HomeMy WebLinkAboutBLD2015-00078 - COU r%) DEPARTMENT OF COMMUNITY DEVELOPMENT
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621 Sheridan Street,Port Townsend,WA 98368
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Tel 360.379.4450 Fax:360.379.4451
Web:www.colefterson.wa.us/communitydevelopment
f \O' E-mail:E-mail: dcd a co.jefferson.wa.us
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CERTIFICATE OF OCCUPANCY
PERMIT #: BLD15-00078
APPLICANT: GABRIEL GREENSTEM PHONE:
1014 NW 178TH ST
SHORELINE WA 97177
206-327-0149
SITE ADDRESS: 205-A N OTTO ST Issue Date: 06/15/2015
PORT TOWNSEND, 98368 Final Date: 6/17/2015
SUBDIVISION: 9867 - PHILLIPS BAY VIEW Block: 19 Lot: 3+
PARCEL NUMBER: 986701902 Section: 16 Township: 30 N Range: 1 W
PROJECT DESCRIPTION: CHANGE OF USE PERMIT
I-502 PROCESSING & MANUFACTURING
Existing floor plan permitted through BLD15-150, no change in floor plan
on this permit.
CO2 machines permitted through BLD15-175
SEP07-159
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2012
EDITION.
OCCUPANCY GROUP: B
TYPE OF CONSTRUCTION:
SPRINKLER SYSTEM yes rto
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 6/17/2015
\\tidemark\data\forms\F_BLD_Occupancy.rpt 6/17/2015
S
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD15-00078 Received Date: 3/12/2015
SITE ADDRESS: 205-A N OTTO ST Issue Date 6/15/2015
PORT TOWNSEND, 98368 Expiration Date 6/15/2016
OWNER: GABRIEL GREENSTEM PHONE: 206-327-0149
1014 NW 178TH ST
SHORELINE WA 97177
9867 - PHILLIPS BAY VIEW
SUBDIVISION: Block: 19 Lot: 3+
PARCEL NUMBER: 986701902 Section: 16 Township: 30 N Range: 1V\
CONTRACTOR: PHONE:
PHONE:
PROJECT DESCRIPTION: CHANGE OF USE PERMIT
1-502 PROCESSING & MANUFACTURING
Existing floor plan permitted through BLD15-150, no change in floor plan
on this permit.
CO2 machines permitted through BLD15-175
SEP07-159
TYPE OF WORK COM SQUARE FOOTAGE: COMMERCIAL: 2,500
TYPE OF IMP COU MAIN: INDUSTRIAL:
VALUATION ADD'L: HEAT TYPE
CODE EDITION: 2012 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: 69000 Type Amount Paid By: Date: Receipt:
BATHROOMS: Change of Use or Occupar $468.00 SRE 03/11/15 154202
Exist: State Building Code $4.50 SRE 03/11/15 154202
Prop: 1 Potable Water Application $68.00 SRE 03/19/15 154226
Total: 1 Total: $540.50
NUMBER OF EMPLOYEES:
Directions to Site:
HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION
THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED
BUILDING INSPECTION HOT-LINE 379-4455.
Request must be received by 3pm the day before the inspection is needed.
Office Hours 9:00 am -4:30 pm MONDAY- THURSDAY
HOT LINE AVAILABLE 24 HOURS A DAY
• •
SPECIAL CONDITIONS APPLY-SEE ATTATCHED
Jefferson County Building Division Permit Number: BLD15-00078
Applicant: GREENSTEIN
BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2012 International Building Codes
To schedule inspections, call (360)379-4455 no later than 3:00PM the day before the inspection is needed.
Requests received after 3:00 PM will not be scheduled for the next day's inspections.
ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries.
The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection
Inspection Item Date Approval Signature Notes
Miscellaneous / verify BLD-150 and BLD15-175 are naled prior to final for this
�l(�1//0 r }permit.
fi
Septic System Finaled /// sep07-159
lanning Approval
1 SO
A final inspection will not be scheduled until the following are completed and signed off by the applicable Department:
• Building Permit Conditions are met • Septic Permit Final/Complete for any building containing plumbing
• Land Use Conditions met and signed off • Public Works Permit Final(where applicable)
FINAL INSPECTION (oil` �5
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• I
CONDITIONS for Building Permit# :BLD15-00078
1.) JCPH approval for the septic system connection is approved based on the applicants
statements that processing is limited to the use of the CO2 extractor to manufacture
cannibis oil into vaportizer cartridges and small glass containers ONLY. No other process
or manufacturing is approved. The applicant has stated NO WASTEWATER is generated
from this processing. The septic system is designed for residential waste and approve for
sanitary use by employees ONLY.
