Loading...
HomeMy WebLinkAboutSEP2013-00116 Jefferson County Department of Community Development 621 Sheridan St., Port Townsend WA 98368, (360) 379-4450 SEPTIC PERMIT APPLICATION PROPERTY OWNER Ann Matsunami MAILING ADDRESS 1650 Liliha St., Suite 201 Honolulu,HI 96817 PHONE (808 )753-0737 SYSTEM DESIGNER: Michael S.Deeney Designer Phone#: ( 800 ) 395-7296 LEGAL DESCRIPTION: Section 13 Township 26 Range 2W PARCEL#963900023 Subdivision Name V.4 Surveys, P.69(Jackson Cove Park) Division Block Lot(s) 17 Site address/Directions to site 190 Bee Mill Rd., Brinnon,WA 98362 SOURCE OF SEWAGE/USE TYPE OF WORK WATER SOURCE Residential X New Tanks(s) only Private Residential ADU Modification Public X Commercial Expansion Cnmmiinity Upgrade Repair X SITE SIZE 11,713 sf SYSTEM TYPE Partial Repair- (tank) (drainfield) Previous Evaluation Conventional Designate Reserve Area Yes# tech review Alternative X Redesign No SYSTEM DETAILS Number of Gallons/day 240 Soil type 4 (attach soil eval.) Application Rate 0.6 gal./sq.ft./day Drainfield Length N.A. ft. Trench/Bed Width N.A. ft. Trench/Bed Depth N.A. in. Septic Tank size 1,000 gal. Pump Chamber size 1,000 gal. TYPE OF SYSTEM Glendon Biofilter M32 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 applicatio will be separately judged by the rules and laws in effect at that time. 174( //ii' I " j- S K3 Property Owner Signature Date FOR OFFICE USE ONLY {� / 1\�\ • PARTIAL �l ASBUILT I•0/N/e ti't�FINAL IQ/WC-CP ,t,'`a APPROVED / INSP/PUMP TEST1/,I, 7/!5_ eap,x.SVAX %VIjAtc 4\--/ ALL HOLD REQ. MET Dat�(1 z Fee3 Rec#/4 Check#m f - //Case#SEP C1 ata W�pvdu nty&Stat F (Jefferson\Septic/Permit F endons atsunami 963900023,Septic Peirnt�ti.wpd `� JEFFERSON COUNTY PUBLIC HEALTH 615 Sheridan Street •Port Townsend•Washington •98368 www.jefferson countyp ub licheatth.o rg one .1- : ax .1- •-, ON-SITE SEWAGE DISPOSAL PERMIT PERMIT #: SEP13-00116 Date Received: 10/08/13 SITE ADDRESS: 190 BEE MILL RD Date Issued: 12/04/13 BRINNON, WA 98320 Date Expires: 04/04/14 APPLICANT: ANN N MATSUNAMI TRSTE PHONE: A N MATSUNAMI REV LIV TRS 1650 LILIHA ST#201 HONOLULU HI 968173169 LEGAL DESCRIPTION: JACKSON COVE PARK LOT 17 PARCEL#: 963900023 Section: 13 Township: 26N Range: 02 W DESIGNER: MIKE DEENEY PHONE: (800)395-7296 CREATIVE DESIGN SOLUTIONS PO BOX 2787 PORT ANGELES WA 98362 SYSTEM DESCRIPTION: GLENDON BIOFILTER-M32 No. of Gallons per Day: 240 Type of work: REP Drainfield Trench Septic Tank Length: feet Width: 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 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.: SEP13-00116 1.) This permit was issued to correct a violation of WAC 246-272A for paving and building over a drainfield. The permit must be completed within 120 days of the date of issuance, may be extended due to wet soil conditions and if home remains vacant. 2.) H - Note the bentonite dam specifications on page 1 of 7 for the existing laterals 3.) H - Traffic barriers are required and must also divert stormwater away from the septic system. 4.) Divert all sources of drainage, including roof drains away from septic tank and drainfield area. 5.) H -An asbuilt drawing and certification of completion by the designer is required prior to final approval. 6.) Contact designer prior to installation for staking of drainfield area. 7.) This site has been granted a waiver from the state onsite sewage regulation 246-272A- for reduced setbacks to surface water and a building foundation. Compliance with conditions of the waiver is required. 8.) 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. 9.) 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. 10.) 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 11.) This system must be constructed by an installer certified by the Jefferson County Public Health Department per state code WAC246-272A-0250. 12.) This site has been granted a waiver from the state onsite sewage regulation 246-272A-.0210. Future approvals and compliance with conditions of the waiver is required. 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.) Health Dept. required to observe pressure test with system designer when system fully installed/complete, 48 hours notice to be provided for scheduling. 15.) 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. 16.) Notification of the start of construction shall be faxed or emailed to Jefferson County Public Health ONE WORKING DAY prior to start. 17.) 10' separation required between a Water line and all portions of the onsite sewage system; effluent transport line, tanks, treatment and disposal components. 18.) Dry season installation required. 19.) 