HomeMy WebLinkAboutSEP2015-00021 RT 7-116 ifG/I
SEP 0 '\--)
Now filed to
SEP 1
Jefferson County Department of Community Development
621 Sheridan St., Port Townsend WA 98368, (360)379-4450 ft,SEPTIC PERMIT APPLICATION PC1
Mardella & Brian Rowland 2
PROPERTY OWNER
MAILING ADDRESS 100 Dennis Blvd 5 042 .1,4v
Suzanne L Martin 1
Port townsend, WA 98368 nlS ' t;
Dames vnm
PHONE ( 360 ) 37q Qy2)
SYSTEM DESIGNER Suzanne Martin Designer Phone# 990-3304
LEGAL DESCRIPTION: Section 13 Township 30N Range 2W PARCEL# 940 200 006
Subdivision Name Cape George Village Division 2 Block Lot(s) 6 & 7
Site address/Directions to site 100 Dennis Blvd-PT
SOURCE OF SEWAGE/USE TYPE OF WORK WATER SOURCE
Residential ✓ New Tank/s only Private
Residential ADU Modification_ _ Public 1/
Commercial_ Expansion_
Community Upgrade.
Repair ✓ + SITE SIZE +/-17389sf
SYSTEM TYPE Partial Repair-(tank) ✓ (drainfield) ✓ Previous Evaluation
Conventional Designate RPSprve Area ✓ Yes# SEP80-00011
Alternative ✓ Redesign No
SYSTEM DETAILS
Number of Gallons/day 240 Soil type 4 (attach soil eval.) Application Rate 0.60 gal./sq.ft./day
Drainfield Length 17 ft. Trench Width 14.5 ft. Trench/Bed Depth mound in.
Septic Tank size 1000 gal. Pump Chamber size 1000 gal.
TYPE OF Glendon Biofilter 31
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 be separately judge, by the rules and laws in effect at that time.
44,4€14, /357,o/
Are
Property OWn- Sign ture Date
FOR OFFICE USE ONLY
3)7(2/� PARTIAL 401
ASBUILT � , FINAlA 144C/
i6.
APPROVED
INSP/PUMP TESTS `1/1146'5^ P '` ?ik1`7
ALL HOLD REQ.MET
v0
Date_Z 2-� I IJ Fee 1 L� Rec# L S 5 11 I Check# 2—Z-5 Case#SEP 13 oo
C•\Dnc»merts and S=ttings\Sv,ann,p martin\MY 7anno\mh1-17ry affarcnn rn,,,,-y\TcffCo
forms\Suz\2008 SPA.DOC
w. n JEFFERSON COUNTY PUBLIC HEALTH
615 Sheridan Street•Port Townsend•Washington •98368
www.jeffersoncountypublicheakh.org
1-'none ibU-36b-9444 fax MU-J(9-446I
ON-SITE SEWAGE DISPOSAL PERMIT
PERMIT #: SEP15-00021 Date Received: 02/26/15
SITE ADDRESS: 100 DENNIS BLVD Date Issued: 03/20/15
PORT TOWNSEND, WA 98368 Date Expires: 06/20/10
APPLICANT: MARDELLA ROWLAND PHONE:
BRIAN ROWLAND
100 DENNIS BLVD
PORT TOWNSEND WA 98368-9480
LEGAL DESCRIPTION: CAPE GEORGE VILLAGE DIV 2 LOTS 6&7
PARCEL#: 940200006 Section: 13 Township: 30N Range: 2W
DESIGNER: SUZANNE L MARTIN PHONE: 360-554-0224
PO BOX 125
CHIMACUM WA 98325
SYSTEM DESCRIPTION: GLENDON BIOFILTER-M31
No. of Gallons per Day: 240 Type of work: REP
Drainfield Trench Septic Tank
Length: 17 feet Width: 15 feet Depth: inches Size: 1,000 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 vironmental 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.: SEP15-00021
1.) This permit was issued to correct a violation of WAC 246-272A for a failing drainfield. The permit
must be completed within 90 days of the date of issuance.
2.) 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.
3.) 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.
4.) The existing RV hook-up is to be removed as designed.
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.) 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.
7.) 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
8.) Contact designer prior to installation for staking of drainfield area.
