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HomeMy WebLinkAboutSEP2014-00140 r i; erttrtirt.y 615 Sheridan Street PutAic Port Townsend..WA 98368 www.JeffersonCountyPublicHealth.org NOAH P MIDDLETON January 12, 2015 PO BOX 676 PORT TOWNSEND WA 98368-0676 RE: NOTICE AND ORDER TO CORRECT-Septic System Corrections Required Septic System Monitoring Inspection SITE ADDRESS: 841 S JACOB MILLER RD PARCEL# 983200001 CASE#: SOM14-00140 Dear NOAH P MIDDLETON: On December 11, 2014 a monitoring inspection was completed on the above referenced property. The following issues identified below require correction: Based on review of the existing records it appears that the septic tank was installed with out obtaining a permit as required by Jefferson County Code. Because neither the design nor the installation of one or more of the on-site septic system components found to be present at the real property listed above have been reviewed or approved by Jefferson County Public Health violations of the following provisions of the following regulations have occurred: > JC Code 8.15.060 Adequate Sewage Disposal Required > JC Code 8.15.080(1)Onsite Sewage System Permit Required > WAC246-272A-0200 Permit Requirements Other items identified above are in violation of the following sections of JCC8.15: > JC Code 8.15.150(1)Operations, Maintenance and Monitoring 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: > Hire an Onsite Wastewater Treatment Designer, or a Professional Engineer to inspect the septic system components that were installed > Submit the inspection report to the Jefferson County Public Health, Environmental Health Division for review to determine if your system can be permitted according to WAC 246-272A and the County Codes or a design for a system that complies with state and local code to the Jefferson County Public Health, Environmental Health Division for review, and: > Obtain a Sewage Disposal Permit from Jefferson County Public Health pursuant to JCC 8.15.080. > Correct items identified above. > Contact this office 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 violation may result in the issuance of a civil infraction to you pursuant to section 180 of said regulations. The civil infraction may result in a fine of up to$513.00 per violation per day to be assessed to you. A permit is required for any repair or modification of an onsite sewage system, per Washington Administrative Code 246-272A and Jefferson County Code 8.15. A list of designers that have submitted work here is enclosed.The code sections referenced are attached for your information. 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, O&M Provider Pne List of Desionprs 4/2/2015 Enviro Cheer,LLC 1612 Hastings Ave. West 360-379-9400 Port Townsend, WA 98368 • PROPERTY INFORMATION House Location:841 S Jacob Miller Rd Port Townsend Tax ID:983200001 Mall To: Noah Middleton PO Box 676 Use:Residential,Single Family Port Townsend,Wa 98368 GENERAL SYSTEM TYPE:Gravity Owner:Noah Middleton ON ID:SOM14-00140 Fold '- ON-SITE WASTEWATER TREATMENT SYSTEM INSPECTION REPORT Fold Here Inspected:12/11/2014 - Inspection Type:PROPERTY SALE - Correction Status:Some Corrections Made Here Company: Work Performed By: Submitted 12/11/2014 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-No permit is on file as to size,location or adequacy and it could not be determined.(System installed prior to 1970 when permits were not required) 2-The septic tank needed to be pumped and was by Enviro Check,LLC on 121114. 3-Risers on septic tank are mandatory on next inspection(Date of 121117) 4-The well is less than 50'from septic tank.Code states wells need to be 50'or more from septic tank and 100'from drainfield.Contact County for more information. 