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. SEP13-00116 Page 2 of 3 \\tidemark\data\forms\F_S EP_Perm itmod.rpt 12/4/2013 20.) 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. 21.) The site plan as submitted with the septic repair application on October 29, 2013 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 October 29, 2013 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 22.) Approval/issuance of a sewage disposal permit does not guarantee the approval of other development or a building permit on this site. Compliance with other Jefferson County and Washington State Codes is required. 23.) 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. 24.) This approval is for a septic repair 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. 25.) Jefferson County determined that this proposal is categorically exempt from review under the State Environmental Policy Act (SEPA) pursuant to WAC 197-11-800(2)(d). 26.) The project was reviewed and approved as a Shoreline Exemption under JCC 18.25.090 (5). SEP13-00116 Page 3 of 3 \\tidemark\data\forms\F_SEP_Perm itmod.rpt 12/4/2013 JEFFERSON COUNTY PUBLIC HEALTH, 615 SHERIDAN, PORT TOWNSENrD WA 98368 CONSTRUCTION INSPECTION REPORT For RECORD DRAWING O0- 19 pepper 201x Designer /14/C.i/-`4c'G Paihtirt P / 3-,c9 9//moi Installer s/-,✓r�fi; lz 3 S `/ \v/c5 Parcel # sf 'ti 0 Q 23 Electrician Design Flow Property Owner ,4NA" /-t 7.50.A7..4A1 / Site Address / qa B Ee /'z/ t r . 1 / �' /' ! ( /4 ZO Answer all questions or indicate NA Tanks, Pumps and Controls Date Insp. Tank (manufacturer, size, baffles) ®®G 64e, 7c'ca/4',v';'; W✓ /IF L1S-?44?-17-1-e- g--,rS Pump chamber (manufacturer, size)/az, -78-! 5- Screen(s)and/or Screen(s)and/or Pump Shroud (type, location) PU/4-7i-' Vi40/7- v+il3ioy'1�13,g ,/G7'", 9-/B-15 Were Tanks tested onsite for water tightness? Yes / No Panel Model "/Q4'41A/e X /PG-sb Timer Model ,4454.1"9"/ X Pump 1 - Man./Model o .1'/ve- S--// Flow Rate / �� gpm Pump Location (i.e. garage, treatment unit, basement) Bottom of transducer to bottom of tank Float settings (above bottom of tank) / transducer settings Timer Functions: (above bottom of transducer) On/off - o, 9 " On - Veto - z e a" Off- / Alarm - Z I, r`` Veto On - €� Storage Above High Water Alarm 3 29 gal. Veto Off- / 6-ice SS-re C Dose Counter Reading t Z bc'sE <6 v.t>tose ' # gallons/dose 1. cbG Elap. Time Meter Reading /2/-".c /7ser-c Pump Throttled? YesCN-o) Dose Drawdown (in inches) D. / Pump 2 - Man./Model Flow Rate gpm Pump Location (i.e. garage, treatment unit, basement) Bottom of transducer to bottom of tank Float settings (above bottom of tank) / transducer settings Timer Functions: (above bottom of transducer) On/off - On - Veto - Off - Alarm - Veto On - Storage Above High Water Alarm gal. Veto Off - Dose Counter Reading # gallons/dose Elap. Time Meter Reading Pump Throttled? Yes / No Dose Drawdown (in inches) If additional pumps complete this info for each C:\Data\Wpw\County&State Forms\Jefferson\Construction Reports\Alternative sys ASBUILT 2010-2.FRM.wpd 07/14/15 page 1 of 2 %'''46 Pre-Treatment Date Insp Sandfilter basin high water alarm shuts down pump to Sandfilter Yes / No <,; Sandfilter Basin size/location Sand Fill met design spec? Yes / No ��e' /-?/27,ersr. ATU (manufacturer, model) Alarm tested :Yep/ No Disinfection Unit (manufacturer, type, model) Independent Alar'rii'. Yes / No Drainfield Transport Pipe Size/Sch. / Scfi` �O Manifold Size/Sch. Orifice Diameter Lateral Size/Sch. Barrier Material Cover Material/Depth Residual Head (lat.# & ft. Head) Source/Manufacturer of Drainrock/Gravelless chambers Drainrock Clean? Yes / No If no, what action taken? Mound/Glendon Site Prep. Drainfield Length _ft Width ft Depth inches Caps for measuring residual head stored (location) COMMENTS (inspection notes, changes from design or deficiencies in installation) Attach additional sheet(s) if necessary Other Aquaworx panel settings: SWarn at , ZBios at c , Autoclear set at 28 doses min-sec. & t / 'e L LrG P/?/c/2 }p /A/. c}-fit,"/ ,'c��i<«T> ,2!®h o //v -lc) , z /-T idse.,ri2 Health Department Inspection issues resolved CS-re-i) No / NA If yes how? T2- A /c re,/-2r--7 S/per c l:-'/ L37 Ai Co /A.1-C7',5f G.eL)e Z 3wwSF'l�l�l 5 v /2?