9.) Health Dept. required to observe pressure test with system designer when system fully
installed/complete, 48 hours notice to be provided for scheduling.
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.) Notification of the start of construction shall be faxed or emailed to Jefferson County Public Health
ONE WORKING DAY prior to start.
12.) H -An asbuilt drawing and certification of completion by the designer is required prior to final
approval.
13.) 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.
14.) Dry season installation required.
15.) Divert all sources of drainage, including roof drains away from septic tank and drainfield area.
16.) 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.
17.) 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.
SEP15-00021 Page 2 of 2
\\tidemark\data\forms\F_SEP_Permitmod.rpt 3/20/2015
R �
JEFFERSON COUNTY PUBLIC HEALTH, 615 SHERIDAN. PORT TOWNSEND WIA�9836L,,c9
ASBUILT INSPECTION REPORT For RECORD DRAWING 1.421
Designer Suzanne Martin Permit # SEP 15-00021`
Installer Toby Killam (Ericsen Excavating) Parcel # 940 200 006
Electrician Cascade Electric Design Flow 240 gpd peak
Property Owner Mardella&Brian Rowland
Site Address 100 Dennis Blvd-Port Townsend, WA 98368
Answer all questions or indicate NA
DATE
Tanks, Pumps and Controls INSP.
Tank (manufacturer, size, baffles) 1000 Cotton, risers, baffles, outlet filter installed 4/3/15
Pump chamber (manufacturer, size) Cotton 1000 gallon tank 22 gal/inch 3/30/15
tanks have been set in pea gravel
Screen(s)and/or Pump Shroud (type, location) shroud in pump chamber 4/3/15
Were Tanks tested onsite for water tightness? G/ No
Panel Model Infiltrator Timer Model Aquaworx IPC 4/3/15
Pump 1 — Man./Model Liberty 150 Flow Rate n/a qpm 4/3/15
Pump Location (i.e. garage, treatment unit, basement) pump chamber
Float/transducer settings Inches Timer
from bottom of tank- On/off- 20.9 in. Functions: On 0=05 se min
Veto - 29.4. in Off- 8:42 : sec/Yhr
Alarm - in. Veto On - 0:05
�` �min
Storage Above High Water Alarm 395/495 gal. Veto Off- 6:31 sec(4111,hr
Dose Counter Reading 1044'dose/0v dose # gallons/dose per gbt gal.
Elap. Time Meter Reading 00:09:55. nil ' Pump Throttled? . es /''No
Dose Drawdown (in inches) n/a= in. marked at throttle point
Pump 2 — Man./Model n/a Flow Rate qpm
Pump Location (i.e. garage, treatment unit, basement)
Float/transducer settings Inches Timer
from bottom of tank- On/off- in Functions: On sec/min
Veto - in Off :- sec/min/hr
Alarm - in Veto On - sec/min
Storage Above High Water Alarm gal. Veto Off- sec/min/hr
Dose Counter Reading # gallons/dose gal.
Elap. Time Meter Reading min/hrs Pump Throttled? Yes I No
If additional pumps-complete the info in this table
Dose Drawdown (in inches) in
for each and attach.
Other Timer functions & settings (e.g. override on/off) ZB-08; 240 events; autoclear 22 doses;
ID= 05-08-2013
H:\WEB\ONSITE\Asbuilt_Report_Form.doc 04/28/10page 1 of 2
a a
Pre-Treatment Date Insp
Sandfilter basin high water alarm shuts down pump to Sandfilter Yes / No
Sandfilter Basin size/location n/a
Sand Fill met design spec? 0 No
ATU (manufacturer, model) n/a Alarm tested Yes / No
Disinfection Unit (manufacturer, type, model) n/a Independent Alarm Yes / No
Drainfield
Transport Pipe size, schd, diameter 2"pvc sch 40 Manifold size/schd 1"pvc sch 40 4/3/15
Orifice size n/a Lateral Size/schd n/a
Barrier Material jute over pods Cover Material/Depth Glendon 4/3/15
Residual Head (lat.# & ft. Head) n/a
The laterals/pods were balanced es / No 4/3/15
Source/Manufacturer of Drainrock/Gravelless chambers n/a
Drain rock Clean? Yes / No If no, what action taken? n/a
Mound/Glendon Site Prep yes
Drainfield Length 18 ft Width 15 ft Depth n/a inches
Caps for measuring residual head stored (location) n/a
COMMENTS (inspection notes, changes from design or deficiencies in installation) Attach additional
sheet(s) if necessary
.2.)septic and pump chamber had extra protection, bentonite around inlet, outlet&riser/tank interfaces
3.)septic tank associated with case#SEP80-00011 was abandoned (see pump out receipt&abandonment form)
4.) ry hook up was removed, power of the hook up was utilized for control panel
•The low area in the Southwest corner was filled with clean fill soils.
