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HomeMy WebLinkAboutSEP2015-00006 /4114$ Jefferson County Department of Community Development $ Si 621 Sheridan St., Port Townsend WA 98368,(360)379-4450 .��,_ 8/./. . !1: SEPTIC PERMIT APPLICATION ifr°•" r7 PROPERTY OWNER '' .�/ L. N ■► - g 4 . II / I r� O� �r "51002 9 _ I, MAILING ADDRESS ,_ J • . A!.� r) •, !_ ,. •.UL ERICSEN 11 di ' i• 1 ' N 0 .0 -$tibE 1 NEB... / PHONE -/l-1 --Q/ 57 y'©c ' S • 111 1h SYSTEM DESIGNER I'/GSP� t)&J(514 Designer Phone# 30-3 3 i 03.E* 1-,27-is LEGAL DESCRIPTION: Sectiond7 _T ship 3 0 N Range I W PARCEL# gi�7d0039 o Subdivision Name (141-7 /4 La po f 1411 f A. Division Block Lot( )/3/s" Site address/Directions to site /D WM/S1 '/1 56-01144- d iu i Z,p 11. 1Q/ht DM. SOURCE OF SEWAGE/USE TYPE OF WORK WATER SOURCE Residential )4 New Tank/s only Private Residential ADU Modification Public $ Commercial Expansion Community Upgrade Repair 14 SITE SIZE 16,OW Sgt SYSTEM TYPE Partial Repair-(tank) 7t (drainfield) A Previous Evaluation Conventional_ Q Designate Reserve Area Yes#SEP 76-8$ Alternative Redesign No SYSTEM DETAILS Number of Gallons/day a lfQ Soil type i (attach soil eval.) Application Rate .53 gal./sq.ft./day Drainfield Length 150 ft. Trench Width .3 ft. Trench/Bed Depth .24.-3 G. in. Septic Tank size I600+50O qal. Pump Chamber size gal. TYPE of system Addle-1-tart aQ, I ank # IJe.&.t asrt-Pi(Lk 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 assur- ou of any other County approvals. For example, it DOES NOT GUARANTEE that you will I- - obtain •-rmission to build a permanent residence or other structure on this parcel. Any future a/v. - ion W b7 '•ep.rat- •ged by the rules and laws in effect at t at time , 1-1 i�. d- vr P s pew Owner Signature ate Z�c, / l FOR OFFICE USE ONLY J I t'' \ ' 3 l/`l5 PARTIAL 3(oQ 0 I (� ASBUILTQQLI 3/ TI J5" FINAIO ) APPROVED INSP/PUMP TEST - \P - C\ 31at-(i5 ALL HOLD REQ.MET /_ v Date /2_14 1S Fee ( .2--142 Rec# I r1-4 VO r Check# `4 (J Case#SEP `C"()OlP H:\WEB\PDFs\Septic\septic_permitapp_2008.DOC JEFFERSON COUNTY PUBLIC HEALTH ..,---" , 615 Sheridan Street•Port Townsend•Washington •98368 www.jefferson countyp ub lichealth.o rg ~none 36.U-365-9444 Fax 3t3U-3/9-446/ ON-SITE SEWAGE DISPOSAL PERMIT PERMIT #: SEP15-00006 Date Received: 01/27/15 Date Issued: 02/19/15 SITE ADDRESS: 10 WINDSHIP DR Date Expires: 05/19/15 PORT TOWNSEND, WA 98368 APPLICANT: DOUGLAS H LA BARRE TRSTEE PHONE: DULANIE E LA BARRE TRSTEE 206 S BLANCHE ST OJAI CA 93023-3236 LEGAL DESCRIPTION: KALAPOINT#1 LOT 38 PARCEL#: 964700038 Section: 27 Township: 30N Range: 1W DESIGNER: BERNT ERICSEN PHONE: 360-301-0324 293 PINECREST DRIVE PORT TOWNSEND WA 98368 SYSTEM DESCRIPTION: CONVENTIONAL TRENCH No. of Gallons per Day: 240 Type of work: REP Drainfield Trench Septic Tank Length: 150 feet Width: 3 feet Depth: 24 inches Size: 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 Environmental 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.: SEP15-00006 1.) This permit was issued to correct a violation of WAC 246-272A for a failed septic system. The permit must be completed within 90 days of the date of issuance. 2.) When the existing drainfield is crossed with the new drainfield, bentonite dams must be installed to prevent effluent from entering the old system. As per the design 3.) The new poly septic tank must be fitted w/a riser to grade, baffles, and an effluent screen. 4.) H - AS PER WAC 246-272AAND JEFFERSON COUNTY CODE 8.15 ALL ONSITE SEWAGE SYSTEMS REQUIRE THATA 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 5.) Approval/issuance of a sewage disposal permit or installation of a septic system does not guarantee the approval of other development or a building permit on this site. Future buildings that require connection to an on-site sewage system (OSS) shall only be approved if the OSS meets the current standards and codes in effect at the time of the building application. 