-- ,c ,I 6s .et•Ai �g Users Manual Provided to Homeowner w/ ` R,E -o '- w/Ae Date Tank/component Decommissioning Report Attache• No / NA Installer Certification attached/signed Ces No ATTACH RECORD DRAWING stamped/signed by Designer or Licensed Professional Engineer I certify the information provided above was verified by inspection (with exceptions as noted, if any). I also certify that this on-site system was installed in accordance with the approved design and verified through periodic observations of construction such as site plowing for mounds, pressure testing with all system components exposed (no backfill, except over transport pipes), and final inspection of the completed system (with exceptions as noted, if any). To the extent revealed by these periodic inspections, the system complies with all the conditions noted in the permit as approved by Jefferson County /2-4Z--!3 (Permit Approval Date) or that changes have been noted and the system is in compliance with WAC 246-272. /0-lG --/5„ 5100110 Designer Signature Date License # C:\Data\Wpw\County&State Forms\Jefferson\Construction Reports\Alternative sys ASBUILT 2010-2.FRM.wpd 07/14/15 page 2 of 2 2 m Oa Q ri > < n �.°o- Nilliirr Z D m-, z � \ 6-.) o Z Cr) 0)0 8y v/ N. s's Cp Z '\' N — � ow3 \ I I / -O / a o —� R. okik.. / cn z z ` .. n� Ns mRI+o N. 01-05 ,o Pi x i t� -i= m 8, �qj!�r� ___>< �� o ��R1vr ,,-"F-11, .. Fq�%_L- C-) o '`1 iO y fl s w /. ', // / / ♦° o -�� � zr6i41/1'"' ♦ II S� 6,0 • O j',///11.W H//// `�' / ,� O v 2k 0rri min -000Z ' y W W ------,1,_ 1,1 O p--.1. / mon T:1>C I z�� " ' f --loo' I I yl Cot''''''N n,ci vxx I a 0 At. �, �. (� i , I32 G � �rx'lCA I �o L ` rrl o `� jaJR° O. x . a ?..< nim G") zv �U' °7° o I ac, a z I �� _o II N 0 I � --J 0 t-) C> CD I I -, I I , c CO 0 CO IPCr'--2. ,\" " -I eCO i ` C3 1 �O , rO _ ti foV 1 . L - - i CAI \ ii (., _ _ _ _ - - - -I - - - - _- L - - I i , ...� 0 v1LCr O v 1 0z��V 33 v i � m o �o I ) ,, I A 2 - Z n1 �IV O ti O Z omoQ oc�� rrn WQom� r I x r �IZ A �� i°CI m m0 i 1\ 1 o z inina �ul � o Q Q) rn Z zrl nzc) mmv o� �nDo� Zov � 9 mro0 Z]>)J m�z om I F,-) I Ix �x D (771 II o 1 zZ,= Qoo ^ o 0 �1 ',1 x 1,1 r 44r1: j nA 37 Z nICv prom .. 2 � im x O IZ� om z xyOIro� atI�noQ o� I m�aN ,zI azo 0INJ��, . Z co-0,0, ,,,„1 A I Cm I nzCxI — k1 m� n�Zo I mr- ymzop �Q ' �AINIIN r 0 I z�0 n, I x �= pr�OI xc0mao 2-1 Crri\*"..... In9m -,0 b R.7v, o -, . 0 ....................L a °v00 , .. 17) 0 45Sgx �rn dvy 4) .2. M0) CD 67- �,.e 1,; 'tea '/A� COm y VI x cn r• cn fp 1111 a n 3 w n G> 9'y®n I m O�y V1 C)'C �� 1 --,---> O m r cma� Z 0) z �� \ Oce-`namo �� n -,• =omar Z CD m C •• . I =oi o =� o� CO �n -< CD nom CN Ong 7 O N \ �ry2 n�Z� y Co Z -- 00l \ p• Oc -<Zt MZO rc o r n N v XI Opo N. m 2 t+1 o T p p ri D < n .o ` k m m N ��o m nm 0A�cn Z p ), cn2k �c� rrl Z rrl ,c..:&,' �b 0 -<mp�'Ol O 1.CA rl NI r- o icn o r C4 D Z N —4 y y y y y y O Ill ri w \, C) w� k 0M 0 �3 y m�Cii Zv D O no --,.- r.,� rr1 Z 1 � � 0 � m I �m D 0 pn bb m-0 Or v 0) NO (R. I I ?� o g I i 2p C71 p b O �� OI rx�n Om � q (,)m(� b Cos ,,,.., Ix c , mO11n1 ?mz IV jfr„''(:) n ba2 �� o (1 p~ b�r NO CD n II I ll MI �O � m km Dy — M �� I 4_ bm bm n0 0 OC 0 C �/I� r � c, z o 2` �+i�_ 2n2lT 0p0Z� QN�� O r-bt0 2- SC��� X�r 41-61.1,- oo 00 y �� � Z 2oa= y OCn/ n x riA Oz m I O3�m A Sr � o� ' IammAFiQ � r- Aoo / NOz r` V. I v J ----1 ." v1 co 0 m 0 .� %%//I///, r I ti w IV Cry x`53 Z yI,!/, , I Sys j%//1r.. `�� 13.0' - 2'I � I / �j/d/� '` � O 0 2 rrl 0 kiN I 2° • I r c N O r m 1 I �0 I- CO n z I III 0c00 zz 0x m � I 1II 5i 0 OtiO A C NC�C 13. I I Onmn ti O�z--1O omm /Ozmzk z • •I 0 m v / 1v �m , Opa �I z \ _� ry�z`A CD� m ' II: 1 . z t lOn N bzA.0 o me ��l 0n L > n �0�0 Aai2c _ _� 7 1a ! �zi -,00 ^ Iboa + z�oo0 � n , \ 112x nl2� t �nInI 10 no �a ` . — — ---J t O � n 2 n � 0 -----;.- 6- 2 07CbCa o �z0no 0 n �qoo x )0 r -0 - n2 ' 33 M 0 oc0 -I 0�oz / o� R°b 0mD n F-1. po~ �z° � m xoQai 2bbn0ry � 01 � cn Iom A2 O mnnm m7:-..` � OZ oCo � Tin � 2avz 2p � �'l 20cO � nI2A ` z � go a �ab0b2CO C0Z Y1o o00b0OD0 O ro p ,m m C hl xz o 2� zbn r,„r-1 z zZ=p �z' o0 � AnOoO OAN m C4 bm �-r0 r' oyzpbmbO°c) o � z bb -., m m 20 /2� nACAzo pIZ ~ � _ \bCz'- oi � " � O ' < CIx L zAz 020 0 Z Zrvm 1 m A-0 Iry�o o n,nnO p2 q) zn nn N cnb=2cnr"m,,zz z,-imCl - mb 0 On bt0 x ownm� Im20 C'Tm O 0 no2 �b11 p2 ? °bt2mbac -0ucn � � Al oo,m2 •Cm_ ' CO y AL Do ril rilb0 tro co ncnocmo0Cno C'-2i�20 Yn p on b z azo / yo z��Dok��mo �Znoom z �z -1I x 20 � INIANk7N' �AooOo"1Zo )1 21=2zzp I c ba Cl) bni(4m). (nbi "I Or0,bb1. 0 b0 m 0 C x 2b 4%,780, ' 4--,n1-0'0)0° 1---412- -IC) < N2mn C) p � �a�r-2 CUn vtpn b - iesz? O manc• oo , o cio ' o 2brn0Z'-t`n Ifiz mn C b7C] mOx r'lx n" Oz - , 0 �y �-.m ocn 2o ! ' Co 23 CO o to h . x -oci , iuiii sc 0 0 TI CO ■Ifb mrT1y ' —Oif v OI O '1 r `QoO ^ ryvOnO = Zv� A �C - ' CD A„,,,A„,,,(o V � oa =n ,n � co I x Z , -0C) - � 2Z m a -0n fi„°CIA mOpmOu) z Oy � 0 a) mCDcANc A y tZ)m �0nym3, bbb ,� r� A. C z Wn2 y�' Si) -i 10 rmi�c-) z0 I o kpb n �� � x , ^ A m m yesa k ..,+ ; �bm0CO < -DD 'CC1bOyy 2 b � ,'r = -Opmi2r .2 O rel 0Cin 46,,” Cr' Ca Onzm prOn k 2mCO Po Nb z ti 1,, '" Q ~� O~ ? b n � no' � 2 mr2 rn n Zb c)r ~ o c �= ZCO 11 � znb b�CiT � --o 1:. �n c)n o CD nmm r, O b m W ri -m= CD znTC A 111 m� a o00mb�c,ao� o C coOry ` m O m Cb 'i � � m\ b Co x (4 rrin ok b�0 f 01 r--.