Water lines within 10'of OSS components have been removed
Health Department Inspection issues resolved Yes / No / NA If yes how?
Users Manual Provided to Homeowner mailed Date 4/17/15
Tank/component Decommissioning Report Attached es / No/ NA
Installer Certification attached/signed ED 1/ No
ATTACH RECORD DRAWING stamped/signed by Designer or Licensed Professional Engineer
I CERTIFY THE INFORMATION PROVIDED ABOVE WAS VERIFIED BY INSPECTION, THE
SYSTEM WAS INSTALLED AS DESIGNED AND APPROVED by JEFFERSON COUNTY
(DATE) OR THAT CHANGES HAVE BEEN NOTED AND
THE SYSTT E IS IN COMPLIANCE WITH WAC 246-2 72. + Ra+•
16 April 2015 5100342 '• ;;1
'? r • 6
Designer Signature Date License# si 502 ''�'4
Suzanne L Martin '.:j 1+
H:\WEB\ONSITE\Asbuilt_Report_Form.doc 04/28/10page 2 of 2
APR 2 0 2015
System Owner: Mardella & Brian Rowland
SEP15-00021;
Parcel #940 200 006
Site Address: 100 Dennis Blvd-Port Townsend
Pump Tank Detail
17"Installed Riser "<"from top of riser
il..:,r•::�'.v 'i"..!'.t.;::[ •. tw.x.v._.:;et.'S"•`_;ter:.ry a v..
Inlet 1.76 ±27"/595 gallons of r~
;a� storage above high 55.5"
water alarm r
` -not including additional
f' capacity in septic tank
7' and tank risers ':
1,;4 -±18"1395 gallons :4
, storage below invert of t, Veto set 9.4"from the
inlet of pump tank bottom of the bell
y Yr - alarm set for 9.2"from
'31' 7.".„1' of the bell
}� -±180 gal working volume
i' - •.
Cotton-1000 gallon pump — _ �.. on set 0.9"from bottom
9 P P . of the bell
k' tank;22 gallons per inch 20"from J•
n -zb-08 Aquaworx IPCS01 bottom of t
# tank to the
`i bottom of the I.
bell la
* Y.i
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page 3 of 8;Rowland;
Tank Cross Section Not To Scale parcel#940 200 006
(For illustrative purposes only,actual tank configuration may vary,tanks must be,on list of approved products.)
SECURED LID WITH GAS TIGHT SEAL
1 ACCESS RISER t 2� c a
201
FINISH GRADE
,,
\` n ®
I TO PUMP
/ I + --� CHAMBER
FROM SEWAGE it '—
SOURCE` FLOATING MAT
APPROVED
—' EFFLUENT
FILTER
SEDIMENTS- Max.1/16''filter must
— be installed
pOSAL�ESI ---_.
SE\NNG �Ifor o uctiw
APPC �D t' SEPTIC TANK
pate (TYPICAL)
SECURED LID WITH GAS TIGHT SEAL
THREADED UNION
ACCESS RISER
SERVICE
FINISH GRADE VALVE
,/------
FROM SEPTIC p
TANK –L, J IU . –II.TO DRAINFIELD
ri
— 180 1 I •
EMERGENCY STORAGE ANTI SIPHON
HIGH WATER ALARM LEVEL --0, + VALVE
180
NORMAL TIMER OFF LEVEL WORKING VOLUME 1 Aquaworx Transducer
ENCLOSED PUMP
SEDIMENT SHROUD* I ( CHECK VALVE*
18"
—____,.. .. •-4
......
