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HomeMy WebLinkAboutSEP2010-00090 Jefferson County Department of Community Development ` • r 621 Sheridan St., Port Townsend WA 98368, (360) 379-4450 SEPTIC PERMIT APPLICATION PROPERTY OWNER Mike_Saia MAILING ADDRESS 4222-47th St.S.E. Auburn,WA 98092 PHONE (253)709-0055 SYSTEM DESIGNER: Michael S. Deeney Designer Phone#: ( 800 ) 395-7296 LEGAL DESCRIPTION: Section 34 Township 27 Range 1W PARCEL#701341001 Subdivision Name V.21 of Surveys, Pq. 175 Division Block Lot(s) Site address/Directions to site South on Coyle Rd., rt. at Mail Box 7462, rt. at signs for"Olson", Killien", and "Olsons", follow gravel rd. to project site(property line to project site is before the gate-contact owner regarding gate access). SOURCE OF SEWAGE/USE TYPE OF WORK WATER SOURCE Residential X New Tanks(s)only Private X Residential ADU Modification Public Commercial Expansion Community Upgrade Repair SITE SIZE 24.0 acres . SYSTEM TYPE Partial Repair-(tank) (drainfield) Previous Evaluation Conventional Designate Reserve Area Yes# Alternative X Redesign X No SYSTEM DETAILS Number of Gallons/day 480 Soil type 4 (attach soil eval.) Application Rate 0.6 gal./sq.ft./day Drainfield Length 268 ft. Trench Width 3 ft. Trench Depth 6 to 18 in. Septic Tank size 1,250 gal. Pump Chamber size 1,250 gal. TYPE OF SYSTEM Pressure Distribution Drainfield with Gravelless Chambers 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 b separately judged by the rules and laws in effect at that time. / ro• -rty 0 - ' / -5-i i Owner Signature Date PARTIAL FOR OFF/CEASBUILT �i'I1N��Z FINAL 'I1 a (.?— b / f PRO ED INSP/PUMP TEST 3 \Z- PUD 161(2.I tZ. Pil ALL HOLD REQ. MET Date I.I 1 kid( Fee ((5.1jP Rec#04- Check# T zis Case#SEP lb--"l U C:\Data\Wpw\County&State Forms\Jefferson\Septic Permit Forms\Sala 701341001(Rev.1).wpd w , SEWAGE DISPOSAL PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend WA 98368 (360) 379-4450 PERMIT #: SEP10-00090 Da - -^ ; . P'" SITE ADDRESS: 7462 COYLE RD P ate Issued: 05/24/12 QUILCENE, WA 98376 Date Expires: 08/24/12 APPLICANT: MICHAEL SAIA PHONE: 503-.' - A-' 4222 47TH ST SE AUBURN WA 980928443 LEGAL DESCRIPTION: S34 T27 R1W LOT 1(LESS S300'&N200') PARCEL#: 701341001 Section: 34 Township: 27N Range: 01 W DESIGNER: MIKE DEENEY PHONE: (800)395-7296 CREATIVE DESIGN SOLUTIONS PO BOX 2787 PORT ANGELES WA 98362 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 rs (unless otherwise stated above) in accordance with Jefferson County Rules and regulations for on-site, a age systems, codif-. .15 a . -nded per ordinance no. 06-0719-07. This permit may not be renewed. /� =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: 480-PRESSURIZED TRENCH-GRAVELLESS No. of Gallons per Day: 480 Type of work: NEW Drainfield Trench Septic Tank Length: 268 feet Width: 3 feet Depth: 6 inches Size: 1,250 gallons SPECIAL CONDITIONS APPLY - SEE REVERSE CONDITIONS OF APPROVAL- PERMIT NO.: SEP10-00090 1.) H -Record drawings must show location of all wells both existing and decommissioined and designate use of each existing well. 2.) This permit was issued to correct a violation of WAC 246-272A. The permit must be completed within 90 days of the date of issuance. 3.) 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 4.) 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. 5.) H - Existing tank shall be properly abandoned. It shall be pumped and filled with clean fill. Documentation to be provided to Health Dept. prior to final. 