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HomeMy WebLinkAboutSEP2014-00144 '•d Jefferson County Department of Community D:, =lopm ' 621 Sheridan St., Port Townsend WA 98368, 360 •` ',50 • SEPTIC PERMIT APPLI ',` Dale Goddard Family Trust (Dale Goddar•e 'rly -ok PROPERTY OWNER ' t MAILING ADDRESS 964 North Little John Way / 4'' 5 ox N y,� Stizane L Mertln Sequim, WA 98382 �� ,.. ��� PHONE ( 360 ) 643-0646 SYSTEM DESIGNER Suzanne Martin Designer Phone# 990-3304 LEGAL DESCRIPTION: Section 18 Township 29N Range 1 E PARCEL# 921 182 026 Subdivision Name Goddard Short Plat Division Block Lot(s) lot 1 subj/ease Site address/Directions to site 209 Old Oak Bay Road-Port Hadlock,WA 98339-Primary Dwelling Unit(PDU) SOURCE OF SEWAGE/USE TYPE OF WORK WATER SOURCE Residential ✓ _ New Tank/s only Private ✓ Residential ADU Modification_ _ Public Commercial Expansion_ Community Upgrade, Repair SITE SIZE +/-61217sf SYSTEM TYPE Partial Repair-(tank) (drainfield) Previous Evaluation Conventional ✓ Designate RAsArve Area Yes# -99. 44 5 -V' i 2I tp Alternative Redesign ✓ No SYSTEM DETAILS Number of Gallons/day 360 Soil type 3 (attach soil eval.) Application Rate 0.80 gal./sq.ft./day Drainfield Length 150 ft. Trench Width 3 ft. Trench/Bed Depth 24-36 in. Septic Tank size 1000 ex gal. Pump Chamber size n/a gal. TYPE OF Repair of drainfield (conventional trench)that has been partially damage due to soil sump(SEP84-0216) 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 judged by the rules and laws in effect at that time. ` el f-41 Property Owner Signature Date FOR OFFICE USE ONLY 4 PARTIAL 5/1 I 15 ASBUILT Reek' !°'( / ��/� r //� FINAL APP D INSP/PUMP TEST 1��42;� \1S ALL HOLD REQ. MET Date 5 12-16- Fee 12...L. 00 Rec# J 5611 iv Check# 041 Case#SEP 1 I q L\ C:\DCn men*s and Settings\Sr7an^e Martin\My 11cctments\my 'inrnmanra 7anne\mhh9n\TAff.rann ro,,.,fy\TaffCQ forms\Suz\2008 SPA.DOC c o` JEFFERSON COUNTY PUBLIC HEALTH 4 w•_- 615 Sheridan Street•Port Townsend•Washington •98368 www.jeffersoncountypublicheakh.org I'hone 3bU-3b5-9444 I-ax 36U-3/9-44ö/ ON-SITE SEWAGE DISPOSAL PERMIT PERMIT#: SEP14-00144 Date Received: 12/16/14 Date Issued: 03/05/15 SITE ADDRESS: 209 OLD OAK BAY RD Date Expires: 06/05/15 PORT HADLOCK, WA 98339 APPLICANT: DALE H GODDARD TRUSTEE PHONE: GODDARD FAMILY TRUST 964 NO LITTLEJOHN WAY SEQUIM WA 98382 LEGAL DESCRIPTION: GODDARD SHORT PLAT LOT 1 S/EASE PARCEL#: 921182026 Section: 18 Township: 29N Range: 1E DESIGNER: SUZANNE L MARTIN PHONE: 360-554-0224 PO BOX 125 CHIMACUM WA 98325 SYSTEM DESCRIPTION: CONVENTIONAL TRENCH No. of Gallons per Day: 360 Type of work: REP Drainfield Trench Septic Tank Length: 150 feet Width: 3 feet Depth: 24 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 E/pr . .l Health Specalst This permit with conditions must be onsite during all phases of construction HEALTH DEPARTMENT MUST BE CONTACTED FOR FINAL INSPECTION. SPECIAL CONDITIONS APPLY - SEE ADDITIONAL PAGES CONDITIONS OF APPROVAL- PERMIT NO.: SEP14-00144 1.) This permit was issued to correct a violation of WAC 246-272A for a damaged drainfield due to a slump. The permit must be completed within 90 days of the date of issuance. 2.) The drainfield location has been approved as part of a geo technical report. Any movement of the drainfield location will require a redesign and approval from a Licensed engineering geologist. 3.) 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. 4.) 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 5.) This system must be constructed by an installer certified by the Jefferson County Public Health Department per Jefferson County Code 8.15.120 (9) and state code WAC246-272A-0250 due to proximity to shoreline. 