6.) 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. 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.) 10' separation required between a Water line and all portions of the onsite sewage system; effluent transport line, tanks, treatment and disposal components. 11.) 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. 12.) 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. 13.) 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. 14.) This parcel is within a no shooting area per JCC 8.50. SEP15-00006 Page 2 of 2 \\tidemark\data\forms\F_SEP_Permitmod.rpt 2/19/2015 CONVENTIONAL SYSTEM ASBUILT INSPECTION REPORT INSTALLER ERIcsEm Ex.. CToh44.1 k►:l haw.) PARCEL# 964- 76003R Permit Owner Do U - 1,A13,AR R E Permit # S EP 1 5. 0 0©041 ABSORPTION AREA: DRAINFIELD TRENCH , TRENCH TANK #OF #GALL LENGTH 1�� WIDTH DEPTH .24 -3(o SIZE BEDRMS 02. DAY .2 y-0 Tank Shroud/ IF PUMP AND PUMP CHAMBER REQUIRED: Size Screen Float Arrangement High water float—distance to top of tank/emergency storage Dose drawdown (#of inches) #Gallons/Dose Timer/Dose Counter info Pump Size/Manufacturer I CERTIFY THIS ONSITE SEWAGE SYSTEM WAS INSTALLED AS DESIGNED,PER PLAN APPROVED 19 — 1g 84.14\1- E4A.c..R.4e) 3- 102 DATE APPROVED -Ue6t.✓ SIGNATURE DATE 0 see a acdhec2 Re cow (vauhrl cc t-a,c b►e.41, TaM.k. 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L S ./ d to q in. -57N Ls 12 to G7 in. TN FN 5ND r. 5 q to GG in. TA) FN S\ \\ (� to in. Anticipated water table'747 in. Anticipated water table>(,(,in. Roots to 3f, inches Roots to Ail inches Health Dept. Cpmments Health Dept. Comments V SOIL LOG #3 SOIL LOG #4 Q to 102 in. 16R i■ LS to in. 12 to 702 in. TO F N SKID 7' `'1 T'/' to in. to in. to in. to in. to in. Anticipated water table-7V in. sue Anticipated water table in. Roots to 40 inches �! !1, Roots to inches Health Dept. omments : '+, Health Dept. Comments A. �' t fi •:` 1- v i ii SOIL LOG #5 s • y . , . 1r SOIL LOG #6 r r , to in. I . 5100259 ,V to in. _ rI BERNT PAUL ERICSEN h _ to in C I4S1=D DE I NER / to in to in. EXPIRES 0 1 C to in. I-17-/5 to in. to in. Anticipated water table in. Anticipated water table in. Roots to inches Roots to inches Health Dept. Comments Health Dept. Comments H:UNFOHLTHISOILFRM 1/00 srQ�` � ‘ .1\0\6 a5ooa� \ \ i \ 0 56220 5, \ O \ etie� �a,�ec�°use / Drive/Parking 0.. Oke�°\Heal \ �� loo e�ec� -\ Ex. Garage \ DSS 6 \ \p° o. �p∎SP GQ�NS cC. 0� \to t G A OC \ \ PN' a Vat \ Ex.2 BDRM \ Home Ex. Deck O O '- 0 °> Ex. Fence. 0 . ,0) 36"Cherry \ 'IL). er .....„....::,_..,.. ........:„. ..,,,,„,...0 ..K.,1(.......*„.?ele.... Ex. Cedar Trees or f i. ..—II ' / w sy;'.� ►/ �`o� ,,r;: i D / ` "Found" o y' '510025 %� Rebar /*FILE NAME 0 uo Nttb b f Ne •. /�/ DOUG LABARRE.TRV •�o��`������►a��w...�ww,, SCALE DATE DRAWN BY E o' 11 25 Ft/In 1-25-2015 Bemt Ericsen ^�1,i15 JOB REVISION SHEET `964700038 1/1 1/1 This map drawn with TRAVERSE PC,Software Norwesco :: Below Ground Tanks :: Spherical Pump Page 1 of 3 121 . 111131RWESCO S7WAGE DISPOSAL DESIGN Home (I) Approved f r Construction Poducts - l/ lli' r> opal Pump� s� Tanks ate ijaW4tigitYsUfkattattigif~fa used as a holding tank or pump tank. LigghwroigpstAks, these tanks may remain in the ground when empty. These tanks are furnished with manhole covers and include a pump stand on the b ttom of the tank. v /2V' ./[ '147 6C11?