SEDIMENTS SUBMERSIBLE
CENTRIFUGAL
PUMP
PUMP CHAMBER
(TYPICAL)
*AS NEEDED
Page 5 of 8; Rowland;
■
Parcel#940 200 006
csii
Effluent Pumps CrencoSystems°
Incorporated
1-800-348-9843
100 Effluent Pumps
90 PEF 1501 PEF, PKP Series
11/3 hp to 1-1/2 hp
BO
PEF 1001
70
d .
Et 60
H PEF75
13
10
= 50
ea
.E .
C PEF 50
a. 40 _
W
0
H
30 -
(effluent pump [......................1%........:,...s.:.......s
20
15'of ■
head
10 -
IPKP35DI 1773171
0 4 i
0 10 gpm I 20 30 40 50 60 70 80 90
Net Discharge,gpm
NOW-PC-PEF-1
Rev.5.0,®9/04
Page 1 of 1
Page 7 of 8; Rowland;
Parcel#940 200 006
Design Manual for Glendon®
BioFilter Systems in Washington
Downslope Feature or Vertical Separation(See 2.4.1 and 2.4.2)
Object -< ' 18"-<30" 30+"
Property&Easement lines 30 Feet 15 Feet 5 Feet
Building Foundations 30 Feet 110 Feet 10 Feet
Mounds 30 Feet 110 Feet 10 Feet
Glendon Basins 30 Feetl 110 Feet 10 Feet
Interceptor/Curtain 30 Feet 30 Feet 30 Feet
Drains/Drainage Ditches
Other objects that impede 30 Feet 10 Feet 10 Feet
the movement of water
through the soil
I As measured from the downslope edge of the full absorption area(and the full replacement area,if the replacement
area is concentric with the initial area)of the upper unit to the upslope wall of the lower basin.
Figure 5—Minimum Setbacks from Downslope Feature
447 NV411;
• rs a°
a s1
Wit#
c #
2 t f
8x g s
Figure 6—Typical Glendon®Model M31 System Layout
Multiple unit systems should be designed to facilitate dispersing the treated effluent over a broad area. For
example,two rows(lines)of three basins each oriented on the contours is better than"stacking"three rows
(lines)of three basins each oriented on the contours(each basin normally has its long side perpendicular to
the direction of the slope). When the site characteristics require"stacking"the primary units should be laid
out in a checkerboard(alternating) fashion rather than selecting units immediately down gradient.
Page 8 of 21
Copyright Glendon BioFilter Technologies,Inc.2003. All rights reserved.
WA Design Manl 122003.doc
Page 6 of 8; Rowland;
Design Manual for Glendon® parcel#940 200 006
FEB
BioFilter Systems in Washington
Model M31 Sizing for
"Fred Hill"Style Basins" 2 6 2015
Slopes 5<20%
The calculations presented herein apply only under the following conditions for the slopes listed:
• Basin width and length is 6'by 10'with a Glendon BioFilter Model M31 hydraulic capacity of 120 GPD.
• Soil load rates are those currently approved by the Washington Department of Health."
• Note that adjacent basins along the contour may not be set closer than the spacing required to
accommodate dimension D to provide for installation of all absorption areas if required.
Any deviation from these conditions renders these calculations invalid.
5
Basin \
-�
10' \/ 1
✓" y / \/
17'
100% Primary Cross Section through Basin
Perpendicular to Slope
14.5
Down
Slope
USDA Type Soil 1&2 3 4 5 6 Dimension
Soil Load Rate
11 Gal./Ft2/Day 1.2 0.8 0.6 0.40 0.2
100% Abs. Area 100 150 200 300 600
Primary Length 14 15 17 20 Note 11 A
50% Abs. Width 6.5 8 9.5 B
100% Abs. Width 10 13 14.5 17.5 C
Reserve Length 16 17 23 D
Reserve Width 15 20.5 25.5 E
10 Area is in square feet. Width and length are in feet. Minimum Installation Size includes nominal 5'width of cover
sand upslope of basin.
" See Page 21 for Type 6 Soil pattern for a 360 GPD system.
Page 20 of 21
Copyright Glendon BioFilter Technologies,Inc.2003. All rights reserved.