5-APPURTENANCES-A revised"Plot Plan"is en route to County,Ref-Structures,tank and well locations only.There was no indication of the drainfield location and would need to be located to be verified. GENERAL SITE&SYSTEM CONDITIONS The General Site and System Conditions were: Fully Inspected All Components accessible for maintenance,secure and in good condition: NO-Deficient Surfacing effluent from any component(including mound seepage): NO Components appear to be watertight-no visual leaks: YES 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: N/A 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 NO-Deficient 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. YES-Deficient Is the SEP case in a finaled/completed status?(if NO explain in comments) NO-Deficient ONSITE SEWAGE SYSTEM INSPECTION DETAIL TANK:Septic Tank-2 Compartment 1000 gal This component was: Fully Inspected Component appears to be functioning as intended: YES Effluent level within operational limits(if NO explain in comments): YES All required baffles in place(N/A=No baffles required): YES Effluent Filter Cleaned(N/A=Not Present): N/A Compartment 1 Scum accumulation(Inches,if other specify): 12 Effluent filter/screen needed cleaning on arrival N/A ReportiD:412672 View inspection reports online at www.onlinerme.com Page 1 of 2 Compartment 1 Sludge accumulation(Inches,if other specify): 22 Compartment 2 Scum accumulation(Inches,if other specify): 0 Compartment 2 Sludge accumulation(Inches,if other specify): 30 Pumping needed: YES See Comments Approximate Gallons to be pumped(if needed)by Certified Pumper: 1000 grainfield.:Gravity This component was: Not Inspected Component appears to be functioning as intended: Ponding present?If YES explain in comments: 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:412672 View inspection reports online at www.onlinerme.com Page 2 of 2 .. . . • • Iniskskythe foilaveng terns on your plot pima a bonadaden _- 12 Names of adjacent streets .. 1:1 SePlic Ws' 'C)grunimmio - Driveways and parking spaces /( ,)tcredissitirti."..,. ,Nrt, 62 tle , -...-:, a Surface inter(pondescreeka,ete) 0 NorthArroW, * - 0 autengsgesainsle,she ,et) , PLOT PLeAt-dafe Pn3Pered—laat____ . ki"t-- cl.8-5),000c. i :, tes4 En .. L / /(/ i'clef-At I...Au- / , / /- (I nAtivA - I 9 SO1 f?;)i N 16's 0 Si 7 / s / ... . 064 - / al , / ...1 , H d •s - - ' - . t 1 '''''''-,,.._.,......„._.,,!.:-1.g'•LIP ' - -. ,, -. -- - ttp °Stisitr4e j --.1 MAO- / /;/ / - / ■ 7 NOT TO SCALE W. 1612 Hastings Ave. 14 Porribwnsend,wAstees is Plot plan submitted by PainatiorPousig. 4- 14o - as a part of a Monitoring inspection 41 S dat_ b llt Not reviewed or aPprOved by JCPH. - S . o iittbr Pct . _. .•._ ---- Jefferson County Assessor & Treasurer - Property Details - 57 ... Page 2 of 3 Exterior Wall: SI/ST Fireplace: SIN 1-AVG Floor Construction: FRAME Foundation: CONPR Heating/Cooling: F/A Inside Verify: YES-FIX Roof Cover: COMP Sub Type Description Class Class Year Area CD CD Built MA Main Area 2 1S 4,956 1150.0 HCPOR House Concrete Porch 2 * 1950 116.0 HENCL House Enclosure 2 * 1950 60.0 OTHER Other * * 1950 0.0 Sketch Property Image This property contains TIFF images.Click on the button(s)to download the full image(which may contain multiple pages). fl `ate it J . t / http://trueweb jeffcowa.us/propertyaccess/Property.aspx?cid=0&... 