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SEP2014-00033
t�4 i F 'L Art 615 Sheridan Street Port Townsend,WA 98368 www.JeffersonCountyPublicHealth,org ERIN READING May 23, 2016 12252 OSLO DR TRUCKEE CA 96161-6335 RE: Septic System Monitoring Inspection Report SITE ADDRESS: 1152 OLD EAGLEMOUNT RD PARCEL#901314016 CASE#: SOM14-00033 Dear: ERIN READING A review of our files for the above referenced property shows that when the title was transferred on or about October 8, 2015 a monitoring inspection was not on file for the onsite sewage system serving the residence. Jefferson County Code 8.15.150(7)d.iii. requires that a monitoring inspection in compliance with the frequency identified in code be on file prior to the sale or transfer of property. A list of O&M Specialists and a copy of the record for your system, if available, is enclosed for your convenience. 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. If you should have further questions please contact this office at 385-9444. The code sections referenced are attached for your information. This letter is intended to serve as formal notice that no further approvals shall be granted until a monitoring inspection is completed and any required corrections are made and approved by Health Department staff. A permit is required for repair or modification of an onsite sewage system, per Washington Administrative Code 246-272A and Jefferson County Code 8.15. Sincerely, Environmental Health Specialist Jefferson County Public Health 360-385-9444 c: File, O&M Provider Code References 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. I. 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_no_inspection.rpt 5/23/2016 Jefferson County Department of Community Development 621 Sheridan St., Port Townsend WA 98368, (360) 379-4450 SEPTIC PERMIT APPLICATION PROPERTY OWNER Sean Steen MAILING ADDRESS P.O. Box 1003 Chimacum,WA 98325 PHONE (360)531 -0036 14,9 SYSTEM DESIGNER: Michael S. Deeney Designer Phone#: ( 800 ) 395-7296 '" ' 2,7 LEGAL DESCRIPTION: Section 31 Township 29 Range 1W PARCEL#901314016 Subdivision Name V. 11 Surveys P. 138 Division Block Lot(s) Site address/Directions to site 1152 Old Eaglemount Rd., Port Townsend,WA 98368 SOURCE OF SEWAGE/USE TYPE OF WORK WATER SOURCE Residential X New X Tanks(s)only Private X Residential ADU Modification Public Commercial Expansion Community Upgrade Repair SITE SIZE 5.1 acres SYSTEM TYPE Partial Repair-(tank) (drainfield) Previous Evaluation Conventional Designate Reserve Area Yes#SEP05-352 Alternative X Redesign No SYSTEM DETAILS Number of Gallons/day 480 Soil type 4 (attach soil eval.) Application Rate 0.6 gal./sq.ft./day Drainfield Length 161 ft. Drainfield Width 3.0 ft. Drainfield Depth 6 in. Septic Tank size 1,500 gal. Pump Chamber size 1,000 gal. TYPE OF SYSTEM Pressure Partial Fill Drainfield 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 requir s prior notice. Inspections shall occur during regular business hours. Initial here if you require notification before entry S S . 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. 15 Maech ao 19 Property Owner Signature Date FOR OFFICE USE ONLY �Je PARTIAL E ASBUILT C ' , FINALN 16- A"'O D 014 pp _/ 731/V INSP/PUMP TEST Eb \ -/i /1 s1 RLIB FoJam/ ALL HOLD REQ. MET Date 3106 I I L I (�Y ff C Fee (p (� Rec# /417 60 y !!d Check# c�`' 1 Case#SEP `-1 4(')% .JEFFERSON COUNTY PUBLIC HEALTH 615 Sheridan Street•Port Townsend•Washington •98368 www.jefferson countyp ub lichealth.o rg t'none :ibU-3bb-U444 Fax 3b0-.3/9-44d/ ON-SITE SEWAGE DISPOSAL PERMIT PERMIT #: SEP14-00033 Date Received: 03/20/14 Date Issued: 06/19/14 SITE ADDRESS: 1152 OLD EAGLEMOUNT RD Date Expires: 06/19/17 PORT TOWNSEND, WA 98368 APPLICANT: SEAN STEEN PHONE: GAIL ROWELL PO BOX 1003 CHIMACUM WA 983251003 LEGAL DESCRIPTION: S31 T29 R1W SW SE SE(LESS S 1/2) PARCEL#: 901314016 Section: 31 Township: 29N Range: 01 W DESIGNER: MIKE DEENEY PHONE: (800)395-7296 CREATIVE DESIGN SOLUTIONS PO BOX 2787 PORT ANGELES WA 98362 SYSTEM DESCRIPTION: PRESSURIZED TRENCH/REDUCED No. of Gallons per Day: 480 Type of work: NEW Drainfield Trench Septic Tank Length: 161 feet Width: 3 feet Depth: 6 inches Size: 1,500 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. Jefferson County Env,' onmental 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.: SEP14-00033 1.) This system has been designed using gravelless chambers and a reduced size drainfield. Gravelless Chambers must be used. 2.) H -the existing outhouse must be properly decommissioed prior to final 3.) Health Dept. required to observe pressure test with system designer when system fully installed/complete, 48 hours notice to be provided for scheduling. 