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.) Distribution boxes shall be fitted with a riser to grade, constructed of durable materials and a secured lid, adequately sized to allow visible inspection of the liquid level in the box. 8.) Notification of the start of construction shall be faxed or emailed to Jefferson County Public Health ONE WORKING DAY prior to start. 9.) H -An asbuilt drawing and certification of completion by the Designer is required prior to final approval. 10.) 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. 11.) When/if designated reserve area is utilized an alternative system providing an additional level of treatment may be required and must comply with code at the time of application for use. 12.) The site plan as submitted with the repair to septic system permit application on December 16, 2014 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 approved site plan shall be resubmitted for review and approval by Jefferson County Department of Community Development. 13.) This approval is for a repair to an existing septic system only. Any future permits on this site are subject to review for consistency with applicable codes and ordinances and does not preclude review and conditions which may be placed on future permits. 14.) Geologically Hazardous Areas in Jefferson County are characterized by slope, soil type, geologic material, and groundwater that may combine to create problems with slope stability, erosion, and water quality during and after construction or during natural events such as earthquakes or severe rainstorms. SEP14-00144 Page 2 of 3 \\tidemark\data\forms\F_SEP_Permitmod.rpt 3/5/2015 15.) A Geology Hazard Assessment prepared by Stratum Group (recieved December 16, 2014)was submitted in conjunction with this application. The report addressed the stability of the geologic hazard area. 16.) 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. 17.) VOLUNTARY MEASURES OF COASTAL&AT RISK SIPZ: Water conservation measures: 1. Roof and other intercepted precipitation shall be routed to on-site detention ponds and/or other approved means and allowed to be released to the soil slowly. 2. Water collected from Storm water and roof catchments may be used for watering lawns and gardens. Unless catchment water has been treated to meet drinking water standards, there shall be no cross connections allowed between the potable supply and impounded water. 3. Water withdrawn from wells on each property shall not be used for watering of lawns and/or gardens. 4. Ground water withdrawn from each property shall be restricted to a rate of three (3) gallons per minute. 5. Installation of water conserving fixtures such as low flow toilets, faucets and shower restrictors and other water saving plumbing fixtures. 6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation). Please NOTE that the above listed measures are not intended to be exhaustive, but rather is intended to be illustrative of the types of water conservation measures. 18.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ: 1. Installation of a flow meter. 2. On-going well monitoring for chloride concentration. 3. Submittal of monitoring data to County. 19.) This project was reviewed and approved as a Shoreline Exemption under JCC 18.25.560(2). 20.) Submittal of future septic system permit applications in the proposed reserve area shall fully comply with Jefferson County Code regulations including those for criticals current at that time. 21.) 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. 