WA Design Manl 122003.doc
Page 7 of 8; Rowland;
Parcel#940 200 006
Design Manual for Glendon®
BioFilter Systems in Washington
Downslope Feature or Vertical Se aration See 2.4.1 and 14.2)
Object 12"-<18" 18" <30" 30+"
Property&Easement lines 30 Feet 5 Feet F 5 Feet
Building Foundations 30 Feet 10 Feet 10 Feet
Mounds 30 Feet : 10 Feet 10 Feet
Glendon Basins 30 Feet1 10 Feet 10 Feet
Interceptor/Curtain 30 Feet 30 Feet 30 Feet
Drains/Drainage Ditches
Other objects that impede 30 Feet 10 Feet 10 Feet
the movement of water
through the soil
1 As measured from the downslope edge of the full absorption area(and the full replacement area,if the replacement
area is concentric with the initial area)of the upper unit to the upslope wall of the lower basin.
Figure 5—Minimum Setbacks from Downslope Feature
1hLJL
modulars
°JLn
house
1120
•
■
Figure 6—Typical Glendon®Model M31 System Layout
Multiple unit systems should be designed to facilitate dispersing the treated effluent over a broad area. For
example,two rows(lines)of three basins each oriented on the contours is better than"stacking"three rows
(lines) of three basins each oriented on the contours(each basin normally has its long side perpendicular to
the direction of the slope). When the site characteristics require"stacking"the primary units should be laid
out in a checkerboard(alternating)fashion rather than selecting units immediately down gradient.
Page 8 of 21
Copyright Glendon BioFilter Technologies,Inc.2003. All rights reserved.
WA Design Manl 122003.doc
• Page 8 of 8; Rowland;
Parcel#940 200 006
Design Manual for Glendon®
BioFilter Systems in Washingtot LB 2 6 2015
Construction Notes,and Disclaimers
The following construction notes and disclaimers are binding upon the septic designer,the installer,and the
owner or grantor of the property on which the septic design is accomplished.No substitutions can be made
without the designer's approval. The construction notes assume that the designer is not a licensed surveyor.
1.This site map does not represent a survey nor does it purport to show all easements or encroachments, if
any.If easements are not shown,it is the responsibility of the owner and the owner's liability.
2. The location of this drainfield is based on the owner or the owner's agent locating property lines and
corners.If those boundaries are not accurate,the designer is not liable for mistakes in location of primary or
reserve drainfields on the design.Easements not shown on design or on the plat map included with the design
are the sole responsibility of the owner.However,the designer must make a good faith effort to accurately
locate drainfield areas according to these instructions and,as circumstances permit,the preferences of the
owner.
3.All surface water must be diverted away from drainfield area.Insure that final grading of drainfield area
directs water away from the drainfield.
4.Prepare the site and install the units during dry conditions so equipment does not damage the structure of
the soil in the absorption area. Use of tracked machinery is strongly recommended on Glendon®sites.
5.This system is not designed for use with a garbage disposal installed in the building(s)served. Use of a
garbage disposal in a Glendon®system will require a larger than normal septic tank and additional expense in
pumping fees due to the markedly increased quantity of solids in the septic tank.
6.The property owner is responsible to fill soil logs after final approval of the design.
7.No burning on drainfield area.
8.No vehicular traffic on drainfield area allowed.
9. This system requires a proper degree of maintenance by a Glendon®licensed technician.Certification,
design and installation does not necessarily guarantee trouble-free operation.
10.No septic additives are to be used.
11. The property owner is responsible for damage done by landscapers.
12.Curtain drains may be required at time of installation even though not shown on design.
13.The owner/grantor acknowledges having read the above construction notes and disclaimers and agrees to
abide by the content.
Code of Good Practice for Glendon®Designers:
1. When considering locations for Glendon®units,try to locate them so they are not too noticeable.
2. Staking out the Glendon®is a good practice so the Health Department can see the actual location,and the
installer knows exactly where they are to be installed.
3.It is important to see where surface runoff from the adjoining property may be coming,and,if necessary,
install a curtain drain to protect the area with the Glendon®units. Avoid installing Glendon®BioFilter units
in swales.
4.On tight soils(low permeability),surface runoff can be a major factor, and a swale or berm can be
effective to divert surface water from flooding the area.