4.) MAXIMUM TRENCH DEPTH 6 INCHES 5.) This septic system is only sized for one residence 4 bedrooms in size or two 2 bedroom residences. Three residences are not allowed by Jefferson County 6.) This septic system has been designed taking sizing reductions of the drainfield area. This permit has been issued based on the understanding that the applicant has signed an affidavit that they are making an informed decision and are aware of the increased risks. 7.) Notification of the start of construction shall be faxed or emailed to Jefferson County Public Health ONE WORKING DAY prior to start. 8.) H -An asbuilt drawing and certification of completion by the designer is required prior to final approval. 9.) 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. 10.) 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. 11.) Setbacks to all wells- 100' required from drainfield and reserve areas. 50' required from tanks and effluent transport lines. 12.) H - AS PER WAC 246-272AAND 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 246-272AAND 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 13.) 10' separation required between a Water line and all portions of the onsite sewage system; effluent transport line, tanks, treatment and disposal components. 14.) 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. 15.) 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. 16.) 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. 17.) 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. SEP14-00033 Page 2 of 3 \\tidemark\data\forms\F_SEP_Permitmod.rpt 6/19/2014 18.) 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. SEP14-00033 Page 3 of 3 \\tidemark\data\forms\F_SEP_Permitmod.rpt 6/19/2014 JEFFERSON COUNTY PUBLIC HEALTH, 615 SHERIDAN, PORT TOWNSEND WA 9368 CONSTRUCTION INSPECTION REPORT For RECORD DRAWING Designer M /C/1 d/e L Permit# SEP / -42L9a 3 3 Installer / -4' Y -°KiTeyGAe L 4/ / -c' e .E'CC.'V-4r v ' Parcel # q°/ 3/4 o« Electrician = Design Flow 4- Property Owner S E.4A,/ Site Address //SZ aL_!> o12 764)N4—&- >, 1,0V4 `z3fJ'3(QS Answer all questions or indicate NA Tanks, Pumps and Controls Date Insp. Tank (manufacturer, size, baffles)/ S2906,44. Z es 44 ovrr. i-P71-7-ed Pump chamber (manufacturer, size) oaa e,44- Screen(s)and/or Pump Shroud (type, location) Par-r1=' Vden,G.T a/07-0134r /2-Z lg Were Tanks tested onsite for water tightness? Ye No Panel Model A<P -k /P G- s-161 Timer Model 04 W )( Pump 1 - Man./Model vfz -Alco /S./ Z Flow Rate 2--7,9 gpm /Z-z�¢- Pump Location (i.e. garage, treatment unit, basement) Bottom of transducer to bottom of tank Z�/'• 75 Float settings (above bottom of tank) / transducer settings Timer Functions: (above bottom of transducer) On/off- D.9 On - /M, , Veto - z 9 Off- Alarm - zS, " Veto On - /r-r/Az s -� Storage Above High Water Alarm 3 7 Z- gal. Veto Off- z , Es c Dose Counter Reading 0 Pws 46 vi>e9-se # gallons/dose S 3 - 3 Elap. Time Meter Reading 34v-I, r Pump Throttled? Yes No Dose Drawdown (in inches) Z •4° Pump 2- Man./Model Flow Rate gpm Pump Location (i.e. garage, treatment unit, basement) Bottom of transducer to bottom lof 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 07/23/14 page 1 of 2 Pre-Treatment Date Insp Sandfilter basin high water alarm shuts down pump to Sandfilter Yes / No Sandfilter Basin size/location f ll Sand Fill met design spec? Yes / No qA ATU (manufacturer, model) Alarm tested Yes1 No Disinfection Unit (manufacturer, type, model) Independent Alarm Yes / No Drainfield /s „ , F ER ,i Transport Pipe Size/Sch. Z c Ind Size/Sch. / s-cr5i Ara //-- 1-14- Orifice Diameter l8" Lateral Size/Sch. l".SG, 11- ¢-/4. Barrier Material &Rr4vZZA-SS ,9 -r I W S Cover Material/Depth to "SL t Z-2"/4 Residual Head (lat.