1/11/2015 Jefferson County Assessor & Treasurer - Property Details - 57 ... Page 1 of 3 Jefferson County Assessor &Treasurer 37457 NOAH P MIDDLETON for Year 2013 - 2014 Property Account Property ID: 37457 Legal Description: ONATRUE F SUBDIVISIC PARCEL 1 SUBJ/REST #564347 Parcel Number: 983200001 Agent Code: Type: Real Tax Area: 0111-1-50F1E1H2L1 Land Use Code 11 Open Space: N DFL N Historic Property: N Remodel Property: N Multi-Family Redevelopment: N Township: Section: Range: Location Address: Mapsco: Neighborhood: S8&9 T30 R1W,BRIGGS,SYNDICATE, HOMESTEAD, KOZELISKY Map ID: Neighborhood CD: 5330 Owner Name: NOAH P MIDDLETON Owner ID: 22516 Mailing Address: PO BOX 676 %Ownership: 100.00000( PORT TOWNSEND,WA 98368-0676 Exemptions: Taxes and Assessment Details Property Tax Information as of 01/11/2015 Amount Due if Paid on: ' NOTE:If you plan to submit payment on a future date, make sure you enter the date and click RECALCULATE to obtain the correct total amount due. Click on"Statement Details"to expand or collapse a tax statement. Year Statement ID First Half Second Half Penalty Interest Base Paid Amount Due Base Amt. Base Amt. ►Statement Details 2014 27337 $847.10 $846.99 $0.00 $0.00 $1694.09 $0.00 ik Statement Details 2013 27413 $819.85 $819.73 $0.00 $0.00 $1639.58 $0.00 Values Taxing Jurisdiction Improvement/ Building Improvement#1: RESIDENTIAL BLDGS State Code: 11 1150.0 sqft Value: $38,248 Bathrooms (#): 1 (FULL) Bedrooms (#): 2 http://trueweb.j effcowa.us/propertyaccess/Property.aspx?cid=0&... 1/11/2015 Jefferson County Assessor & Treasurer - Property Details - 57 ... Page 3 of 3 Land Roll Value History Deed and Sales History Deed # Date Type Description Grantor Grantee Volume Page 1 06/02/2014 SWD Statutory Warranty Deed PAM PORTTOWNSEND ONE LLC NOAH P MIDDLETON Payout Agreement This website is under active development. Some functionality is not yet available and data is not guaranteed. Assessor Home Page Treasurer Home Page County Maps Disclaimer Website version:9.0.32.2200 Database last updated on:1/11/2015 3:50 AM ©2015 True Automation,Inc.All Rights Reserved. Privacy Notice http://trueweb.j effcowa.us/propertyaccess/Property.aspx?cid=0&... 1/11/2015 Parcel Print Page 1 of 1 Parcel Number:983200001 08/15/2014 Owner Mailing Address: NOAH P MIDDLETON PO BOX 676 PORT TOWNSEND WA 98368-0676 Site Address: 98368-0676 160b n 1 f Section: 8 School District: Port Townsend(50) Qtr Section: NE1/4 Fire Dist: Chimacum(1) Township: 30N Tax Status: Taxable Range: 1W Tax Code: 0111 Planning area: 98368-0676 Sub Division: 9832 - ONATRUE FARMS SUBDIVISION Land Use Code: 1100 98368-0676 Property Description: ONATRUE FARMS SUBDIVISION PARCEL 1 SUBJ/REST COVT #564347 http://www.co jefferson.wa.us/assessors/parcel/parcelprint.asp?PARCEL N0=983200001 12/11/2014 Map Output Page 1 of 1 ArcIMS HTML Viewer Map 001062039 907600305 -- -_--- 097800004 1 007000301 , I997800015 j 3 x02 1 - 407 51 103 x $97800002 f *0800204 i ' ,, i 080600x0/6xo1 l Li 14a 1 1 f OOx i2 -_-_�_.__., _ .. --- 1 F�� # 1 I ; 001061007 £ 11 001 001(682093 £ 007097009 - Legend 40i0flv0B5 i selected Feabeea 001081001 # TOM*# I 0070920x4 J�nC'i, r �'1 co�eviysut 1 �*- RugiCrriaa 963200004 , 1 _.-_.� --- Parcels-01 1 007082019 i �: # 9832007)03 l Oei0940Rx l It 001083007 001087007 001094008 0050&4009 I Obx 001 .._. ' 001084010 ----- -+ ..._... ' 001 Hidden 1).-Fkittim 401094014' 1 I 00109401$ _�- ---;I___--_�_, 1, 001064010', 0010840220 , 00106.4009 1 0010784012 1 j 001084002 001084015 40100402, I r 7 -- - . — =. -- ..,_GwntyL"andri ed - - ..._.__ -. -- 1 r 00x083412 1 _.--- 001 'w---"-°---_ .441083412 1 6A.C.+mithi"7 C liter Ctnirt051012 078 -�. 01 - `--.-•—..._ 441093021 007 FOR INFORMATIONAL PURPOSES ONLY- Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its correctness or validity.Data contained in this map is limited by the method and accuracy of its collection.Thu Dec 11 11:12:34 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=... 