2.) Per septic permit exceeding the permitted design flow of 478 gal/day max. shall
constitute a violation of this permit. Water usage monitoring shall be monitored monthly.
These monitoring results will be required to be submitted to the Jefferson County Health
Dept. upon request.
The current use of the septic system is for 2 employees in #203, this application in 205A is
for a proposed 4 employees and 205B is vacant. Current water use provided for 2014
indicates the two employees use an average of 100 gallons per day, which includes
landscape irrigation and water leaks noted in March, August and January.
3.) Waste Strength (BOD, TSS, Grease and oils) may be required upon request by Jefferson
County Public Health. Resposiblity is that of the owner.
4.) Approval of this permit does not provide any assurance of future approvals for onsite
sewage disposal on the property or use of any existing septic systems. Actions taken to
date and proposed as part of this project may limit or prevent future development of an
onsite sewage system. Future proposals must meet current code at the time of
application.
5.) The applicant shall obtain and maintain a State License to process cannabis.
6.) The site plan as submitted with the Building Permit Change of Use application on March
12, 2015 has been reviewed for consistency under the UDC, and has been approved by
Jefferson County Department of Community Development. Any modifications, changes,
and/or additions to the stamped, approved site plan dated April 2, 2015 shall be
resubmitted for review and approval by Jefferson County Department of Community
Development.
\\tidemark\data\forms\F_BLD_Permit_Bldg.rpt 6/15/2015
r
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD15-00078 Received Date: 3/12/2015
SITE ADDRESS: 205-A N OTTO ST Issue Date 6/15/2015
PORT TOWNSEND, 98368 Expiration Date 6/15/2016
•
OWNER: GABRIEL GREENSTEM PHONE: 206-327-0149
1014 NW 178TH ST
SHORELINE WA 97177
9867- PHILLIPS BAY VIEW
SUBDIVISION: Block: 19 Lot: 3+
PARCEL NUMBER: 986701902 Section: 16 Township: 30 N Range: 1V1
CONTRACTOR: PHONE:
PHONE:
PROJECT DESCRIPTION: CHANGE OF USE PERMIT
1-502 PROCESSING & MANUFACTURING
Existing floor plan permitted through BLD15-150, no change in floor plan
on this permit.
CO2 machines permitted through BLD15-175
SEP07-159
TYPE OF WORK COM SQUARE FOOTAGE: COMMERCIAL: 2,500
TYPE OF IMP COU MAIN: INDUSTRIAL:
VALUATION ADD'L: HEAT TYPE:
CODE EDITION: 2012 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: 69000 Type Amount Paid By: Date: Receipt:
BATHROOMS: Change of Use or Occupar $468.00 SRE 03/11/15 154202
Exist: State Building Code $4.50 SRE 03/11/15 154202
Prop: 1 Potable Water Application $68.00 SRE 03/19/15 154226
Total: 1 Total: $540.50
NUMBER OF EMPLOYEES:
Directions to Site:
HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION
THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED
BUILDING INSPECTION HOT-LINE 379-4455.
Request must be received by 3pm the day before the inspection is needed.
Office Hours 9:00 am -4:30 pm MONDAY- THURSDAY
HOT LINE AVAILABLE 24 HOURS A DAY
• •
SPECIAL CONDITIONS APPLY - SEE ATTATCHED
Jefferson County Building Division Permit Number: BLD15-00078
Applicant: GREENSTEIN
BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2012 International Building Codes
To schedule inspections, call (360)379-4455 no later than 3:00PM the day before the inspection is needed.
Requests received after 3:00 PM will not be scheduled for the next day's inspections.
ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries.
The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection
Inspection Item Date Approval Signature Notes
Miscellaneous (l// ` verify BLD-150 and BLD15-175 are finaled prior to final for this
/O permit.
Septic System Finaled sep07-159
lanning Approval
� `S- \ 50
A final inspection will not be scheduled until the following are completed and signed off by the applicable Department:
• Building Permit Conditions are met • Septic Permit Final/Complete for any building containing plumbing
• Land Use Conditions met and signed off • Public Works Permit Final(where applicable)
FINAL INSPECTION (p// /'s /y1:
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
CONDITIONS for Building Permit# :BLD15-00078
1.) JCPH approval for the septic system connection is approved based on the applicants
statements that processing is limited to the use of the CO2 extractor to manufacture
cannibis oil into vaportizer cartridges and small glass containers ONLY. No other process
or manufacturing is approved. The applicant has stated NO WASTEWATER is generated
from this processing. The septic system is designed for residential waste and approve for
sanitary use by employees ONLY.