-1 0_ �2 COm co m C) 2 I R, x aT _ ri > < n F.o r in )32,om z o a'1 cn2k m z °; �� rl -. O p ),v (n C4 a Z w ti 4 w v v w v rl (44 `'a — Si) ' v o c - m � z � v�1 Y) o v> m nz kt) N3 E cn og I - 6^ o I (i)(1 I x E o lJA_`1� � m� I I O t ' I , Ii______„, I 1..n\ • E iTe-%..., 20 I YJ x� m = Cyq�p4.0"....„0.,!, I Orl' ' Iin • mcg 70 V z a s ��� ry o E rTi C. 1 r Q -03m Z -‘,:i..44/1. \ r --I E cr • ///i// ...44 ,,, I I I E 7__,_+ -, CJ rte- s i .)1 C") I • I E l 1 1 : { I I I 0 I I ;t I 1 E C jV�� i I I X 10.4' I iV:.%3 33•..3., 3,3.'f'3.3..3'.'.: :::::' .l.3.3."'.::.:.:::;.3:.3;•'s3 3:.:',3::if.',:..:3.:1 '.1',I',.3:::...'.3 33.......:A......3. ,y t O I , i I O • i K E 0 • SOie IV I I G.I I I I x L I E I �ti 1 0 \ 1 x c;' �.. s ,-- J E v t A. Ix g O ' ' � I x Z � I � 0v .. ,n x E -■ 7.8' 0 _ m r- 0 �__ 0, �o x E (1-74 ��62° v Iv i 0 13.7' C(( x Ka O ?a E , OCO o 1 x \ze„,,, ner) t rrir- 1/4 +a111 \(�Wr 1*. x 'I V-... V E ciD 0 I O x I.n io N)y � �c V - •-o v v 4'7 l Q1 m y co 1'Ci ��, :.a �� mG) Y Ix Z n n r = In /� y V/ r C) � c• m o0oo co I I O N x y Q o C7 I x 1,9 ce CERTIFICATION OF PERF PIPE AND DRAINROCK REMOV ors -0,, � l�` (i", '1/74, �a�th Company Certifying Abandonment: R.J. Services Phone: (360)457-1420 Site Address: 190 Bee Mill Rd., Brinnon, WA 98320 Parcel Number: 963900023 Abandonment as required in SEP13-00116 I certify that the existing perf pipe and drainrock was removed and backfill placed as specified in the plans approved under SEP13-00116. Additionally, the existing d-box was destroyed. cam-- — Lvi S_ Signature Date 11V\ \rte Print Name C:\Data\WpwiConsirochon1Certificafions\Abandon Ex.DF Line,Bentonite\Matsunami,963900023,Certification of Pert Pipe&Drainrock Removal wpd 6:),,$>1 CERTIFICATION OF PERF PIPE AND DRAINROCK REMOVAIoorso ��Oj5 �e'it/o(/nty h%�j�h Company Certifying Abandonment: R.J. Services Phone: (360) 457-1420 Site Address: 190 Bee Mill Rd., Brinnon, WA 98320 Parcel Number: 963900023 Abandonment as required in SEP13-00116 I certify that the existing perf pipe and drainrock was removed and backfill placed as specified in the plans approved under SEP13-00116. Olnit -23 -7 " Signature Date Print Name C\Data\Wpw\Construction\CertificationslAbantlon Ex.DF Line,Bentonite\Matsunami,963900023,Certification of Perf Plpe 8 Drainrock Removal.wpo 'PA\ CERTIFICATION OF RELOCATION OF WATER LIId �°* d� ®% C `O,3 i tied/6,"'e:/- oai Company Certifying Crossing: R.J. Services Phone: (360) 457-1420 Site Address: 190 Bee Mill Rd., Brinnon, WA 98320 Parcel Number: 963900023 Stream crossing as approved under SEP13-00116 I certify that the water lines reflected on the plans approved under SEP13-00116 have been relocated to 10 feet minimum away from all septic system components except at follows: 4 P a sG°fit F �✓ r 6 rem t t taro L 0-3 Signature Date Print Name c1Data\WpwlConslruclion Certifications\Water-Sewer Xing&proximity&capping old Imes\Malsunami.963900023.Certification of Water 10'from Septic Components wpd "It• !?<® F' ..i Obis CERTIFICATION OF SEPTIC TANK ABANDONMENT/a, d',Q =.. '5,00;').; Company Certifying Abandonment: R.J. Services Phone: (360)457-1420 Site Address: 190 Bee Mill Rd., Brinnon, WA 98320 Parcel Number: 963900023 Abandonment as required in SEP13-00116 I certify that the approximate 750 to 1,000 gallon septic tank for the above referenced site has been abandoned to Washington State and Jefferson County requirements. See also, attached pumper's receipt. a 4._ °�--- zi Signature Date f.. - J _/ c e.. (..c..�-- Priname A COPY OF THE PUMPERS RECEIPT MUST BE ATTACHED TO THIS FORM C:\Data\Wpw\Construction\Ce,fcations1ST Abandonment\Matsunami,963900023.Certification of Septic Tank Abandonment.wpd . 04/23/15 9:51 AM GOODMAN SEPTIC SERVICES 3604575596 :ge 1 , 0 REC&VEL Septic Services OCT 19 2 P.O.1Doz 208 Jeffers Port Angeles,WA 98362 Er►Vir Orr CO (360)457-5596*(36o)385-2357* (800)974-2597 c�rtmOntc�i "YOU'RE#i fN OUR BZ BUSINESSI" c" ( rORDER N0. PHONE 45 7 _ 114 ac) _ T 1 r_`oi ADDRESS ., ) CITY,STATE, IP jz i, 't'lil SOLD BY CASH C.O.D. Clin) RGE ON ACCT MDSE PAID OUT QuAN. DI_SCRII'EREM 'IUN PRICE AMOUNT 1 2 X Pt,.WY10., 1 /.1 1_5 p X S-4.4 - O i 4 5 6 7 8 9 1 CP1:171.\ )E. ,SENi.b ('19�Z Fi r , i`ifil.((-Pi=:Rinnk)rAx di Enii LE TOTALT RECEIVED BY TANK LOCATION/SIZE: r"Rc I wioic.E.- 106 57- q7a)-4- A r+is . E rMsE. TAv> i..E AS PLEASE PAY FROM THIS INVOICE TERMS ON REVERSE 1 II \ II/ z1. N ,C rri Q• \ N Y I o ao 6 v0 -6 cr) ,,,,L. cfeN s(< / Pi o to — !,-) oho N /I -,13 � �� m NI z o X / Z / �o K a / -� c� I m n 2p 4�/"�---i- I C , Pit c F �o � = gsx � ),k tm w m ry x z, • z co No m / N I o V` • • �jl///iii 69 t� r....