12/11/2014 C R JCC ode 8.15.060(3)eferences 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_Inst_nopermt_vio.rpt 1/11/2015 Piz rnd 1950 • Jefferson County Department of Community Development CN°t 5 rte/ 79'ZI� Office Use Only 621 Sheridan St., Port Townsend WA 98368 (360) 379-4450 tV lYO Date Evaluation of an Existing Onsite Sewage ystem (EES) Fee Recpt Draw on the back of this sheet a current,plot plan showing location of: check •0i 411) Buildings, Drainfields, Septic Tanks,Wells, etc OR attach a current plot plan Case# identifying these items. ALL SPACES MUST BE FILLED IN. t �'O -� ��- If information is not available enter(NV)or not applicable (NA). c_ ca. cfn ■ Type of Evaluation Reason for Evalua on ,,pp , El Routine Operation and Monitoring Inspedtion Vtv'� to Val 5 al Evaluation of on-site sewage system ❑ Real Estate transaction ` j� o Evaluation of drinking water ❑ Complete a Permit # V�' _ ❑ Building Permit Review and/or no septic permit on file ❑ Evaluation of on-site sewage&drinking water ® Other,explain PAR CE L 5 w6 D►V t 5 t arl Date of evaluation 5< i 312-"g Inspected by TotN 5.ft-EKING, P.E.,�'SF£K41N EMI{c ?CP.MtTS Tax Parcel# 001-6$t-a0Z Perml`ff3Sys em yes no Permit/case#SEP Subdivision, Division, Block and Lot(s) Lot Size a (() Acres or Dimensions X Current Owner I-ED AAA-s'rf rS Site Address 8'fI $04,111 it "11 11.t. f. L, fas50GI, ' 36 Owner Phone# v (1 - 1 Previous property owner name(s) - (NN if not known) Directions to Site 0.73 q ow rt cw v at y A a 4 rFt 11.L —t 9,0ND Date System Installed ViLicAz viio Age of Dwelling I95o C-') # Bedrooms House Occupied )X yes no, vacant how long? Who installed system? ow�s'R Send completed report to: Owner Name is Mailing Address 64 s S. q— oe• IAIJAZ& R- , Petbez 'TbwtASSOD,(Nik t83CS Phone/email/fax -3 60. 3e)5 -2-9 41 (3014-5114 Q. caliESPEG-b.co-M Realtor or Other Representative Name T¶RLR.Y t c. Ftw M Mailing Address O. 'O( gal t Pcr Trw 5 b ,k0 A Phone/email/fax EES Evaluation Form_07-30-04_pdf page 1 of 5 /)4//4355-/S1,vc. Include the following items on your plot plan: 56C 5th Sik..PAA5 foot` SE? °}-t95, k►SD BI-va}-4o , A"D C_.L.A55 4 W ArTGR- 5 Ni 5 tb- t ❑ Property boundaries o Wells ❑ Names of adjacent streets a Septic tank ❑ Driveways and parking spaces ❑ Drainfield(enter NN If unknown) ❑ Surface water(ponds,creeks,etc) ❑ North Arrow RoX1L�+Xr . ❑ Buildings(residence, sheds,garages,etc) I�c4--rf"" s1TE of SATE Fees Mze- APP PLOT PLAN-date prepared 5/13/26'5 8 a 1n' 25' So' 5cp -E 14 43 III L^'r J /`-.,ct9TLN p - PE'RM.LT /QV� D0.MNftEi D PO- p owN SLYE?' ' L2-1131 t \ ! O \ UJ o� J ,eve i*v ��\ `MO �� \ SEE EN t nti"r't, >r of 1401A4 i, \ NOT 'f vlat, etrf EXLSTImec a r ® i:xI tTt'4 So IL-TEST 8 ! suwT 1150 strrcc GIP ptT N Tom'K i - yr E �eso / r ®n 110' P., Id EXtyT'N LL.4/414P N.7ElL DRWEw ' IA/1 rear EMS n N<-Stmt4-4E L t 1 getLLDIN4- 5c4.TEST (4i PLT 2 too' ro sonArfi V pizet / S� ESTPL7® rle EKtSftrs ?sit -nix Af- "FALtt /� 6�DtG-bCM XZ3DR+MN=LE.D�56P0l--"t5 51651TPec P YL)1+-M nREL D 0 ek SI&oi'145 Permit#or Parcel# Ba j-6$1 -00 L Evaluation of an Existing Onsite Sewage System_07l30f04_pdf page 2 of 5 . f Evaluation of Existing Onsite Sewage System —Addendum ( • Date of Inspection 013i°g Inspected by Z-1)140 F'-EMIricc, NSFE''(x)NV-IL C- #4 -Treatment Unit(Sandfilter, Proprietary Device, etc) pro" -(M Appropriate Vegetation in area yes no. Describe vegetation Indications of surfacing sewage yes , if yes, describe and diagram on plot plan no overgrown/not observable Riser to grade? yes no Signs of parking/driving in area yes no Ground settling or erosion yes no overgrown/not observable Monitoring ports in good condition yes no none present/no port found Monitoring Port Observations Residual Head yes, if yes, #of inches no. If no, notify Owner immediately Ponding in trench yes, if