2.) Per septic permit exceeding the permitted design flow of 478 gal/day max. shall
constitute a violation of this permit. Water usage monitoring shall be monitored monthly.
These monitoring results will be required to be submitted to the Jefferson County Health
Dept. upon request.
The current use of the septic system is for 2 employees in#203, this application in 205A is
14
for a proposed 4 employees and 205B is vacant. Current water use provided for 2014
indicates the two employees use an average of 100 gallons per day, which includes
landscape irrigation and water leaks noted in March, August and January.
3.) Waste Strength (BOD, TSS, Grease and oils) may be required upon request by Jefferson
County Public Health. Resposiblity is that of the owner.
4.) Approval of this permit does not provide any assurance of future approvals for onsite
sewage disposal on the property or use of any existing septic systems. Actions taken to
date and proposed as part of this project may limit or prevent future development of an
onsite sewage system. Future proposals must meet current code at the time of
application.
5.) The applicant shall obtain and maintain a State License to process cannabis.
6.) The site plan as submitted with the Building Permit Change of Use application on March
12, 2015 has been reviewed for consistency under the UDC, and has been approved by
Jefferson County Department of Community Development. Any modifications, changes,
and/or additions to the stamped, approved site plan dated April 2, 2015 shall be
resubmitted for review and approval by Jefferson County Department of Community
Development.
11 tidemark\data\forms\F_BLD_Permit_Bldg.rpt 6/15/2015
• •
CERTIFICATE OF OCCUPANCY
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451 (800) 831-2678
Al ScaIf, Building Official
PERMIT#: BLD08-00269
SITE ADDRESS: 205 N OTTO ST Issue Date: 09/11/2008
PORT TOWNSEND, 98368 Final Date: 4/8/2010
APPLICANT: GLEN COVE PROPERTIES LLC PHONE:
101 KIWI LN
SEQUIM WA 88382-8550
SUBDIVISION: PHILLIPS BAY VIEW ADDITION Block: 19 Lot: 3+
PARCEL NUMBER: 986701902 Section: 16 Township: 30 N Range: 01 W
PROJECT DESCRIPTION: NEW 4959 S.F. UNHTD COMMERCIAL WAREHOUSE
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING
CODE 2006 EDITION.
OCCUPANCY GROUP:
TYPE OF CONSTRUCTION:
SPRINKLER SYSTEM yes C no
Tt—PR.QJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 4/8/2010
JEFFERSON CO lNT
NO.
RECEIVED FROM } DATE "
DESCRIPTION •-�--mac_- '�.. E E- q+ Fr-S
A4P.S s
�°�, CURRENCY <` AMOUN7
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CHECKS
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RECEIVED BY
MICHAEL J.ANDERSON
Civil Engineer a Land Surveyor
330 Cleveland Street
Port Townsend,WA 98368
MEMO
DATE: May 7, 2015
TO: Jefferson County Community Development Department
Attention: Building Department
FROM: Michael J. Anderson 1,
PE &PLS /
SUBJECT: Revision to Existing BLD15-00150:
205 North Otto Street, Port Townsend
Reference: BLD08-00269
APN 986 701 902
Attached are two (2)copies of the building floor plan that was originally filed with the
referenced BLD08-00269 to supplement the application filed on May 1, 2015. The plan shows
the two toilet facilities but three were constructed,the two shown on these plans and the
additional facility in Unit B as shown in the filed for BLD15-00078 and the subject BLD15-
00150.
Please indicate if you need any additional information to complete your review of this pr i ject.
Attachments: 1
„\c, `\
C: Dan Tittemess, DBA Glen Cove Properties LLC, Owne
O �P�
Gabriel Greenstein,DBA PDT Technologies, Tenant o��w �Nt
1 M
\/ DF t!
M:51-911
MICHAEL 1.ANDERSON t S on
Civil Engineer a Land Surveyor
330 Cleveland Street
Port To tinsend.WA 98368
MEMO
DATE: April 2, 2014 __�I
TO: Jefferson County Community Development Department / ' - Ii
Attention: Ms Sally Ellis, Permits !
FROM: Michael J. Anderson CC'''.UNITY DFv'nor"cn T
PE &PLS
SUBJECT: PDT Technologies (Tenant: Mr. Gabriel Greenstein)
205 A No. Otto Street,PT
APN 986 701 902
RESPONSE TO: 1) March 19. 2015 e-mail from Ms Mary Blain, Building Dept.