# &ft. Head) S`'®``, At t S eir's- 12- Z-14" Source/Manufacturer of Drainrock/Gravelless chambers Drainrock Clean? Yes / No If no, what action taken? Mound/Glendon Site Prep. Drainfield Length /6'/ ft Width 3 ft Depth CD 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 Aquaworx panel settings: SWarn at , ZBios at 0 5—, Autoclear set at 1 doses min-sec. 8' fc,e1c'/4.-�e/:› P2i4,2 5—o /Al S,'" cTiic,",1 Ne"T-46: avrHov s E /Y-4.S BEA-Al -7 V r i. /7—I/Lz.er Health Department Inspection issues resolved Yes / No / NA If yes how? Users Manual Provided to Homeowner W/t H 124-e"0/2D 2,2,1w/A"h Date Tank/component Decommissioning Report Attached Yes / No / N Installer Certification attached/signed Yes / 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 system complies with all the conditions noted in the permit as approved by Jefferson County b —11-/4 (Permit Approval Date)or that changes have been noted and the system is in compliance with WAC 246-272. -/11176"1//7:-.°7**--- -------- 1--/--/S— 5100110 Designer Signature Date License# C:\Data\Wpw\County&State Forms\Jefferson\Construction Reports\Alternative sys ASBUILT 2010-2.FRM.wpd 07/23/14 page 2 of 2 N C QQ o 1//e2 rTI o . z o z C n CO, �q a • G) :" - -irr Oi'�2j p W 2 rn 40 m �r., cn _ y r- ° $�j/lll/ �o ryz� Z rri _ \% .l//111 1/ r J M 9L 9fr N U CZ 2 0 ^ 0 rh2 w r `C v SC o ° 0 ° 6S! n40 2Z2 O Cb�m O � �I Onp I OC ;' 0_ �nO Z zvo ` r'� 00 2OV, � ,x • § COp iv1vJ I°• M�.e� o � I �2� oav �� Ia� y0 • O`� \� 2 I 2 I moo, m2 0, PJ^� �m �y �� C;) �,OF—►i. �.OFI �1 20 ro • ki \ �� ` , .sL — J • °a (0) ,*t �� v, oOO• o c -0a ri riogo�^ r I I zz2�0 n1 I xy2 ��_ C vc,, 0,I I _= x,� "' Zt t °02 ~ I a w 2a2 � p0 ( i c)oyOrnC row a�' I I wz �� 1- n c x of I 6;l c ...;3_,21 ,fri („1° C "00r I I co a I 2 °� O 0F° _ J 0 op rr \ T , �C p I I o c 00 I°p 2�4 gz 4, a�sv,o2�2 v, 2� cV o rri A rs- � O ooNn�1. s? r- ��v °°� o°� 3 z o O. 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HOLE 11 ,Pn+ NO L F= TYPE w O" ui OF DEPTH z CO w TEXTURE APPL. z SYSTEM (Inches) , F- co 1-Q- ' m RATE O DATE O c w Fw- c (gpd/sq.ft.) v J OBSERVED 2 1.- < U O O H Z 'LS- 34 3z >33 G se- e, Pg t, 36, 3 / >3 G SL o-fo l 1 3 z 4,. >35— 4, .5 G . 42-4, 35 Mc & G L a,45 .`/ P7 4..z>i4 P" `g ai --z- 4F ?35`` G SG ev,� l= G 3 z pn' //, ,pJ ' ' 44vel.4/ AFFIDAVIT Reduced Size Drainfield for Parcel #901314016 As required by the Jefferson County Health Department, I, Sean Steen, hereby acknowledge and understand the following information as provided by Michael S. Deeney (Creative Design Solutions, Inc.) regarding the proposed reduced size septic system design as authorized by State Guidelines: • As with any septic system, the proposed system is designed to function satisfactorily as long as only typical residential strength waste water is introduced into the system in quantities typical for the designated number of bedrooms (all as outlined in the Operation and Maintenance Manual). A reduced size septic system does not have the safety factor available in a full sized septic system, therefore, as with any system, care must be exercised to ensure only typical residential wastewater strength and wastewater quantities are introduced into the system. If greater than typical residential wastewater strength and/or quantities were to be introduced into a reduced size septic system then there would be a greater possibility for drainfield failure than with a full sized system. Therefore, proper Operation and Maintenance of the system correspondingly more important than with a full sized septic system. • Although Washington State Department of Health (DOH)Guidelines authorize the septic system size reductions proposed in this design, there.. is a logical corresponding decrease of the "safety factor" in comparison to constructing a full size septic system. Long term monitoring of reduced size drainfields utilizing gravelless chambers will help clarify the degree (if any) to which this safety factor is reduced. With this affidavit I acknowledge the responsibility and importance of ensuring proper Operation and Maintenance of this system in light of the lower safety factor inherent with septic systems constructed smaller than full sized. Signature Date Print Name C:\Data\W pw\County&State Forms\Jefferson\Reductions\Affidavit\Reduced Drainfield Affidavit-Filled Out(Rev.1).wpd f 'r::