---.1 I I �� 100' 1,1 o t QI ax ''r--------„ ...... i rn 1 _ l v"'i� -Db.- --V r R p (--, I FS I o0 x c �� N ,)„ r— fit' 2 111 I % t,os"ore/1* p, !? g 1; i I I 1..03 �O - 0 io 2 \ 1..- "-< r / 1 ` T (0 �� -- -- — 1 r I •.I rri rrt �� - - - j � 1 I �� ii R 78.0' , S _.—I 4 *\ _ i P ' x 'v % \ ti 1 1 .I1 L. ()%1 \ 1 ``� O L -- - — ---- / I e :....... ......' 21Z� �`: - - -I- � I � I � 0gyp'' .. o -I - - - - Q �'s 0 j�1 1... _ CD 20) 1 1 \ a.• � ` ate, • I [ • t3 0.-0,,— t I of 1 ) o �" dU, I xI 83 II rn m CD C) r 1 iv `2' �� 9 I I0';'' i , O� II Ix rTi,z13 r- rli O I �� I �� [ (Th C �ni 2 ? k I O Ix 1 ric) I r 0 IL \ x Ix I _ c,, I m ,¢ �, OD ID XI— --X �,..., -0 0, � —�—� \''-'.....""••••.........s � s x 2> X o'�� w Ox'C 4558 0 1� N I rn yL ori ..�... x 2. v v _...�-... 'w► 130.45 • m y CO 01 M� I aca .- Z L cam 0 O 2 to g Z .w a a o �•Zl"` ,� ILZI c-> z :3 r i I cno\rlyam C"' Com Co CO C) C �� I °O np�O C� < � ••••• 0 ao�0QDzo cti 0 N y Q 001 \ 0�2 a� o 0 0 x, 3 0,, *"- . m D < n .m 2„. r- � v m� nrati n ZON � r2o om \ n2x / ;41 C. -13 r_ O��It -e 0 Oao vo D rn Rl N '' n rrl ,w ocoawz Z C) 0 m- 2ar'a 7C -�y V V V V V y ¢ V 2 �U [0rrcn�r V V y V rrl rrl 0200iv 1 p 2 r rr ram O 1 fc, Tic 0 2 O O a n Z �IN�� 2 O� Cb o �2ca,)0 M In 0 Cg C v ^� Cl 0 o `"" oce 0 GI co I In_ 2cn � ap c,.., c) no O-r. n CO oIn� d w � � �ao on o I )D iii Ozej y� ���!�� Nom' �� �r- z1 o a0 o • ' I (y_� x ims = `•�'4,p,470,-;.:,.� I cCy [t1j r� (r)--.1.19 cn m a n k ` J Z a 'ii ii��� f't yr; r�Oj (1)(4); n la N n I-- - y w\� grFR O G7 0 �� Ao �o `� I rn2 T o z cbkm v Z. , . ay ///1♦ oO o �0 2 u �o �� 1 c . In Z RI rli ) zR -CSI .rN/////iks/s� o o �" g 2ifC -I 1 i ) 1'` m \ IIti PLI 13.0' Z 1 _ 12 I 11x c0 Lc N‹ • 1rn ti °�z� J 0 o o i � o I o m� / o \\ 2 1 o " ITI 0`n I Cr) • 1 o / \ x t 1 rC -' t O I I h WIA 11 illk," j 5iitH IN. (n 1. fW I I i .... „ \ 1 (0 0 0 r1 13.7'-...--1 � I o onL _<20 I p 2In cri 2> S1 / rl rF ` t / c)Z 0 QQ r C,� �5 I p/94p---2(1. _ - Ing a �0� 20,cIx Z �42nj0 k y -C coo t mI Q �^ri2r�2po / � n(((��� g= ` m e 1��212' xO � zC11v oak �-0 16p p9L co1. 1. --< ((7�17LC! '-any I r�a k o t — J1— _o } �-2c) ��;2a 0i0 \Na ry-0 2�� Opo ��A / _ N�Om* \mak7 O0rn^1C �6z cNcn� ( k0 O m� o Oen Z% �o? O� -0v)a �0 5. x n O 0O �n� • O o Z...1 O 2= O1.�k MIN. �MlN.� p m 2 -10- O m r 1 0 O o 0 0 O a p 2 2pi 1. c(ncan�t moa 1 r".c 0rn 2mry 0 oa �Zo0 �k is 2.c�� �o� ...,10 6-. 0~ -I N kp 022 aZ x C c2n 2 O\'acn r�2 ? C0 a -n 2 2 t��, a n Z n o r'l '1 cn n^l r rn c)0 n t 3 l' - OrI�O -n ao rl 000 2r'1r - r m c2i�0�0 a�o r� ti x --I XI a 2. -(74 �1.2r�1� vI 20 OOO y a�� =��.�2C x r---I p O - c) .*' o O� r'1m� 202 Aa 0(a 0 �r O I z=mo � I �0� =a a �� � � � a r� r N oA �' 2? �0o oo�o x try 2 E.."-.N I 0 0 p 2 ) y n0 r0 2110 0130 2� 2 �y=0 O (/� ��n �0-0 2- x a D .. 1,._,(,, .... : ,13 m rli -I-0 8 f‘Nt r-2. Rl Z 21.=o1. m�. 2 likruir c)co \I 2nc2n Fp Rl c)0: u)2 A '^ v ' t N �O 1p r r T ti2ti� ti ti r - nim ^��O c o ZOZn � 'O a O Z0-r- vAinC o ' 0 � v CO m �0110 Of C) 0 2 2�r oaf �(,) X a o 0 m0 �_ ccj�rrn0 ZO \ � i1. O or 0 CO� m N o� I/ '��� � e �� o a O o v 2 2 r0 Ci Ln 0 I)2. t�2 N 4,N\qa D ^ O c�� 2 G.) CO 'C n rVf� 3c. �� ' rn y2 my, � a0/ �� a�� 0X xZ 'f�a�o�d3$ 0'a t+S 145•9 r2. �+ r'l Fc 1-11 z y O ,l r � 4 21-----...:x cCO" V r30 m a CO CO 0 �_ 1 S' r7 r 0 =▪ "VNO IL. Ok m� �� 1X n Cl) x U) 72 X XI m Ooii a )o m > < n �.m 1.71 • --1 Z O m •• Z O, ..: ry co --- 4. SEAL WITH BENTONITE o I III p(no ")� / III oc rw • t. ��%%I�I l ills / 4% pi , III Vrti cc)0 Loc I II Co co o r^ ^ O ' TTTTTTTTTTTTTTTTTTTT D O 3 O — ° [...., 8" rIII : ivZ:4IIIo C - . w ACn ` C) ' ^— ` ) .: II \ J . ac � pi y �2n o 0rn a�f my2 • 0 �yay`2o II � R1 arm ti � a�oo� II Z \Z J' rn'10 2 ..' n 2 I I Q Z LIQUID LEVEL i 0 2 I C 2o�g 309 TO 409 OF "n2ar-0to II p 2 oil \ •. LIQUID LEVEL o a�C 0 mra p Z \ �cp O ��� II • L — 2p"00 1"0 -� \ r--.. T m 2 i y TT `ln \ Q 2 h <. 70 88 ZT' .�/ o y 0 0 II\; 0 m-- O TTTTTTJTTTTTTTTTTTT'9. 1. ...ID6'n -02" rn 0 � C I • • oa� I, � II <' o�0 ,a� \_. � 9 �?a ' i Op rnOv 2 \ aCr --m ��r- crri I . , o SEE "TANK DEPTH ar lay ir 0�r� NOTE" ON SITE PLAN OR SITE PLAN DETAIL V o„1a [ \rn 1�X awq — II ir- ji q ri SEAL WITHBENTONITE 0 +� m Ss�ayi�. — �� \I to ���,/////// J I.; ao ••• '6 0,/ 1 III II ` 2 r nw� AW III --��.- Zc ti : �111 � I22�'c � • () rima' Ill s z 2,,,)-r71....,:, a y 00, — Z '�m ,Q1 ilt ' 2O �y�,tCr- 0 � -$ o — - o C) Z �2am� ooc 2 cnoA2 � o m m `nQ IIIoao _ m 3'‘. 