22.) The project shall adhere to the Best Management Practices (BMPs) to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. SEP14-00144 Page 3 of 3 \\tidemark\data\forms\F_SEP_Permitmod.rpt 3/5/2015 a This is only a record of a system that was instil*litptApermit, not a certification of the drainfield . CONVENTIONAL SYSTEM AS-BUILT INSPECTION REPORT 4r, Installer: Shold Excavating (Evan Neville) Parcel # 921 182 026 Permit Owner: Dale H.Goddard(Goddard Family Trust) Permit# SEP14-00144 Designer: Suzanne Martin Design Flow: 360 gpd Site Address: 209 Old Oak Bay Road-Port Hadlock,WA 98339 ABSORPTION AREA: DRAINFIELD TRENCH WIDTH TRENCH DEPTH TANK SIZE #OF BEDRMS #GAUDAY LENGTH 150 3' 24-30 1000 gal(2 compartment) 3 360gpd IF PUMP AND PUMP CHAMBER REQUIRED: Shroud/Screen Tank Size: 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 COMMENTS (inspection notes, changes from design or deficiencies installation)Attach additional sheet(s) if necessary Risers&outlet filter have been installed by Shold Excavating. New distribution box with riser&speed levellers have been installed by Shold Excavating. New sewer line(astm 3034) has been installed between septic tank and d-box. All of the laterals are minimum 50'one of the laterals,the existing one is 52'. Monitoring ports have been installed. Users Manual Provided to Homeowner mailed 1 May15 Date ATTACH ASBUILT DRAWING signed by Designer or stamped/signed by a 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 HIS SYSTEM IS IN COMPLIANCE WITH WAC 346-272 21 April 2015 5100342 Designer Si nature Date License# /s41a; rr s� az arti Suzanne L Mn .. (f. f 4;'- ewr.3.vnrn „, • .. / c7 fit, e --------..:. ■ ■44,' i 8°c(ti , ,-,-- ,, / + 1 - 1II : ' ,,/,--- - ----- / *4(.0,-' / w:' \ '''',.). 8 11 8 0 / . , 7 /1/ . o•rnrn i °cn -1 ) m (D (D O N m t?�/'�. 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N (D r m -c -I opa �(D33 �' _ Yom' J' CD la. =O .,.... 7m - ,a p O0 O 0. of n rr ti,r+ N -) a -' + O ' m -, O N ;�D r 3 = N o = •- o p i o n = a � oq •� Cr �`� X c* a- �. .N.. -, C-0 cr 'd CD 0 N E. 7" 0 --nom -. -' '+ CD co 3 (D CD 0. O, 0 (D (n Cl. O, a 3 X r o N 0 O 0 <. 7- C CO 0, co-n a N 0',CD d 0 a CD m a a N G S <<, m N D = O O cD CO M P r I I O T m , 2 n - o 3 m 0 o � �rT N o ' �a ,, t\ a (� o Cr N3 -0 Q) ;L.r. -�v' Z 1d p A TI C l N _ 'Iu d - d � O dim _o _ _ i . s - X _ 13 m m A 4-co � o 'a 3 c P A " Q o ' � (D CD O 7 3 N D Cl.o co n.. 7,7 ( CD i.a ,4. 1, . . O c*i Z G d= o m�a � a m o a 0o s s a Page 1 of 3; Goddard; Parcel#921 182 026 JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVEkOPMENT Primary Dwelling (PDU) 621 SHERIDAN ST.. PORT TOWNSEND .WA 98368, (36 379=4450 SOIL EVALUATION ,-,,� Goddard Family Trust(Dale Goddard Trustee) + PROPERTY OWNER I , ;^q/ l I, Suzanne Martin o! �` ' '�4' SYSTEM DESIGNER �s 5 oa/2 ;+�* 18 29N 1 E 921 182'026', rc ""�'' LEGAL DESCRIPTION: Section Township Range Parcel # "„^ Subdivision Name Goddard Short Plat Division Block Lot(s) 1 subj/ease` Date Logged: 6 June 2014 Logged By: Suzanne Martin Include soil textural characteristics and the depths at which significant changes occur. Be sure to include depth where mottling or impermeable layers occur. SOIL LOG #1 SOIL LOG #2 0-0/26"Type 2&4 fill 0-8"Dark brown loamy medium sand 0/26-24/50" Medium sand and compact gravelly 8-52/60"Yellow brown medium sand with few inclusions mottled sandy loam of massive clay loam(2-5"formations) 24/50-60" Grey weakly cemented loamy fine sand 52/60-70"grey mottled fine sand (North side of pit) 5260-70"Yellow brown fine sand (South side of pit) Anticipated water table n/a in. Anticipated water table 60/70" Roots to 24 inches Roots to inches Health Dept. Comments Health Dept. Comments Soil Log 3 Soil Log 4 0-15/22"Yellow brown gravelly medium sand 0-5"dark brown gravelly loamy medium sand (maybe fill?) 5-34"Yellow brown medium sand 15/22-17/24" Dark brown medium sand 34-67+"Yellow brown gravelly medium sand 17/24-72+"Yellow brown gravelly medium sand 5-34"2 small inclusions massive clay loam with some small inclusions of dark brown medium some mottles as well sand (about size of 1/2 dollar) Anticipated water table n/a