yes, #of inches of ponded effluent no Electrical Components Pump operating yes no, if no, describe High water alarm functions yes no, if no, describe Elec. Panel condition good needs repair, describe Pump cycle drawdown inches. Time for pump cycle min/sec. Timer Settings min/sec on min/hrs off Floats secured yes_ no - Section below line to be completed only by Licensed Designer, Professional Engineer or Health Department staff - i #5 -Detailed Drainfield Evaluation Complete this section if system is permitted but did not receive an OK to cover or final approval OR there was no septic permit on file)j-- Describe materials ebserved in drainfield construction: PO"' 17110171 5(''E P'- , 0' °"°4 444 D-box present yes if yes, material X trio Drainlines rigid PVC corrugated flex pipe clay tile concrete tile seepage pit or cesspool other Drainfield dimensions 160 (engt width 1- i#of drain lines Do observations coincide with permitted system requirements/conditions?yes no A) Soils in area of drainfield evaluated? X ai2SD no If yes, describe soil profile below and identify location on plot plan. s� pAc6-3F Fo2sei'. D$scRit � A-TlED so�4 �-c�c What is the vertical separation from the bottom of the drainfield trench to a restrictive horizon? Z- Inche-MO (*) Comments (attach additional sheet if necessary): Permit#or Parcel# eol-o8t-ooZ Evaluation of an Existing Onsite Sewage System_07/30/04_pdf page 5 of 5 Date of Inspection /13/ °°8 Inspected by 4- N 5.FLEt"44 RE �sP ENCvr"-b"6r Water Supply (fill in only if water supply is being tested in this evaluation) Sample was taken Yes No Sample Results Well casing 12" above ground Yes No Sanitary Seal in place Yes Na Public: offsite onsite Name of System Individual: . offsite onsite Is well more than 100' to drainfield/disposal component _yes_no, if not, distance Is well more than 50' to tanks and effluent transport line_yes no, if not, distance ONSITE SEWAGE SYSTEM #Bedrooms/gallons per day indicated in County Health Dept.records for this case Z A5^56,10,-S 11-61-aws #1 - Septic Tank Tank size 1000 gal. single compartment Z two compartment G°' 4-1'6TE material Riser to grade on inlet yes X no. Riser to grade on outlet yes g no Condition of tank X Caood� needs repair,describe 1st comp.Scum(top layer) 11. in. sludge(bottom layer) 2 o in. j6"tam p Ep Di of 2nd comp.scum 0 in. sludge 19 in. (Li a top A$oYE r4/4 Ft-mot Was ground water observed leaking into tank? yes X. no If yes,where was water observed? Condition of baffles: Inlet: X good) needs repair PVC material(PVC,Concrete) I Outlet: )C_ good needs repair P`/C, material(PVC,concrete) Screened Outlet 'DC CD yes,condition clean clogged/dirty Septic tank needs to be pumped (per Jefferson County code 8.15.150(1)(b)) X C, no Effluent level at outlet(mark level on circle) ( eg: © ) L,p.,%0 o If effluent is below the outlet, indicate when tank was last pumped: LFsv NT- ?If E Ipve kT Does system include a pump? yes If yes,complete the next section X no(if no skip to section 3) #2- Pump Chamber Tank size gal. Material. Riser to grade? yes no Condition of tank good needs repair,describe Solids in Tank(see 8.15.150) yes no scum in. sludge in. Was Ground water observed leaking into tank? yes no If yes,where was water observed? Screen around pump? no yes, condition clean dirty/clogged Shroud around pump? no yes Electrical Components Pump operating yes no,describe High water alarm functions yes no,if no,describe Elec. Panel condition good needs repair,describe Pump cycle drawdown inches. Time for pump cycle min/sec. I Timer Settings min/sec on min/hrs off Floats secured: yes no Permit#or Parcel# 00 - 08I -OOZ Evaluation of an Existing Onsite Sewage System 07/30/04_pdf page 3 of • , #3—Drainfleld