1) -i 0 —/ � Zo �42, Z1 2 Voll p0 ,„D,-,i; `) —o � v � mo -I � o 20 0200100 m o\ 00 2F+" y wo o� o oA� oy wm Cy C1 w \ o T III ®' 0 --, r c, ,_ -III-II -III-III- II-III 1 -III = p 0, �� U1 °' (� S III (D o �,' A 22 III ' . 2.. ` 4 z rr ^' n ra ...r...........1 I.III f �V---<1:)` '+ H �• rOdP Vly 2 2m x of'� r . N O cm(r)mvi yrmo ` III==oa o IIIm y2 2 cv> o 0 12" o o 1. m ZS N� 7 iim 4".--C 6" o r� to NO m 02� m0 � " tm< Zi \ Am2 m �, m m Z i 0 24" MIN. n mo ami j — o 0 0 0 2~ C.- I/ III n 4, zCpv 2 �11 r-m� = 0 iam m gy=m (3N Urn 't3 .;zA2� HJ � ! !IP! 22 �p rt� — 2 cry � 0 CD �a2 �y,�a-oQR �n om �ao� III as ..; 0 o A2\a`"2e�o fila n= v,�o� III r = Cl) 2r"i'-0 ��`ymy Om2 --, ' c •,,,1•• _= = R -I ,.O n)mi 2m20),.e. .F,O� mz�,.i� mat III � Z� r �vm 1.3 W�'o�c2i0 0 a2 k2� III o m e "' �' o a 20~ — cnao C �o�ooymo - 2Lo a ti = < `rn o -,2�x�A��o ,� of o III C N O m0 Cr'lUl n A .. 2 df m o y Z-- .. y o°0D rr, > < n .T 7, (n Z csr �j n SEE "GENERAL CONSTRUCTION �' n v NOTES" FOR PVC THROUGH m 43= a 0 t 01 pow O- [Ti�� CONCRETE WALLS. ALSO BENTON E. o III a 1-2 �v � • 'off %�/ I �\ �•rritiO� �m Vrrl 2 oo �� r�� .441j1�11 Iii/j14 1,0 �l �� I\I \ ,--c)�$k0 \ 33 0 r O 0 2-0 • : w• . . . ►.r ; Via . .. \\ (.0 rr 10 II iA v C a ni j 1 �mooA 1 22 !., t.�� 2 0 Q K o No - 1 ti • SEE "TANK DEPTH N m NOTE" ON SITE PLAN OV (.a �', , :- OR SITE PLAN DETAIL II ry \•.: 1• • � -12a 2n \\I : Ci rn rri p - ° " /� 0 � • C iii a �o Ill III III �jC � oo o 1. mk fa Z0ma2 0 0� ) � ON co ,"' a � °vso2 �o 0 ~ ' m '- S °� ' � 1)t °J FO C) kr' ttU�, (r)CZ) = O � . ONN �2 .• O (I) 02�Zn � 2 c 0 r- 0 yC� QJ, �§ • r ��� Onl�°� � z0 �� =O �' 0'ioo .16020 7.,. 0a t1 �rC cnz O � I ���n r 1.O �� �O 11111 �IZ(T41 nl Z�� 2 �� eC2 n �� W w� A � .i�� ? om� yy � �2 hII • ;- � r 1,1 `c,13,-., ~ C ~ in CODo 0 � 1. ��( ) Co y t \. • • Al'. - o-0a ; •••C O .1:a i P - ' y . 11111111 llhil ' ' I 2° o \ I ON �� aa 2~1 0 : Za ' i •\ . p �' l0x <� _ .01 1.136 • U I On 11 . ., IllNM --....--1 Z S.r in P- iR� III �_ oho L :;. �Z - •n ?Aa e '�' � •p IIII \ � � � O _ j �. �, i ti IIII © u _ 20.0" ° — •,:„-._ 44 4 i . i ,.. I / Om 1.00 * .r- cn O� O� ti �, o $ C r., z cn g y p. ,F. A z zaQ -� No z �� ° �� u. �� 2 * -0 z C Z~? r'1. t O m ' y %' A 0 • ac.) cin '0 ;rte c ,.� O 2 RII -, oZS n R. ..i 11 II ® Cs7 O °N2 r` ?l O D ,C �lC ~ �O t Li rCO 0 ^Io ru b NI "C1 Q r1 � r n� 'o r-'43 N....1. 2 cn ° mO \ o � �r- 2 22 a 1.-1. CD O �, r t 1.- 0 2 N 2 2 2 0 co gym to P•—• rtO ci °r v (n -,,•-, U!*l O O U 0 c� O Z b g Q I I I I b� ��y-2,�am 2 _�� A ,c.„r,ej, y 1.O Oa 00 P arn�� '. C2 2� c gl`nO ,-*R02 '' 1)� pi n Q `cA °0 °: too! �a �Oa cn i� anir•�-0 r� �� C� �CO �� i���'''' �2 Ay�a �'°T 2 2 iO� y_�2PRo 0� 22 � Coiv 0 6 \ ry y -\ t - Oaf I r',O 13 2 W-- Z N 1:).'1 Ds. >c m�,_- n �rFw�'�% o� a ° o°Oap NI c crii NI_..., 2��y� "r °� o 02--r -0� m mCO �t z > s�`9r6r(��'� �, i t 1. Q 2 0 N o 0 a A)01 t 0 0 z NI a m r-y war 3\wm �O c pt') t�� �, �"2^�o�''a"'a �° zo ov B \mr ol �'= 2 y °r 1-C°8°° -0O m o n,c"OO�^ic-,2 CE o op •stn o-I. "~'� rn 2 rn oa0�0 in k c(n ri -� 00�i02a can .CJ1 —Io. z) y ONO \ .�.:..._ 1\ �* 1) 0 c °p2aa a 'n 0 O c)�{`trp+t,~2 OC �O E2 yV/ m •:- L j%1111/' c, c r r ° 2 p�,i ~ ,°° �01 RI°, °0 2 °c� � � ^ \ Z N//� �� cn OOH°� 2~ r+, r` =2�Kcn�Oy� O'� 1.2 m Li) \ R1 6 /i.• -, -, n r0ZA t-y O toa nt 2 a a z k �� m .� yg*• 1111 �r� i g a to ° OC2��=p� y2a \ / C C C� �, O�� r0/ of >ff y /1111/ 1)� -0 -0 200NO ..2\r•► A O rnpZ01 2/3�-1.i Lo I cje ~ s c 9• ��/N1/ ...% 01. rn o ° 1) .° 4) (I)rn� 0 2 i 2''p O n t'''P n� c�r'j ti n -1 _0 — - a c c c y2�a� �`na �„z -,...i� ��� 2 °� m 0 . ^,t t t r` 2� • i A r �z �r0'1 a� � Zv C i oaf 'Fa s o 2�`n�'�oz�, r, �� °i pcnm n 2 y (n y �ti O 1) Al ,2 02,, n0 O ,z2 Co 0 i Or'12 O 2 (4(4 cr mrpC� 2 4.n) V> X1 m °a PI D< C"g F,rn n1 * y3,, -1 Z Z 7• 2 •17 t10� iso:•::;`::;.:r;:i.::`.;:;'::,::,-`;';: .:-.?::}}:ji:%.;r; ?.':`,': j`;;r:;}:.',•`:;':,';:•:`;`;'::}`',,:;:;'r:.,:;:;?;;';::'::.:'::`;'f:�.� I ) I~ o O ---) 3 :... w'}';;'r':;.::':`":•::�::::r}:r`r`;�r`.:;:,;� :�rr:�.''`'r::`i`r:>r:: :':r.}':;,;:,.::�::�r.:. t2 s, .,,.`..... . . ....... ..... r... .. ,:: :' r 4.31' ' 1 VvJ • • E ; '" : :i:.:•:•r?�`::`.` : :a ,;::; i:":f `: '' : ; 'f:":•`%' 7:;:;.'r`:•„;::':•`i;i'r:::j:ir::::r;•r` :':::.:1 r11 �.:;".”r`:r";::.;";'-:;:.:<:}•:`::.;`:}:;:;:; r:•` ':':rr. .�:.:'r::::.:;,.•;;':r;:r?:..r;.:•;°;:.;::::;;:;"r:;:;':;:`,`.. :'?.,-r`:::;}::.::::r,:r7?;:::::r:'r:° ::;� . rrl 2 p • • 7 O 2 ^, ' V m I: CO v1� n /`'� I:.,(r.;.`{ r:,•,.: ;`_,•; .•,.. .:' .:),;,...•. :``,{r:'`...::.:...... . •::.•...r".... ,: r;?'':'.. ?:';�....:.....: is'; .•.. ..•.•,' i)1 ` I • •'• i Cn� Z { V F: ;`.:::::::'::;`: ':`r?r .. `.::f::":' ::.:...:,..-2.,..•::.::...:-:........