6.) This site has been granted a waiver from the state onsite sewage regulation 246-272A-0210... Compliance with conditions of the waiver is required. 1. cased as specified in plan forextra prtoection of integity of line. 2. line shall be pressure tested to 120 psi. 3. performance monitoring annually by approved entity. 7.) H -Contact Health Department to schedule inspection of the pressure testing requirment in accordance with the approved waiver conditions. 8.) A shoreline permit exemption has been issued in conjunction with this septic permit. The applicant shall comply with all conditions of that shoreline permit exemption (SDP10-00101). 9.) Contact designer prior to installation for staking of drainfield area. 10.) MAXIMUM TRENCH DEPTH 13 INCHES 11.) Health Dept. required to observe pressure test with system designer when system fully installed/complete, 48 hours notice to be provided for scheduling. 12.) This system must be constructed by an installer certified by the Jefferson County Public Health Department per state code WAC246-272A-0250. 13.) 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. 14.) Notification of the start of construction shall be faxed or emailed to Jefferson County Public Health ONE WORKING DAY prior to start. 2 of 3 11/22/19 I:\F_S EP_Permitmod.rpt 15.) H -An asbuilt drawing and certification of completion by the designer is required prior to final approval. 16.) 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. 17.) Setbacks to all wells- 100' required from drainfield and reserve areas. 50' required from tanks and effluent transport lines. EXCEPT WHERE EXPRESSLY WAIVED FOR THIS PERMIT APPLICAITON. SEE WAIVER. 18.) 10' separation required between a Water line and all portions of the onsite sewage system; effluent transport line, tanks, treatment and disposal components. 19.) Setback to surface waters- 100' required from drainfield and reserve areas. 50' required from tanks. 20.) Dry season installation required. 21.) PROPOSED ROCK WALL LOCATED UP SLOPE OF DRAINFIELD AREA. If a Curtain Drain is installed associated with this wall, it is required to be located a minimum of 10' upgradient of primary and reserve drainfields. 22.) A 30' setback shall be maintained from the disposal component and reserve area to any downslope footing, curtain or interceptor drain or drainage ditch. 23.) All components of the septic system are to be completely protected from vehicular traffic or mechanical disturbance. 24.) Drainlines are to be installed along the natural contours. 25.) Divert all sources of drainage, including roof drains away from septic tank and drainfield area. 26.) Any portion of transport line under a driven way is to be sleeved/cased or equivalent. 27.) 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. 28.) 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. 29.) 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_Permitmod.rpt • JEFFERSON COUNTY PUBLIC HEALTH, 615 SHERIDAN, PORT TOWNSEND WA 98368 ' CONSTRUCTION INSPECTION REPORT For, RECORD DRAWING Designer / -7/C/1,96.7 Permit# SEP /®- DOS?® Installer 1. 9A-/ Parcel # 7�/ 3¢/ °p/ Electrician Design Flow 4-6e Property Owner M icf/./V52- S /I9 Site Address 7 4-Co Z co y« ,23>,/ Cpt�/GC�iv ! tAv q 71�' Answer all questions or indicate NA " 'f SEP 1 4 20 Tanks, Pumps and Controls Date Insp. Tank (manufacturer, size, baffles) /ZaD 6,4'4• 2 c®/1F, 7-3/-/ a Pump chamber (manufacturer, sizer)Z96P4¢/ ` rl"t` 71-/ Z Screen(s)and/or Pump Shroud (type, location) Pe-"`''/ 17,/o/-7- w/Elo /-7e-T:12 7_ 3) -1 2 Were Tanks tested onsite for water tightness? Yes (No) R Ea Panel Model M4/F'-$/'?)CZ-P7' c