(OVI( .11\:". Below Ground Spherical Pump Tanks Gallon Diameter Overall Height Height Manhole Part Avail Capacity Height to to Diameter No. Inlet Outlet 200 47" 56" - - 1-20"(62408) 43745 B Sphere (/ site_components/uploads/pdfs/ WVM% 20Below Ground/Legacy/200 Sphere.pdf) 300 54" 54" 44" 42" 1-20"(62408) 41319 A Sphere* (/ site_components/uploads/pdfs/WWM% 20Below Ground/Legacy/300 Gal Spherical Pump Tank PN.pdf) 500 64" 67" 56" 53" 1-20"(62408) 40785 B,C,E,H,L Sphere (/ site_components/uploads/pdfs/VVWM% 20Below Ground/Legacy/500 Sphere.PDF) 500 64" 67" 56" 53" 1-20"(62408) 41409 H Sphere (/ site_components/uploads/pdfs/ WVM% (OR) 20Below Ground/Legacy/500 OR Sphere.PDF) *This tank is manufactured with both a flat inlet/outlet and a recessed inlet/outlet for shipping purposes. We ship at our discretion,an option is NOT available as to which tank you may receive. Availability Key: A=AII; B=St.Bonifacius, MN; C=Lancaster, OH; D=Griffin, GA; E=Shawnee, OK; F=Tooele, UT; G=Owego, NY; H=Washougal, WA; L=Hanford, CA http://www.norwesco.com/products/waste-water-tanks/spherical-pump 1/27/2015 Doua l,A-s LA 16/4R1 q 4 4 7000T9 14, swamp um new I 24' ACCESS USER �,r 4411 ii....."- "*".- " .".......V , 4=12==321:=±1 4 4,101 "'\ ra - 14a16., TO RUM I ilia 11114111mmaigr ----a"- CHAMBER - rsim... 7 ,T Illow■in FROW SEWAGE SOURCE 141 APPROVED EFFLUENT RILTE'R SEDDIENTS k ow `81 TANK OAS\G'c\ i .S4 PQ p 5,0022� 110 yip BERM'PAUL ERICSEN• ip 6"1∎ aw.1.ae�s�wia���, E•�•i or 1/ , Trench Profile ( No Scale ) 1-27-15 (See Notes For Details) Finish Grade ` t Native Backfill Inspection Port — 1 Gravelless Chambers Wire Mesh(See Details) End Trench "D" Box Finish Grade 4"ASTM D2729 To Drainfield I—\ 4"ASTM 3034 (Solid) lnW,1 From Septic Tank ,I I c I 36" 1 7---- -----„\\ 5G 0 C ars�c j v W .5.� s y tl Cp\led C ( � • y ��.,� 10° DOUGLAS LA BARRE 964700038 �/ BERNT PAUL ERICSEN'.1h1@ •1 LIC NStD DE 1 NEfi O Project Description Ems' 1 " " y 1.27-15 Replace failed drainfield ( SEP 76— 88 ), install additional tank, transport line, new "D" box and drainfield. Septic Tank Existing 1000 gallon one compartment septic tank appears to be sound. New risers and lids were installed by Enviro Check. New PVC baffles have been installed. Inspect inlet and outlet pipes and reseal and install bentonite. Pump tank immediately prior to construction. Ins+Llt C.O. at'-ere wi hou.se.. Second Septic Tank Install 500 Gal. One compartment tank ( Norwesco — Sphere ) on 6" bed of "pea gravel". Install baffles, riser and outlet baffle filter ( Orenco FTiPW 0418 — W ) or equivalent. Transport Line Install 4" 3034 sewer pipe from new tank to new "D" box @ 1%. Tightline from "D" box to drainlines to be 1% min. "D" Box Install 6 hole "D" box on poured in place concrete pad on undisturbed soil with riser to grade. Install speed-levelers and water level prior to designers inspection. Drainfield Install 5 ( 30' x 3') laterals as shown on plans, Line1 trench elevation to be 95.25' equaling 4.75' below "bench mark" ( Deck — assume 100' ) equaling 24 - 30" depth. Lines 2 — 3 trench elevation to be 95' equalling 5' below "bench mark" equaling 24 - 30" depth. Lines 4 — 5 trench elevation to be 95.50' equaling 4.5' below "bench mark" equaling 24 - 36" ( Gravelless Chambers are recommended because of lack of access ). Install inspection ports ( inside 6" round valve boxes ) with risers to grade within 5' of each end of lateral. Install Digger's 20 Gauge, Hot dipped galvanized wire mesh with %" hexagonal openings over entire trench bottom under chambers. Where new drainfield intersects with old drainfield install bentonite dams to prevent effluent from following old drainfield. Misc "a There is an existing 8' x 8' deck in vicinity of lateral 3 which will need to be moved a minimum of 5' from any drainlines. Water Lines Maintain a minimum of 10' separation from septic components. Water line appears to enter on north side of house, no conflicts anticipated. Inspections Designer needs to be contacted for a pre-construction meeting prior to construction to discuss details and to set up schedule for inspections. Designer is responsible for submitting "Record" drawing, and must be called prior to back filling system. General Construction Notes 1. The work described herein consists of construction of an on-site wastewater system. 