2) March 24, 2015 letter from Susan Porto, Health Dept.
3) March 25, 2015 letter from David Johnson, Planning Dept.
BLAIN MEMO:
In response to the question regarding the floor plan, the only change from the original approval
of the building was the addition of the wall separating the 205 A and 205 B units. Attached is a revised
building and site plan showing the wall. The unit 205 C walls were part of the original construction and
final inspection.
Units 205 A and 205 B has a man door and a garage door that provide two exits.
The building plan shows the details for the interior security fencing required by the State.
An explanation of the use was in the transmittal of a revised building plan on March 26, 2015 by this
office. The attached plan dated March 31, 2015 now illustrates these improvements.
The following is an updated description of the proposed business operations:
The business activities occurring at 205-A N Otto St, Port Townsend WA 98388 will be
marijuana processing.
This will include the extraction of raw cannabis material, and the packaging of the
ensuing essential cannabis oils into retail products.
Raw, pre-ground material will arrive securely from a legal i-502 farm, and be received
into a caged, secured"Quarantine" (see attached PDT Technologies Site Plan) area
within the facility. As per WSLCB regulations, the material will sit in the designated
Quarantine for a period of no less than 24 hours upon receipt.
• •
After the required waiting period, the material will be taken from the secure storage :rea
and moved into the CO2 extraction vessel, where it is converted into oil. This equip ent
is commonly used in the food industry to produce clean, non-volatile, non-hydro car ion
solvent based food extracts.
The CO2 extraction works, by forcing high pressure gas through the plant material ii the
extraction vessel, causing the material to separate into essential oils and plant matter
residue. The organic waste residue is then stored in the Quarantine/ Controlled Area
where it will eventually be mixed with a 50% blend of organic material, and taken t• a
composting facility.
The essential plant oils, will then be stored in Quarantine, while a sample of the oil i. sent
out and evaluated at a 3`d party QA lab for potency and pathogen testing.
Once the oils are determined by the lab to be safe for consumer consumption, the oil will
be taken from Quarantine and placed into retail packaging.
The final products will be placed in Quarantine where inventory will be available fo sale
to licensed 502 retail stores.
To summarize, this application is for a change of use only. No improvements to either the e isting
building or utility systems are required.
PORTO LETTER:
Item No. 1. The new attached plans dated Mar. 31, 2015 show the demising wall as noted
above. There are two employees at the existing 203 Building and both buildings are served Iby the same
water and sewer system. The attached plans show the existing wall constructed without a permit or
inspection.
Item No. 2. The current use in the 205B Unit is"un-occupied" at the present time
Item No. 3. Attached is a copy of the water billing dated Feb. 20,2012 from the City of Port
Townsend that illustrates that the average consumption is about 1000 gals per month with tl-e exceptions
where the toilet overflowed and the summer months of irrigation of the plantings.
Item No. 4. In a review of the operation plan submitted by PDT,there will be 4 employees.
Item No. 5. The existing sink is for personnel hygiene only.Not a part of proposed business
operations.
Item No. 6. The ORCAA responded to today indicating that they are not a party t, this
permitting at this time and will respond to any complaints in the future. As indicated, any w:ste material
from the operation will be mixed with compost and delivered to the JC plant. We will be re.ponding to
today's e-mail from Gary Lee, Engineer from DOE and provide an answer ASAP.
Item No. 7. The water line location has been added to the site plan and is located onsistent
with the Health Dept. regulations as shown on the approved septic permit plan.
• •
JOHNSON LETTER:
The attached site plan has been revised to list the employee number currently planned for 6
people and the plan illustrates how 11 parking spaces can be provided, including one handicap space.
SUMMARY:
Please review this summary of our responses and provide us with your comments. As indicated,
we will be contacting DOE and will provide update ASAP. Thank you for your prompt responses in
processing this application for change in use.