-....:,: r::.:, . :rr :::":.: :::::r :::.'r : :, ";:,(:`.:: : 0 OCD0�c22o�a '61.01 o « r- --1(1)Zi n(02 ar+� mm<r�0 2�a �C2 "0 ��Zi ZZ VI W0 22^� O - �mo�o�o2ce ��C 0m i 22rrj y --c - a2(3VtCcnrj4� (3~010 "0O a NI 2 a�C 221.2 �02� � '% o'1 �21-001i 22� 0'Cr O or�ll�y G) r O 4 0 �Inti0 �y<y� tir 2� t o �D1,2� pat 0, -)23 21-2 1.01 ----L --- k 01'c�- �4)2� p • 010 Z �'� a in m z ��„rll � Zr,�O 2~3�~ 2^1-1 (.n k 1 a�w o co (3�� 22 VI�cCo��m�rrn cn AI'l y” g3 y ��0 \2�iwo ��, �2 ti-,p r-nl r-cDy O a 'L 1 p H- !v 1. cn 4n VI n .13 C���clC Ow ti0 - 0 1 I 1=Na r�2� rr-p=Z a��r a cn� N 4 0!'t2 ter, vl��0O 43 40 rc G 1 A 1 .0.1 o Q -1n0 �oo� ri2 �-< rn a k �� o �� 2'10 Z- ^tCD 0 I U ti 0 P�� 2i��' `" Na I a mo�� 1. O r- m x'01 Oy k-"0.-7,..1Zr,-04 2m 6-n I O -.ZZN� C -- Q �.� -d rnp�atZ p I t -t 6-7 1 O rn tillie rr •cH 0 G7 1 i N t `vJ (-.10-.-1,1r1m Ill rri Z 4) co rTi 024 C/) ON's 80 41 we__ o2m ;) J o00 S/1� � Ill ID 2 I p2LO 40 S OD 2- li;'2 D F gsT�lots. 0 o o 2-s" = o mkm r a ��_ �o ca m 0\G 8 'f boa NI In 0 o' m x vs a k 1 m �/lei. o 001. CD r4 / �_ i a co(4 1. arc` c�a0 y �l m 1 I ��� wm � i1/ ill \_ y 00202 5,' CD W 1.o 2 t �0 i * 3 mo `� I m2?o a a .:,, In^� c� o r — V► II 00 1 �000�� n Fr �� _ 0r,r m t rnn~irn�rn 2=6- r rn w 1.'e ? '01 (--4- 1.-�� om e 6- 0 43 4Z) I o ���� CO o t 0 "1(4 0NII 4 0 �O Vr co O 1 rn otn o ' r V/ - / NI NI r- O cn v m boa M IP < 03 -1 Z O 1. Z o�� V 'C n- !U p )0 W V Sa VI A W IU Rl i` �ro ran , 32 ^c4hc 00a as 2ti cll. cl 3b1-.ti�� a n rw Ha�.�AwC Aa a n A Ornti Dp(n�a � 0202 a0 (.11.22 A.0--r- 2r 02 "(Jr- r 1.1.2202 r O •.a 1(.1201.,+1(,) .c r O Op) 022 A'1'.Or �i n 111 oc., ab3A„1 c'~lO �ti�r+1 COar br �n nr 2 2cpnZ0\n r n �� n3j;m\c�nCr nn r n AC MC DSc'~l�r 20.? rrrn AA rci,rcl 220 rA . ---i �n b ry C c1 n A Hn 1 ti v,A Av, n A n'. DAn con 2Gn 2nD '.cl ;n'i v, b D n'. DO r'. D a) 3c1-1a O r 3b.S rrr O n D c -,no ac1 c N tow Ai1-2 as aw 32 cnA AA '•r 2 1222 2 r ar a'+2AOba A 2 -. 2a ti 2 carr'.(,) 11 Tip nCr-1 r2 nr'. Aacn -1r -< rr k Ab n n 2r 2cnnoo n •'• n n c1r w-i� 2--12-1I- (n0•• clA A '. n-.1 -1 A2.-1 '-,ti D b w 1. .�10 A b 2V,SC\-1c1 2 A +,r rSA 021 n O o C•-.(,)1. c r 1.'-n .--.2a) 2 '-.'1 3 r32C'i r -4 a MN D A DMI n -4 b2 raa Dy3 r2<n A 201.'. pro clv, 2 wa Drorcl'. r a nA a) 32-1 a DA y a r -1n 2' r2 - r Dcic�.-1 n3 H2.ccn AAn 2 A -c-1 n n 3 2r 2 oo a 2wc ct,r n 2 A -1 nn p C ° -1 -40 na --0-n -1 a n'. n '. ti N N 3C >ctiAnr (la a •.tip '.0c-1 O .anA '.-1 A MW -1^•' N r3 C N ar0-, -1 H A2 D'.20br Mn (,) -1A -12A 2C-cn3 D -1Or3 "on C-,rn DAO r n r . --1 2�,02cn a ab r3nC cnr a '.A 2r AcnCA -I 1I 0 2r cn '•A nOb.. '.2 .cr Ma r �C-' n2 2 n rc CI-4W 2 00 ,.cn �1A.-1AO R1 Z Z !n ^S n'. r 2 '.A w ar 2r A �,�1cn D �a 3ruxan -1A 2b nA2 2nnA2 n•.a ba ,.Ac•)c) 2'.3 n tir b cn .V t cn rr O 2b 2C C D a r23rn r2r r DAC cn2a .� pr '� cn r\2 tor aro-it, Aw n nAr cl-1)22 c13 `C D N nrr 2� 2.c'ni0 aasn~1 2 2- 2OA r Saoi .I w 2 rti 2,-. 21.1.-.. oto CCM 2 ti Snr rr ~Li N. -I 0 -1Cw '-, br'.A N A O '. w N N '.r D pa c1-4'. cl c1A a 0-on AO K M Abn --1r r2n� rA'. A 30 ...4-4r0 2r r 2 tines 2 r 3 n1. rnAa Sr w� .n aI' D 1.2 02 3 (4-.4n0 N W� ti \( w -4c) N a Sno aaCc.12 n2A n A Mb rbr C A MM a 2\22s cnc� 2 1aDr A r�A 2rr2a Dcln cnw .-2 .Dv, c1 MM -, a n w \ a�, 2r ao w A••b L1 r'•r .. r c1 nn n2- 0 DA S O rcl n c3 cna n A2 r0 2b0 n3 n 0 cci2 ,2(.12r- C.� 3A rr2 2' cn r �A �r A r .n .r r Cl n010 TO, -c '- S -c 2 nn '• 2anr 3 r1. 2,02=~1 2n a ti Aa =N201 002 rr r11+1 D " ra a-, 32 D c.1'.2.K a r -Da.- 2O D--4--,~ !~lr r 2r2'1 r0 r 2Cb la 0 -r \r�NN A< 0 b Or n2b2� (�(/� o2w cnc AD�1 C r2 b3n 2 �w n3cn.. r'. 3 bb 2 Acn v Jv J 2,,,r n `,a 2 w cI \cl n •.1. nr ..ancny -1r '. QM nbn-1-1 rnr Ob 2Aa n S NN 2w r r- CI a c�122.K2D rr D n�, c�a2 2D A nA- 2 r r 2 • '.nrb OA a .b 112 r rK MQ-4M O�' I rr'i no a 1 b •2 DO rr CI r 'lr 23 r� KW r n hr A'.rn1 c�1 D .2 L3 r� 2b rn rac1A2 A 21. ti --,, r!� an A b r c.,1. c, aA 2 Oro r0 A 00 D'• -1S1a �n 3,. r ti a2 �,�.rtn 2 a rin3 A A =2 clr A.1. �r r n r w !`C -1 A cno'•a-, nb • 2 �n wr • ••1 rrc�r cl �b '•Aran r D D MM 2Onw r 2 S c c 2 Mb D w nn am S NM 2 i1 n 2 A 3\2 a • rrcn r 2M,:-.1A tiA n rw A . rrc4bKD b �, r na obcnAn • r� n0 b2V,1. D nbwrn n2 a2 n2 2 Ob An n� arra n', rcl C2 '� ti bnn� A�aArb z n 2C rAOcl O\ rnr (...).-.1. Ab D N. -..2 2 (,r' a r..rar 2 (40 aMCA `C) rrr 2� ..2r A r 2a .cin r orb 1. 1"--(.1 'n n A -1�1 AA rn O Aa OS Arr O• D !lr 2 •O�,r ry nn c,cl • 2 A A 0~-110 (4.-...-.1 -10 an A2 b n r -122r il'. n w Ar r 0 C(1 c.,32-4C -4n'• n wAIA -1c,1 L A cAa 2 bbnrar L nC err. . aa0 (4-1 r 0-4 C w S a2c) 00 r rb n n -,A A2 OM �� --)N2 • rcnA ba c1 w n,-.31 1'1-00 A m2 '•2ntorn3 A n nA •�, 12r r� r r y D 0-.1.-.N b r b r n c�3 .0 N 3 Dr 3 cn a (.1300bb P023 2 cl o cnba 3 a Aa r 1.