2. The contractor shall be knowledgeable and experienced in the construction of this type of wastewater system and shall hold a valid certificate from Jefferson County Division of Environmental Health. "Approved" septic plans must be on site during construction. 3. If during the installation of the system the contractor finds soil conditions that may lead to premature failure of the system, construction shall be terminated immediately and the designer notified. Such soil conditions may include groundwater, fill, clay, highly compacted soil, bedrock or excessively permeable soils. 1. Any inconsistencies, errors, or omissions that, in the opinion of the installer, would compromise the quality of the wastewater system shall be reported to the designer prior to construction. 1. Backfill in traffic areas shall be pitrun gravel and compacted. All gravity pipe shall conform to ASTM D 3034. All gravity and transport pipe shall be bedded, using native or imported material free of rocks, debris and sharp objects. 2. All exposed soil shall be seeded and mulched prior to the final inspection. Seed shall be spread at an approximate rate of 10 lbs. per 5,000 sq. ft. 3. The installer shall be responsible for constructing the system according to plans and conditions of permit and shall be responsible for its proper operation and function for one year. The owner shall be responsible for operating and maintaining the wastewater system in accordance with WAC 246-272A-0270. 4. Any changes, substitutions, or deviation from these plans shall be approved by the designer and by the Jefferson County Environmental Health Department. 5. The installer shall grade to divert all surface water runoff away from tanks and drainfield/reserve areas. 6. The bottom of the trench or bed may be inspected by the designer prior to placing drain rock and shall not exceed +/- 1/2" from level. Place filter fabric over drain rock prior to backfilling. 7. Setbacks to all known water lines shall be a minimum of 10'. No crossing of water lines with any septic component shall be allowed, except as included in septic design approved by Jefferson County Health Department. 8. Setback from the house foundation wall shall be 10' minimum to drainfield, 5' minimum to tanks and 2' minimum to non-perforated sewer pipes. Water saving appliances, fixtures, and practices are to be used. 9. The septic and pump tanks, drainfield and reserve areas are to be protected from vehicular traffic or mechanical disturbance. 10. The designer is to provide the as-built and letter of certification. 11. This system has been designed in accordance with WAC 246-272-A- 0270 and the most current Department of Health "Recommended Standards and Guidelines for Pressure Distribution Systems," and has been approved by the Jefferson County Health Department. Nevertheless, negligence or improper action on the part of the users could result in the premature failure or malfunction of the system or its components. Douglas La Barre 1 — 26 — 15 SOM 76 — 88 revealed an elevated effluent level and a flooded "D" box. Drain field was exposed near "D" box and at corners at test holes 1 and 3. Corrigated pipe appears to be crushed and or plugged with sediment and roots. No "ponding" was present in drain field where observed. Existing one compartment tank appears sound and has had some upgrades ( see comments in construction notes ) Have proposed 500 gal. Polyethylene tank to serve as second chamber. Site has very limited access and repair area. Respectfully Bernt Ericsen L44/ ri X191