in. �t Anticipated water table n/a in. Roots to 36 inches \ Roots to 24 inches Health Dept. Comments — Health Dept. Comments S � _ SOIL LOG #5 SOIL LOG #6 Anticipated water table in. Anticipated water table in. Roots to inches Roots to inches Health Dept. Comments Health Dept. Comments H:INFOHLTHISOIL.FRM 1/00 Page 2 of 3;Goddard; Parcel#921182026 Primary Dwelling(PDU) ONSITE SEWAGE DISPOSAL -'1+ SYSTEM DESIGN ,n l� t e10 r +Mq Suzr 1 Date 9 June 2014 /� 02 Suzanne��� y ' 4+• y ` ��v»n Property Owner Goddard Family Trust(Dale Go-tar J�'�Irus)&e),`2O,'� ...4 28 February 2015 ,,, b System Designer Suzanne Martin `-� 1.a,,iti' Legal Description: Section 18 Township 29N Range 1 E Subdivision Name Goddard Short Plat Division Block Lot(s) Lot 1; subj/ease I. CALCULATIONS If for residential use: Number of Bedrooms: 3 x 120 G.P.D.. 360 total G.P.D. If for non-residential use, attach calculations used to determine G.P.D. Soil texture waste water application rate 0.80 G.P.D./ft. squared (see page 214 of the EPA Design Manual) DRAINFIELD SIZING: Absorption area: 450 square feet (total G.P.D. :G.P.D./ft. squared) Trench or bed width 3 feet 03)...A) Trench or bed length 150 lineal feet (sq. ft.+trench or bed width) II. APPURTENANCES Septic Tank Size 1000 ex gallons Pump Requirements (If Necessary) Elevation difference in feet n/a Friction loss Pump capacity should be G.P.M. at T.D.H. Number of doses per day Dosing volume gallons Pump chamber size n/a gallons H:\home\pIncntAinfohlth\sewdsn ■ ,■ g 7zfc Page 1 of 3; Goddard; Parcel#921 182 026 / ' JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT ■ 621 SHERIDAN ST.,PORT TOWNSEND,WA 98368,(3601 379-4450 it, I \ SOIL EVALUATION ,P. PROPERTY OWNER Goddard Family Trust(Dale Goddard Trustee) 5 � MP°4 . uzann.;L rtn r ..S a .a t PPf SYSTEM DESIGNER Suzanne Martin l� ... LEGAL DESCRIPTION: Section 18 Township 29N Range 1E Parcel # 921 182 026 Subdivision Name Goddard Short Plat Division Block Lot(s) 1 subj/ease " � Date Logged: 6 June 2014 Logged By: Suzanne Martin Include soil textural characteristics and the depth at whic significant changes occur. Be sure to include depth where mottling or impermeable layers occ SOIL LOG #1 SOIL LOG #2 0-0/26"Type 2&4 fill V 0-8" Dark brown loamy medium sand 0/26-24/50"Medium sand and compact gravelly 8-52/60"Yellow brown medium sand with few inclusions mottled sandy loam of mas ' e clay loam (2-5"formations) . 24/50-r''e weakly cemented loamy fine sand • ,'oaf, 0"grey mottled fine sand (North side of pit) -33 I �` ' 0-3q •0-70'Yel ow bro�"n_fine sand (South side of pit) 334 U44)1'µ. . .�aA�4°'� �_ !�Anticipated water table n/a in. 5 1-4c0 Nil' Anticipated water tab /70a Roots to 24 inches _}. 1A Roots to inches Health Dept. Comments it4e9T1 a Health Dept. Caentetiny ex Soil Log 3 Soil Log 4 UUU 0-15/22"Yellow brown gravelly medium sand 0-5"dark brown gravelly loamy medium sand (maybe fill?) 5-34"Yellow brown medium sand 15/22-17/24" Dark brown medium sand 34-67+"Yellow brown gravelly medium sand 17/24-72+"Yellow brown gravelly medium sand 5-34"2 small inclusions mas 've clay loam , with some small inclusions of dark brown medium • some mottles s well L5 t/� "" QAagrA sand (about size of 1/2 dollar) ©-.3 ( ✓'y� Ic // t�� Anticipated water table n/a in. Anticipated water table n/a in. 3(+ 14/t'/ "4J Roo'it to 36 inches Roots to 24 inches Health Demmen s, 2 Health Dept. Comments SOIL LOG #5 ,b SOIL LOG #6 0 ItAv4 CIAM 4 `" Anticipated water table in. n/��Sg An ticipated water table in. Roots to inches NI 0 to inches Health Dept. Comments 5Y-E- &AI YV' Health Dept. Comments H: NFOHLTH\SOIL.FRM1/00 col � 1 AM C O J(S'" �C JN 3(° q0 r wo . v o N Z L0 r = ° v 05 ti O ,� C7 c p3 ° Nd � 5 u 0 N = to 1— W c a rt, n- •C .- fn e a a. 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