c: Dan Titterness, Property Owner
Gabe Greenstein, Tenant
41'
Cr i
III
_,rowo CITY OF PORT TOWNSEND Account •
250 Madison Street#1 Statement
u. ' 1- ' Port Townsend, WA 98368
ACCOUNT.INFORMATION
ACCOUNT: 012383-000
SERVICE ADDRESS: 203 OTTO ST
SERVICE PERIOD: 1/1/2015 to 1/31/2015
BILLING DATE: 1/31/2015
DUE DATE: 2/20/2015
METER READING
4075 1 MB 0.432 4276 / 4075 19-20-16 page 1 at 1
DAN TITTERNESS Previous Reading Current Reading
101 KIWI LN Serial No Date Reading Date Reading Cons
SEQUIM WA 98382-8550 68098458 12/102014 1240 1,202015 1320 8000
lull'1111'I'Il'lIIIIii11111111111■11111111111L1111'lll111111111
- If not paid by the due date, a$5.00 minimum penalty or a Water 46.75
1-1/2%penalty,whichever is greater,will be applied to the 10%General Services Tax 4.68
account. 10% Public Safety&Streets Ta 4.67
-GO PAPERLESS, GO DOXO. See reverse side of
statement for payment options and billin• info • . '•n. CURRENT CHARGES 56.10
Water Capital Surcharge 21.60
TOTAL CURRENT CHARGES 77 70
USAGE HISTORY
� � --- _
o S 4 o v PREVIOUS BALANCE 43.58
o' PAYMENTS RECEIVED 43.58
ow If Y a 9 DJUSTMENTS 0.00
a v ? d '� �x •DDITIONAL BILLING
V - 7 $ URRENT CHARGES 0.00
soup , ---- 4 77.70
It Z000-1 I
II TOTAL AMOUNT DUE ' 77.70
D X.7 - _- ll !..1 it - .... / ,1
JAN F® .A
MAR APR MAY JUN A AUG SEP OCT NOV DEC JAN del / /• Q
Prior Cons Clifford Cons „j I'9/ /� r 7 /� �,
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4
October 1,2009
Dan Tittemess
Glen Cove Properties LLC
PO Box 1142
Port Townsend, WA 98368
Jefferson County,WA
Re: BLD08-00269 Commercial Warehous+ county Auditor
Stormwater Management Facility Mau ferson St.
C,%!: ::id;WA 98368
Dear Mr Titter ess:
_e!pt: 09-01439
In order to meet the requirements of the Jeffers(
Washington Department of Ecology Stormwate Name Extended
Product $64.CC
stormwater management facilities are appropria AGR Ag;eer ent on
County requires project proponents to enter into 547ot4
D ac(:rnent#
3 e
Agreement with the County. # pages
564.001
Please sign the attached Agreement before a Not Totat
You should keep a copy of the Agreement for yo X64.00
E. _ ..;necK)
Also attached is a bill for the Department's fees f EN COVE
preparing the Agreement. LLC
The Department cannot give final sign off on the '1
has been paid. Thank'(''
Sincerely;=". 10128109 10:33 AM bonnie
�r
James W. Pearson c:1� \ J'
Project Manager
Attachment :\'k
o'.:rtR
MICHAEL 1.ANDERSON
• S
Civil Engineer a Land Surveyor
330 Cleveland Street
Port Townsend WA 98368
*IWCA—CIL Up/ I'M ThniECEIVEr9
DATE: March 26,2015
�? h MAR 2 t 2015
TO: Jefferson County Community Development Department
Attention: Building Department
JEFFERSON OUNTY
DEPT OF COMMUNI OEUFtOPMFNT
FROM: Michael J. Anderson
PE&PLS /
SUBJECT: BLD15-00078: CHANGE OF USE PERMIT
205 A North Otto Street, Port Townsend
Reference: BLD08-00269
APN 986 701 902
Attached are two (2)copies of the existing building floor plan that shows the revisions t. the
interior of the South half of the building which was assigned the address of 205 A as not=d.No
structural changes to the building or its utility systems are proposed. The plans have bee
prepared in response to the e-mail from Ms Mary Blain of March 19, 2015.
The change of use is from an industrial to the I-502 Processing and Manufacturing desi ation
which can be described as follows:
1. The raw material will arrive by truck and be delivered directly into the Securi Area
which is fenced and locked as per Washington State regulations
2. The material is then transferred to the CO2 extraction vessel equipment whic
converts it to an oil. This equipment is commonly used in the food industry to
produce clean,non-volatile, non-hydro carbon solvent based food extracts. e high
pressure gas is forced through the extraction vessel causing the material to separate
into the essential oil and leave a residue. The residue is then stored in the Qu antine/
Controlled Area(see attached PDT Technologies Site Plan)and removed fro the
site after being mixed with 50%organic material that is taken to a compostin
facility.
To summarize,this application is for a change of use only.No improvements to either th
existing building or utility systems are required.
Please indicate if you need any additional information to complete your review of this pr ject.