Appropriate Vegetation in area )< • s no. Describe vegetation -KA-5.5 Indications of surfacing sewage(check one) yes,if yes,describe and diagram on plot plan X no drainfield area is overgrown and not observable Signs of parking/driving in area yes COI drainfield area unknown Ground settling or erosion yes X m overgrown/not observable Monitoring Port Observations(if present): lvoNe P(seEN- Residual Head yes, #of inches X no Ponding In trench yes, #of inches of ponded effluent no Repair area is? X Available as shown on permit.EPON-1`t5) None evaluated or shown on permit Addendum(page 6)is attached for evaluation of Treatment Unit'or detailed evaluation of drainfield yes no COMMENTS(attach additional sheet if necessary): 4 E )r'• siY I;" , Sott- veg MAS1 To Loc -T'LS I EKPOSG. Z�kNK LtD /5 �N L'� �, �_� BELOti. �� , 'a ( " �cEss is t9 ` �S wk5 kat 0 iN�t *ottt1-6-1- A1-1-C" Is 8JCt6 . Pi\iI° DES tat'6y RE oirk ca.c.rebrt otacmurk's),, tLer Ae-GOS wAs PsE+avr->0 t.m0.3 0-O It. s,kt,t.s_D el ow r+ Hupp, lb LT , No pa-Pitt" 651.4 DP-A(..3104 ot4 RE00•D FRJ t2/13/11'-9 SITE PI'^•' dF 4-6455 I/ INkh-9- SYSTEM 4ffl'51A-L. Soli_s tN EXISttN4 CR-MNFIELD A¢FR w N►oR4E4tR�.tGEYF IV V 4 v RpZa ytK46t F ei foP- Q (TP.0 nn4 u R 5) Ep 01-- 115, Tto Z6 £( S 6 n-s Pr r}�C►t 17: Sot L t O r C t k55 wA TW - S'f TW1 'S cm?Law, A - kt- LE---I-TEL,Mi-rfer n�" Lt 4TEIZ, otNNER- LETTER F(Lo''• ►x 711/Ic14°1. % . V5 © 6E70_1.-19.5 9.5 D�5L4�-*fz� SZES�mE �* For... 26;DRA0rA,5' (1s4, .) AND I5tb(Loa/"S �CQ.S Zk4) I6, Ttik-T GoexLU SffR-VLCL=s THiS R.�+td�GFi. A-t A. NEW bP.4INFIELD FAR- tAi.P TO 66Eagaer'ts 0-y.s 1 Ltr+ES� 30 SCOTT F tsvef kct. PQdF' 654'(0 >ce of�ASHiti�!, 4 ..,� eL 1\ 40, i N bR M 4°' ) 7 Sca�E, -re" — — Rm ' s ii'4'c/STERG m k-1},2161 6,6, . L EC • ...- .•••••• u t-1 ESNT. o 1 otr' 60ti 100' 7til '9 I N EXPIRES: 5/25/0? 1308, t NOT ORO GINAL SIGNATURE. DATE ISSUED: ' Was a System Problem Identified?Yes If yes,what section#. f• X gi3/0 8 This report on the existing onsite sewage system is valid for the permitted or historic(if installed prior to permit requirements)use of the system only and does not constitute assurance of future County approvals(such as building permits)on this parcel.Any future application will be judged separately by the rules and laws in effect at that time. I certify that the information provided is based on a review of County records and my direct observations at the time of inspection. to S//3/ZOO$ T'Sf E 0 M 4 Name/Signature Date No guarantee of future onsite sewage system perform is implied or granted based on the information contained in this report. This report constitutes a summary of findings only. Permit#or Parcel# fsol- 0$I-oo2 Evaluation of an Existing Onsite Sewage System._07/30t04_pdf page 4 of 1 I . Include the following items on your plot plan: o Property boundaries o Wells ❑ Names of adjacent streets o Septic tank ❑ Driveways and parking spaces ❑ Drainfield (enter NN if unknown) ❑ Surface water(ponds,creeks,etc) o North Arrow o Buildings(residence,sheds,garages,etc) PLOT PLAN-date prepared 5I 1 ZU°S To DP•MPFLEG9 n A, A ti N ' Xc/TCr`16C -� Rer4taE7*1,E it • 6C�Ronr'►5 V __ S'-8„ gu►t-T 150 ; J 6, �♦ too Rt.ter� [.ON P-elr ''S, y seperc TkN1G 2 t 4PIVE14 ' vc.8 t.e5 v 1,45‘(-0 Tb '$514-04 1t 5 'to' Tb ce--+ t-Lrl6 oF_ 5. 5A-co l> Pt to-Eft, itzukb r i.' „, Li' weu t ►ioUS� EXtSttN4 1,f4s1-1..' ct-k55 'f/Gr►-o W $ 5 CeiP `EGt'r6N ',Xi 01,44, wkTk� Sattace #NPE-oVet) VtilletSD 5u4r-E: TAD/ ENreDy - TaKts B+01F-E,ttD, i-10CVT1.1 D I s 5' to' Permit#or Parcel#06.1 - °‘a t -6(3 l Evaluation of an Existing Onsite Sewage System__07/30/04_pdf page 2 of 5 G— ' Itill v r e* 1 vx.t.511N6r SE. 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