f4 tt gi-t5T ,...2,---4 ‘,4„, __, (.. 4 co = C3 5 (tots ---,./i, ii". c2 z Z 0 -='1 .4M.De-,:,'7,,' 0 = ml 8 a) iie -ri co <> P.. _., 'iris ...•- IP' ,14` r- CO — C 0 Z Ca ', ::*ulti 1" ..' —I 0) SD — .. , ' 1" c,. I 00 cp .„ o) m * o IP- in o — 30 0 I CD —. . ‘ M 0 _■ Check one: MAR 0 3 2014 INSTALLATION START NOTIFICATION DATE SENT X PRESSURE/PUMP TEST INSPECTION REQUEST DATE SENT 3/3/14 This form shall be faxed or emailed ONE working day prior to starting construction OR a minimum of 48 hours prior to pressurelpump test Jefferson County Public Health - Environmental Health Dept. Phone: 360-385-9444 FAX: 360-379-4487 EMAIL: septic@co.jefferson.wa.us PERMIT OWNER Constantine SITE LOCATION 121 Watney Lane- Port Ludlow PARCEL NUMBER 930 700 008 SEP NUMBER 04-61 INSTALLER Shold CONTACT PHONE 360-598-3505 DATE FOR INSPECTION will-call SYSTEM WILL REQUIRE PRESSURE TEST - YES X NO *The designer is required to complete a pre-cover inspection of all systems. Please contact the designer prior to beginning construction to schedule installation inspections and pre-construction meeting if required per the permit or designs specifications. - Jefferson County Staff Only:: MONITORING AGREEMENT MAILED DATE/INITIALS PRESSURE TEST SCHEDULED 10 l iiyArk j $ e 1` k / 7 ,, .,..,... r.,. --, JEFFERSON COUNTY PUBLIC HEALTH ... i.--s,.,,,,,.' 615 Sheridan Street • Port Townsend • Washington • 98368 www.jeffersoncountypublichealth.org Case# 6ZPC)4-- (-0 Site Address la I IA) 6ti-r\IA 1-sr) k . Date/Staff , . . 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' : 1 8 8 ,ci r P i% g i g €\ 01;11FR tA 1 c, t:00,-: ,PA -.,: '?", I r:, 11 IP & 2 t z"' 4 C; -4 A • , •• , , i. g D , m2te' . -r r -s .?.1 1:4 C1 o ...L? i r Ln' - ►1 ! a -1 o S N. r L p ,n a L, J fig . � �� IN NI am, V .O 1 rn n V q C hV A p 0 p V d m = H gym? N rrt.- .� 7C O zo tV uuu A) J V �., ,, 1 -iz L` _ ir : 6 , . 1 m w1 H �. •`l A 1 � S -- v 2 -4: t N INII 4' R t Z . 19' 15- (L ,- s. �J -+.4 i, t . .... . v . . , ...k. 7 ix W t N , , JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELO V i a ;e I' \? 621 SHERIDAN ST., PORT TOWNSEND ,WA 98368, (3601 379- .r� i Li Iii SOIL EVALUATION p l: L' MAR '1 2 2004 _:1 PROPERTY OWNER STEVE (c JS1A,.ITIME • SYSTEM DESIGNER DA,/r0 MARTIAJ DEPT. OF CIA z t�� ; .E"vl<LOPh,'L I' LEGAL DESCRIPTION: Section 33 Township 23N Range IE Parcel # 93000030(gi06)(800) Subdivision Name WA?LIE&Svuutao,q Division - Block - Lot(s) S.4an9 Date Logged: /2-2-2.6A1 Logged By: MG‘iva 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 Typa4l3- 'O 6 69 SOIL LOG #2 Tye 4-/3 . 6.8490/SF • 6 to IZ in. a y4reESAuO1 LmApi a to 6 in. Doti<82owa att.att. $uCyLm►t /2 to 3/3 in,4¢,Ay i-dc r ''� .e1tcu i Fi t4 SA�+o 4 to 34 in. 644y6RAVe.a.v F NG S , * to 38 in EEStstaive So/Ls J to a4 in Res-rElcaiue 5n1-S. to .'A in GR0tiAhO A-ICA ,.;.,-," to 2� in. 6/Low/amino Anticipated water table f Zo in. Cil Anticipated water table 120 in. Roots to inches `b` Roots to inches Health Dept. Comments - Health Dept. Comments - ;..: a 1 SOIL LOG #3 rim 4 ohJPOiW S• b •4 r1Pe 4(3 -4.4.6,0 S-? 