5. When designing curtain drains at property lines,check for roots for mature trees on the other side of the
property which must be avoided.
6.Curtain drains should not be installed against the slope so they become too deep.Also, sometimes you can
be in the shallow aquifer.
Copyright Glendon BioFilter Technologies,Inc.2003. All rights reserved.
WA Design Manl 122003.doc
��%y"Y 1
pi
E-- S�a Page 1 of 8; Rowland;
1 Parcel#940 200 006 p
JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT
621 SHERIDAN ST..PORT TOWNSEND.WA 98368. (360) 379-4450 %,,
J�j��.,1
SOIL EVALUATION �,; °'" / `. : .,
Mardella&Brian Rowland ,
PROPERTY OWNER FEB an z ."
0 4 2015 " Suzen�L Martn '!
SYSTEM DESIGNER Suzanne Martin Jefferso
EnVlronr�p�
LEGAL DESCRIPTION: Section 13 Township 30N Range 2W Parcel # 940 2°"°5' Heath
Subdivision Name Cape George Village Division 2 Block Lot(s) 6&7
Date Logged: 30 January 2015 Logged By: Suzanne Martin
Include soil textural characteristics and the depths at which significant changes occur. Be sure to include depth
where mottling or imperm ble I yers occur.
r
SOIL LOG #1 _ )* ' SOIL LOG #2
0-32/37"type 3!';,. -46'type 3&4; Blocky mottle type 4
i
37-39"Dark brown sandy loam
39-56/59"yellow brown fine sand eclectic soil profile
56/5 + grey mottled very fine sand V a sue '
E S �� 33 lb intocAp4"1
Anticipated water table57/61in. Anticipated water table in. �- i''"�-�,.
Roots to inches Roots to 26/32 inches
Health Dept. Comments Health Dept. Comments
1
SOIL LOG #3 Z !- i t SOIL LOG #4 C7
0-20/21"type 'As.
1A %, 0-15/23"Disturbed type 4 soils
20/21-23/25" Da brown loam 5/23"mott ��
23/25-39/42"Yellow brown gravelly blocky sandy 02' R
loam ez ;I ,� -
��--F- 'per �^J1
Anticipated water table in. Anticipated water table in.
Roots to inches Roots to inches
Health De�ptt..Comments Health Dept. Comments ___ ----- ----�-
SOIL LOG #5 �� / SOIL LOG #6
e?—.15:::5:::.__________ I( 1'
.47,): ,,,,..zi-t,,,,,,Ad. bF .
Anticipated water table in. Anticipated water table in.
Roots to inches Roots to inches
Health Dept. Comments ^' Health Dept. Comments
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• Page 2 of 8; Rowland;
Parcel#940 200 006
ONSITE SEWAGE DISPOSAL %F,
SYSTEM DESIGN 14 �",�/
B z /f
G o
� + 04
r Z Suzanne L Martin
Date 2 February 2015 jS
5 2
Y tas tit%1 u k• 'f,
DAIFFS 911/1?
Property Owner Mardella&Brian Rowland 2 February 2015
System Designer Suzanne Martin
Legal Description: Section 35 Township 30N Range 1W
Subdivision Name Cape George Village Division 2 Block Lot(s) 6&7
I. CALCULATIONS
If for residential use:
Number of Bedrooms: 2 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 0.60 G.P.D./ft. squared
(see page 214 of the EPA Design Manual)
DRAINFIELD SIZING:
Absorption area: 400 square feet (total G.P.D. ;-G.P.D./ft. squared)
Trench or bed width 14.5 feet
Trench or bed length 17 lineal feet (sq. ft.+trench or bed width)
II. APPURTENANCES
Septic Tank Size 1000 min gallons
Pump Requirements (If Necessary)
Elevation difference in feet 11
Friction loss 2
Pump capacity should be 10 G.P.M. at 15 T.D.H.