Attachments: 2
c: Dan Titterness,DBA Glen Cove Properties LLC, Owner
Gabriel Greenstein,DBA PDT Technologies, Tenant
• b 0 0 1
Washington State Liquor Control Board(WSLCB)License Number: Type(e.g.Tier 1):_r
415704
SECTION A. GENERAL INFORMATION
X Attach a copy of the Operation Plan submitted with the WSLCB License Application.
1. Business name PDT Technologies
2. Owner and Operator Gabrial Greenstein
3. Primary contact Gabriel Greenstein
4. Business address 205 A No.Otte Street,Port Townsend,WA 98368
5. Phone 206-327-0149
5. Email gabe@pdttechnologies.com
6. Latitude/longitude in decimal degrees 48.091683 /-122.815278
(NAD83/WGS84)
7. Site size(dimensions in feet) 290 % 184
8. Zoning Light Industrial
9. Soil type(available from NRCS at Dick Loamy sand
http://websoi lsurvey.nres.usda.gov/app!)
10. Nearest surface water body(stream,lake,wetland) Port Townsend BAy
11. Distance from surface water body(feet) 3380 feet
12. Depth to groundwater(feet) 15 feet
13. Average ground slope of production site(percent) 5 %
14. Nearest well(feet),well type and owner N/A
15. Legal description of the nearest well N/A'AS 'AS S TWN R
(to the nearest''A'A section,township,range)
ECY 000-000 (02/15)
S #
Washington State Liquor Control Board(WSLCB)License Number: Type(e.g. Tier 1):
415704
SECTION B. PRODUCTION WASTEWATER
❑Yes NO Is production(growing)proposed at this location?If no,proceed to Section C.
L Describe any differences between the Operation
Plan and the actual planned production(growing)
2. What is the water source?
If private well,provide legal description of the well /.S 'AS S TWN R
(to the nearest 3/4 to section,township, range)
If public water supply,provide name
3. Production type(soil,hydroponic,aeroponic)
If hydroponic, list reservoir size(gallons)
Frequency of water exchange(days or weeks)
Approximate volume of water exchange(gallons)
4. Estimated annual production (pounds)
5. Months of production
6. Number of harvests per year
7. Name(s)of cleaning products used
8. Average volume of production wastewater
produced daily(gallons)
9. Discharge to publicly owned sanitary wastewater ]Yes ❑No
collection and treatment system?
If yes,name of system
10. Do you have written approval? ❑ Yes ❑No
If yes,attach the approval letter ❑
If no,what is the proposed method of wastewater
disposal(e.g. land application, irrigation)?
11. If land application or irrigation is proposed,
provide the number of acres used for application
Provide a legal description of the application site 'AS 'AS S TWN R
(to the nearest ''A 1/.section,township,range)
Attach an aerial map of the acreage ❑
12. Explain what steps or measures will be taken to
minimize the amount of wastewater generated,or
improve the quality of wastewater produced.
ECY 000-000 (02/15)
• S
Washington State Liquor Control Board(WSLCB)License Number: Type(e.g.Tier 1):
SECTION C. PROCESSING WASTEWATER
YES Is processing proposed at this location? If no, STOP.
1. Describe any differences between the Operation NONE -
Plan and the actual planned processing
2. Average volume of processing wastewater NONE
produced daily(gallons)
3. Will THC be extracted? YES
If yes,what extraction chemicals will be used? CO 2
4. Will edible products be produced? NO
If yes,name products NIA
5. What is the estimated annual production(pounds) ZERO
of each edible product?
6. Months of production 12
7. Discharge to publicly owned sanitary wastewater ❑ Yes X NO
collection and treatment system?
If yes,name of system N/A
8. Do you have written approval? X Yes ❑No
If yes,attach the approval letter SEE ATTACHED
If no,what is the proposed method of wastewater N/A
disposal(e.g. land application, irrigation)?
9. If land application or irrigation is proposed, N/A
provide the number of acres used for application
Provide a legal description of the application site N/A 1/4S '/4S S TWN R
(to the nearest'% section,township,range)
Attach an aerial map of the acreage N/AU
10. Explain what steps or measures will be taken to N/A
minimize the amount of wastewater generated,or
improve the quality of wastewater produced.
11. What is the water source? N/A
If private well,provide legal description of the well N/A%S 1/4S S TWN R
(to the nearest'/4'/4 section,township,range)
If public water supply,provide name CITY OF PORT TOWNSEND..DOMESTIC ONLY
12. Estimated average daily water use(gallons/day) N/A
ECY 000-000 (02/15)