S (z Timer Model r'E/-7,67 .S g Z--j Z Pump 1 - Man./Model o/Zk-'nleo PF Zo/ .57 Z Flow Rate 3"•69 gpm g3- 3-/ Z Pump Location (i.e. garage, treatment unit, basement) Bottom of transducer to bottom of tank Float settings (above bottom of tank) / transducer settings Timer Functions: (above bottom of transducer) On/off- 2 4- ?5// On - faEtork./r34rivrta-- zlo D" Off Alarm - 'a0< 7 e-&-" Veto On - `/-r/w // e Storage Above High Water Alarm 3!0 7 gal. Veto Off- 2/792-_s Dose Counter Reading lc, # gallons/dose -4-' Elap. Time Meter Reading /4y.-7/Al Pump Throttled? Yes No Dose Drawdown (in inches) I- S" Pump 2 - Man./Model Flow Rate gpm Pump Location (i.e. garage, treatment unit, basement) Bottom of transducer to bottom of tank Float settings (above bottom of tank) / transducer settings Timer Functions: (above bottom of transducer) On/off - On - Veto - Off- Alarm - Veto On Storage Above High Water Alarm gal. Veto Off - Dose Counter Reading # gallons/dose Elap. Time Meter Reading Pump Throttled? Yes / No Dose Drawdown (in inches) If additional pumps complete this info for each C:\Data\Wpw\County&State Forms\Jefferson\Construction Reports\Alternative sys ASBUILT 2010-2.FRM.wpd 06/28/12 page 1 of 2 , Pre-Treatment Date Insp Sandfilter basin high water alarm shuts down pump to Sandfilter Yes / No Sandfilter Basin size/location Sand Fill met design spec? Yes / No ATU (manufacturer, model) Alarm tested Yes / No Disinfection Unit (manufacturer, type, model) Independent Alarm Yes / No . Drainfield Transport Pipe Size/Sch. Z sC/7% Mailiful�l Size/Sch. / sc' 4 7 -3f-/2 Orifice Diameter 740 1/ Lateral Size/Sch. l`f-s-G '1-e9 7`3/-/2 Barrier Material 6 C veZzAs'S 1Y1/1,-.8e4t..5 Cover Material/Depth 60 !r 'i ' • 7- 31-12 Residual Head (lat.# &ft. Head) S /t/ /7-4G G P'3 g-3-12 Source/Manufacturer of Drainrock/Gravelless chambers Drainrock Clean? Yes / No If no, what action taken? SEP 1 4 2012 Mound/Glendon Site Prep. Drainfield Length ZLog ft Width ft [�`el5t�h .3 K-,11s3 inches Caps for measuring residual head stored (location) COMMENTS (inspection notes, changes from design or deficiencies in installation) Attach additional sheet(s) if necessary Other Aguaworx panel settings: SWarn at , ZBios at , Autoclear set at doses min-sec. *p6A4/N 04,/ 1-TN S Health Department Inspection issues resolved Yes / No / NA If yes how? Users Manual Provided to Homeowner W/TY7' E ' '2 ' '/ v"°AI6 Date Tank/component Decommissioning Report AttachedC / No / NA Installer Certification attached/signed CP/ No ATTACH RECORD DRAWING stamped/signed by Designer or Licensed Professional Engineer I certify the information provided above was verified by inspection (with exceptions as noted, if any). I also certify that this on-site system was installed in accordance with the approved design and verified through periodic observations of construction such as site plowing for mounds, pressure testing with all system components exposed (no backfill, except over transport pipes), and final inspection of the completed system (with exceptions as noted, if any). To the extent revealed by these periodic inspections,the 4 system complies with all the conditions noted in the permit as approved by Jefferson County S-2 . `f Z (Permit Approval Date)or that changes have been noted and the system is in compliance with WAC 246-272. q--- 5100110 Designer Sign r Date License# C:\Data\Wpw\County&State Forms\Jefferson\Construction Reports\Alternative sys ASBUILT 2010-2.FRM.wpd 06/28/12 page 2 of 2 A ' O p N v x, , 0 ? . 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