Number of doses per day proprietary
Dosing volume proprietary gallons
Pump chamber size 1000 gallons
H:\home\pincntr\i of ohlth\se wd sn
•
page 3 of 8;Rowland; •
Parcel#940 200 006
III. DRAINFIELD CROSS SECTION
Ktti
51 2 t
/ Suzennei Waft .,ri to
D /FILLW 2 February 20 1 5
�" Draia Rock
NATIVE SOIL
A
—
B
t E
•
C
IMPERMEABLE MATERIAL/
SEASONAL SATURATION
A. Trench Depth mound inches
B. n/a inches of drainrock below pipe
C. 18 inches of vertical separation from trench bottom to impermeable
material/seasonal saturation
D. mound inches of fill (if needed)
E. Trench width 174 inches
NOTES:
reserve area may require additional treatment. system to be controlled by Aquaworx programmable
timer set as per glendon requirements.
ATTACH DETAILED DESIGN OF SYSTEM
589279 PGS : 1 COV
02/11/2016 02:34 PM $72.00 MARDELLA ROWLAND
Jefferson County WA Auditor's Office- Rose Ann Carroll, Auditor
NM kict 4'Ji1R4114II+ di H illieiKKIIM.1.1 ill'I4 JWI 111111
When recorded return to:
Name: Mardella Rowland
Address: 100 Dennis Blvd
city:Port Townsend
state,zip Washington 98368
DECLARATION OF RESTRICTIVE COVENANT
Grantor(s): Mardella & Brian Rowland
Grantee(s): Jefferson County
NOTICE IS HEREBY GIVEN TO Mardella&Brian Rowland ,his! and
assigns,and the general public. This restrictive covenant shall bind and taste- - land,the
Owner(s),their heirs,grantees,successors and assigns and shall`run'with t - land •erpet ty.
DESCRIPTION OF REAL PROPERTY AFFECTED:
Lot(s) A&7 Block(s) Div.2 ce
of Cape George Village
Section 13 ,Townshlp 30N ,Rang•2W
ASSESSOR'S TAX PARCEL NUMBER(S):,Parcel#940 10'06 N
NOTICE IS HEREBY GIVEN THAT the combination •f t - :bove r, cad description of real
property(lots,parcels,etc)is required to meet W- 46-272 ,• ' urn Land Area for issuance
of an onsite sewage system permit. Sale,transfe o other se, eg,tion of only part of the
property described in this Notice and In the onsite :e :ge per t ill result in a violation of the
terms and conditions of the onsite sewa,a permit.
TYPE OF STRUCTURE:sin.- - i r i•-n,
ADDRESS OF STRUCTURE:_100 Dennis Blvd-Port Townsend,WA 98368
THIS NOTICE may not be lifted or remove• • t the consent and written approval of the
Jefferson County Health and Human Service
•
Recording. Upon its execution,this Declare'•n s I be - •rded with the Jefferson County Auditor. All
contracts and deeds or other instruments of o• nya -- relating to the property or any part thereof shall
contain reference to this covenant.
Compliance with code requlreme Th •- I •oes not amend or modify,nor is It intended to
amend or modify any requirement of -Co n 's 4.
•i •nces or any other law or regulation dealing with
or affecting the use of land or cons on • im• ove-ants upon lands.
Warranty of Authority. The owner(s) •ning ,,low warrant that they are the sole Owners In fee of the
real property describe• above and r d a --ut • 'ze• • make this Declaratio and so bind the property.
GRANTOR(S I t�S /i� /�' /cud•" t.p� J /
ream M Carlltr G� •r_willir Acknowledgment: 411, C ,
SUBSCRIBED AN• • - me thls_ -Alay oficlacjaid ,20 i.c,
'otary•ub-. I4'd f tate of,,-.shington, `•p,p , S .,..adA
residing i• O car Washington. . `jiy;. ..•. 6,
I 9�.
My commission r7� . _
0 NOTARY
1--: PUBLIC =z
pF
WASN,�
41111161(11111*
03/30/2015 10:03AM FAX 3603856930 BERNT ERICSEN EHCAUATIN9 1j0001/0001
INSTALLATION START NOTIFICATION DATE SENT -tr.
This form shall be faxed or emalled ONi, working day prior to starting construction
Jefferson County Public Health - Environmental Health-Dept. < ;.
Phone: 360.3135-9444
FAX 360-379-4487
CIVIAIL
septio@cojefferson.wa.us "P
PERMIT OWNER . 4 £, cl
SITE LOCATION C n
PARCEL NUMBER
SEP NUMBER -5 ) ,- -
INSTALLER > / - CONTACT PHONE 3 ` 7'6,!