0 to /S in P A K i l e o u l a m.:4 4.,„ 'r ' o o /' • .A K ePaido rii(c scayLa4a -if/S to 3Z. in *aunt eilaVi leynueSA►ioi/lem.4 I8 to 26' in e RALE SAS rr\G 04 to B2 in. Re iptc7IJe• Coif a to in. to in. to in. Anticipated water table±13 in. , Anticipated water table ir,. ' t Roots to • inches (9,, .1, Roots to inches Health Dept. Comments Health Dept. Comments \ - SOIL LOG #5 SOIL LOG #6 to in. to in. to in. to in. - to in. to in. to in. to in. Anticipated water table in. Anticipated water table in. Roots to ... ihes Roots to inches Health Dept. Comments Health Dept. Comments H:UNFOHLTH\SOIL.FRM 1/00 ONSITE SEWAGE DISPOSAL SYSTEM DESIGN Date /Z-it-Zoo3 Property Owner S7etie Lau.b-tAu1iiJE System Designer Qw(r) klattml • Legal Description: Section 33 Township Z-BN Range LE Subdivision Name WA-Mc-v.'s .5l+ otA Division — Block — Lot(s) S Auel I. CALCULATIONS • • If for residential use: Number of Bedrooms: Z x 120 G.P.D. = 240 total G.P.D. If for non-residential use, attach calculations used to determine G.P.D. Soil texture waste water application rate o,G G.P.D./ft. squared (see page 214 of the EPA Design Manual) DRAINFIELD SIZING: Absorption area: 4c o square feet (total G.P.D. :G.P.D./ft. squared) Trench or bed width -le{ feet Trench or bed length lineal feet (sq. ft. +trench or bed width) S42,sr 9 MOO ME /C2? 1684 Sp 1o2At,MiA II. APPURTENANCES Septic Tank Size 1125 gallons Pump Requirements (If Necessary) Elevation difference in feet ± ,ZPt. • • Friction loss 1 l.sFT. Pump capacity should be ±ta G.P.M. at T.D.H. Number of doses per day Afw.24 -7. Be.Dezva es(61S1 Dosing volume mow, Io gallons Pump chamber size /llS gallons 7 f e, r-----. MAR I 2 2004 L L.: ... ...J , DEPT. OF C� a r .6E OPtv H:\home\ptncntr\infohlth\sewd sn f- .. _RTA IN I1�&ital SCALf /M tZFP,L-T 1044g S aF S Sewage M 1 �T i.' n "t' '' sp0 0� (� ® _ .;�,,I il Apps veld for CArl tructi D ' '` '` jtit' MAR 1 2 2,,C , [ace tout L PT. Of C5% * t 'vL_0©h:L'Jl _ r ._ „/ - �7. -- ,1 i', ,, . V v Pfr, - - j? O;0�FsE /ABRfc/ t ;� 04i;•, f o , RE&atieo a1J T PQ. (7QAia 4eAY - T/{c,,c�I7i:P�I�AQ(t?5 ;8 co,rmesapeo-UOSLoP .TiseN l u... Writ Deoto to 114koemt 11 a $ ' . ce �#"/ ' AA/4).BMtt.VlSa>�Ea.► LOatr�tut�nDC 7kr�ccKWoi�+�.� b+a'.'' '. k o. , ' 'k'' IYru W[A EO °V./kit,' RAvE.L. & t s,.) • 4101 PBZFORAIMn DDAt►.rtlt E •% IVI►u.bw,t147o P ,a - I I . ON5 *4c1t4N NOTES Aut,SPE6.(FKA-noeus 0 =r'. ,c ;" �' IA � �•*41)Ctl�tut,.t Dtprtt. IF/kb I-IA/OPAL) Ew<es 4►r-tt2en w-•-,' z` - / Cam;., _ - . F .. [Z.t1�Ica3 Z- Mujtguat 41uetr, PeQFaaArrco DeAt rec.e Naha $� s 1... w 4tr,.CttcS 6RAvCe..Uuors PIPE A t. L, t��• ti.f \ ... /.Lfs/.+rI 460 s!J.s 3.. F%t.Te�e FAINYG Musr ZE P[.stc�p�Vart 0 EA/0 6r4►'cz EXPIRES . '�.. - v x REtoe .lEmper• ea,,, QPSwPE. THE icw WAe-.. _ 1 q.�,. 4- /r1ut,4u .4 $MIL Vlsc+tteeu LIwtl2 SJAtA. SG AacQo 00 IDOw •Stovt TRri+w W4u. ItaTOl.)AQ9Ps1eg 57i2A7A . $- ati DQaAaliAVEi/Mlus7l3 WA-i o t .23,45 ReV( 40/4 3/Z7/95- 1f/1;[1.�8 54Y 11 kreR CD► i S'tA R.Ati CURT'wu DeAtN 2-(4-4 Stormwater Calculations IMPERVIOUS SURFACE NEW EXISTING Structures(all roof area) Sn4 sq/ft Structures(all roof area) 6.04. sq/ft Driveway Z9o0 sq/ft Driveway t 2460, sq/ft Sidewalks sglft Sidewalks sq/ft Patios ^ sq/ft Patios sq/ft Covered/Solid Decks sq/ft Covered/Solid Decks sq/ft Other sq/ft Other sq/ft • Total New 4344 4- sq/ft V Total Existing i•3 464 sq/ft TOTAL NEW+TOTAL EXISTING* t 3404 sq/ft • *This amount will be used to check total lot coverage Please also indicate the amount of land disturbing activity, in addition to the creation of impervious surface,that will take place: LAND DISTURBING ACTIVITY Drainfield area cleared 1 663 sq/ft Well,Structures, Utilities,etc. S c 4 sq/ft Driveway 2 9a sq/ft Other • sgfft Total Land Disturbance 4e7 sq/ft • • l .. 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