DATE FOR INSPECTION
SYSTEM WILL REQUIRE PRESSURE TEST - YES 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 speeifloations.
Jefferson County Staff Only; . �. _, � . 1T. tl .�t�w '.- •_._._._._.-.. ,_.
MONITORING AGREEMENT MAILED DATE/INITIALS ` '
PRESSURE TEST SCHEDULED
•
Check one:
INSTALLATION START NOTIFICATION DATE SENT
PRESSURE/PUMP TEST INSPECTION REQUEST DATE SENT 4/6/15
This form shall be faxed or emailed ONE working day prior to starting construction
OR a minimum of 48 hours prior to pressure/pump test
Jefferson County Public Health - Environmental Health Dept.
Phone: 360-385-9444
FAX: 360-379-4487
EMAIL: septic @co.jefferson.wa.us
PERMIT OWNER Mardella & Brian Rowland
SITE LOCATION 100 Dennis Blvd-Port Townsend, WA 98368
PARCEL NUMBER 940 200 006 C SEP NUMBER 15-00021 p
INSTALLER Toby Killam (Ericsen Excavating) CONTACT PHONE 385-3531
DATE FOR INSPECTION
SYSTEM WILL REQUIRE PRESSURE TEST - YES please 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 \ P 4ESSURE TEST SCHEDULED
A-17i .EtP
L, Liz., e. "e
APR 2 4 2075
CERTIFICATION OF TANK ABANDONMENT
Parcel number 940 200 006
Address 100 Dennis Blvd-Port Townsend, WA 98368
Property Owner Name Mardella & Brian Rowland
Septic Permit# (if applicable) SEP15-00021
Individual/Company Certifying Abandonment
Tim Thomas (Ericsen Excavating)
Phone Number (360)385-3531
I certify that the septic tank and/or pump chamber on the above referenced site
has been abandoned to Washington State and Jefferson County Public Health
Requirements.
Signature D Date
Print Name Tim Thomas
Pump receipt attached yes
4ENVIRO 'CHECK, L.L.C.
1612 Hastings Ave. W
Port Townsend, WA 98368
360-379-9400 SEPTIC TANK OPERATIONAL REPORT 4pR 2
0 2015.
Company Name _ i , , 44, Ltd Date of Service *, )/
Technicians signature --- ----
Service provided for
Address } l.,) a. .iF i ? ,. ! , .4 v_
e 4
Phone ;,. %,:
Job Address ; . . T. r',-, i k...-11', ,, \ A
Last Date Pumped , t, #people in home ( ,, )k #bedrooms k :It„,,,,, '
SEPTIC TANK
Size of tank. s \ Gallons Compartments: Single Double
Material: Concrete Polyethylene Metal Other(specify)
Conditions of septic tank: Good `- Poor
Was ground water observed leaking into tank?Yes No
If yes, where was water observed?
Effluent running back into tank from drainfield? Yes , ,. No
Riser to grade on inlet: Yes No Riser to grade on outlet: Yes No -
If no risers, were risers installed? Yes No ''
Solids in Tank: 1st compartment Scum (top layer) in. sludge(bottom layer) in.
2nd compartment scum(top layer) in. sludge(bottom layer) in.
BAFFLES
Condition of inlet baffle: Good Needs Repair Repaired Material
Condition of center baffle: Good Needs Repair Repaired Material
Condition of outlet baffle: -Good °° Needs Repair Repaired Material
Type of outlet baffle: Unscreened Screened Filtered Material
Cleaned outlet baffle and/or screen: Yes No
PUMP
Does the system include a pump? Yes No ' If Yes, complete the following
Size of Tank Gallons
Riser to grade: Yes No If no, was riser installed: Yes No
Material: Concrete Polyethylene Metal Other(specify)
Was ground water observed,l aking into tank?Yes No
If yes,where was waer observed?
1,
Depth of accumulated sludge in pump tank inches
Was the tank pumped? Yes No
Recommended additional information
Condition of Pump: Working Not Working Needs repair
Condition of Alarm: Working Not Working Needs repair
Pump cycle drawdown: Inches Time for pump cycle minutes/sec.
Comments: - r i_> ?t,t._i , ,',' , t