-4'1a O wn n cn D br a K-Ar n -in '•01-102 201 -1 -I) Ob 2 2 3a b >c 2-CNS D 2 DA �clr0� b3� r r r nc� • -, r na r cl !MC An c1S A 2 n cn 2 A�2 ti w rw r � 2 a 3 c rr D 21, 2 ma 3 Ab 0-1 DDO(n D3?-4) a 1 O' I vi cr- N Oy CII T y'V J Da'lcla� n 30'7Awbb--1 C) n A �c A rAc- A r-201-22 0 apDAnan2 ti r c r Drr rbnrbn 2 23A. --1K0 ti r 3 ti NOM A "� 0 -42 1 '�n CA 2 . na•.ncl A 3..'> >c aNbc4 A baa3c,, (,) ^ (1nn- . n nn-. AA nnR, n NQ r ,_T�f Kc) bc�n -1 Mr-M-1C a0 02220(4 .•2r .. WON0 \ R�rcnan n SSp� r D022p� r 12.--,-0 ^ Nr-b0-40A b0.10 N0.--.(4N0.--.(431N-.10.c4a-.10 20-420-4r.-(4-4ccnI 200 w 00-101srrrr n cn - 22 = ar2nm a 22-12n-, a I =Ar...) v) wn0202C 0-12 22.2 ' . m tnno-co '. >c r .c a , 3Cn ror n '1'lror 2 i .r1. A 1� r2f n- n r DD .bD�r O coon . n 01-c) A A ch-r) rADA�• c., ODcIAOAn cn A 2b2 ,�1 nb2w,A , Cprrcn 2M AA t '. '1 Ac,1 A C b nC 2 KbaC +> '.31'. . 2 3331' 3'.2 A PI cn n 21(4.. D '. 312 Sati1D 3'.ab22 a 3Or A ^-.103 D N01-.0r- 0 nb3An N 33ab3A N r r '. n2NDAn O n A-1rC n -1rn a 'c An 'c 2AAA 2 2 N-40 00a02 0 arc�1D1+1a O ,�, DD r ,� co D'1NC 2 �ODb�1' Cl X12 Ar n D bAOC A 2 2 O y2 2 2 O 312 Cl wA,rO 'i cn SAO p t„,--0,, r ,A ana n (Jl-o n -n-0n31, .- onto-0n31:=1 C b n ^ '. -,nr�.A n c� 3c.7� oDA ar'.A -c Orc 2 c12r2 S bA i r0 -1 o.ra2 A nn,.rD A A D ` , AD X12 0 nrnDA3 acnrAnw on O abab a NMOb M AA 2b n a NM 2r r� P1 as y 16, 3M0Mcly C b02 '. cn (.1-,rr n ,i1 '• c.1 (. c.1\ 3 cn m A 3n�C -1 c rrCa -1 31-1 O r'.-A 2 '• a2�1A�1- -- X13 '. n �S Cl ,(-y w mL w, tirW - . - l0 r •� O 2r Da A �, 1 rS cSD 3 ^2n = a0 nn'.A Cl 4 Cl ,-cn Cl C^-,1.3 3, -,z,.c., n OD 2 �,-, •rr 3 a- ar rr Ki.-4-0 q a rn -= ' A '.n r '.ASna 2'.ASnr n Cn ,-, nl. r Cl A 2 rlc,r bW-4 ( C Cl nn Cl .�f 2233 Cl �1� �r Cl b �� -A Cl N tit ^^ A. .n 2 OC-, �AOn roro2n0a n 2 b n'. A -.)Ma.-, n 2naCr r R,a2nao D C Cl `J b-,O�C ti 2nS AA b -1,..... '-'2N 1 4113 .c ciibnA b `-c�1An Cl "pcn ,-(-)Arc-) c1 Cl ,�,b O r '•2n �1naL Ap QR,'�' 'l , 2 L0-1S Cl C .r 1:1.- -.101a) r �tiri" tirr 2 c `/) ,1.1,r1 a c,, 2Lc.,rn m r Cl- A a D •O am L 3b b mar 3ba n cin (-)MN-4M 2 <OnbraaC ar Ap a NI.- .3102 A z1.7.1..-4,:: n • Cl Cl Cl cit ti -11. Sn 3 b cn20\0'.23 a2ka3 2 2r Zr2 . b nS . 3abwr L ab>cabwcl Cl n2 r^ 2aDCa - 2o�,bnn 2b .raA c b -1-1 n A a a 2 rro<a 0 2W..1.-r\- b A 3(.1 V) �12nr c- Cl -,A 2 b wr2.c A w c,�pS • rOsr brR1- WI-.13:0-.1), R, a y 1 O! b�:r ti 3c�3 rna�, 'hr Cl ) p (-)P1 �- -n 1. 2 •. r'1r ,n IA) a ov1 2 tor' 4,-00 L 2 ClA Cl D Clan2S2 bprAr A 2 3 Cl 413(.1 131'-.1 -1 b1/400-0.--NO Cl cn OC cl AOC n nAn2clabD R1v A --1 as clAw -40-4b m� nro c1 U Cl . A 3n •c1r22 OA�,D .2 2 cnvclnE . ry r.n •rrn mnc.,.-,O (.11.(10.1 .32 Cl A� 00(4 a A 3rD22cicn< m" a •A A r CAA 2 cA to-loom2D b'-cc �1 A p'• C C) ;-)0)013;-)0)013-.0 '• A-cAclnnA :t. ciA-101 '. A )01.-0 r Cl nr!4rD •2 A wA z�-,A • 2-44 3n2 ArA 3 r 00 Cl • b2b cr tl 2n �,� Cl .AC DAA s. 2 r).1)31 bAU ab�wAA •n Li -1 2 0 .. n MMMN A A 21 2 `J •1000 2 0020 '.b .K�1rID 2(4 31.K ryal=a * � b2- �D nb -4CL Db L •1 Clti�1c12 •D a- N Cl rn Clb LnciA +�- r rr vbnoLnc, . b rnr yOO iwb 2cor clDcin �Srn Snr Cl O3'1 r An .ar •L • D DVrc7y --102b0 -.0.1nb b 22r- --10^ ;42,� rorn. 22 rn�a~�:42(4311:1 Or---1 2c432 ClDC 0-i Cl -.1.31.2 02r'1c 0r- Cl '•n --4"-..-1W-.12(4A1..OS ,z(„,,:::,Q 10AA22D 2ti WA w -1-.0 Ara 01-- A 000K 2300 -cn2 � (n r1)-02 31.-..--1(.42N'2h r- 0-4 cUAr SO 0312'• '•r-1 '. '. rc12 (1(4(410 ClAcn'12 '1'•2 a0'.a C-, 0•. -4 CM(.10 A 2 OND ClCi (.12 b A nb 0W'1A 2OAr '1 2OAw A-c •�,20C rDAnASn .DA �n bA 3)00'• b nr '•'.D --inn n-1 cl3'•cn cn2rpw 02 r n 3 AA A �12rAnr n� na a-,a ti A D- 2 r.----‹ On c,-0 Ain...-.21. 'lD .w ti ND'.n Cl �,nA- . -..oto-i2.- an [ D 002 •r2n . r2O ClA `^ O '• n20 r. 2 r02'cA A A i1 .312 c Cl vl Oclan2 a2-.-.101.1 r2a .a c.-)ti - inn �,� r Cl a'c D OA 2Ccn r A 23)0O '1�2n .-...,-.< bora) --..-o2 n . . Cl 2 2c C v K.-. r c4An 312 AA 120-c.-.. ClraC ^ bD30 Apc,A A rr bcin aAt Cly a v n- 2 '1r2oC 0120 3 n c1� mac . c1r r S r D n Or-b-0.-4 acn,ra n ti O 3�2 �, c2'lOcytc3'1 rprr 2 Cl r cn b 2 2 - . Y (^ 11 lV N � - ►v "F O rn `' \./10 Imo" 3 z n r* ern 2 rnt Q x kc k I I 232 C G7 Cl -<�231 2 A3N a 00 baa 21. c- H'.n cn r1. -< 3-1 ktin O -,-1-1c�1c- A DK Cl 3'. 0-1 2 8"0401 y r 200 c., Cl ,.1.. Cl r'1 ' )Cl '.2 3(4 C Cl 2 -1 2 ti A '• `kilifflar �i/Iy�-' 2 `1(.(-0,p, ti �Cl \ r' o cam, c2n C) �i� cn -O Oc, Cl Cl r1. 3- 2 A m N�,p�ii� „311 3�o Cl 2 2n 20 2r n or:--- Cl P1OODti Cl D, -I2 nr -, o m♦C 5 / ��y ' -.2'1(10'~-. Cl 2PS'1 Cl DD n2 0 y m x.m = qsrt� CO• .a MECO m e►:wt. Cl � C- A 2r Cl �-i ra 2 M ° c, 3 ( ClC OM 4 m n M o r T'�'. FR V. S c-)--. tib 2 cn m )< cn- OSo . a... N . .`ry N. Cl �k�� Cl ;2 n 1� Cl2 ♦ �� P 0 a`W v g //i/% 7 T.-T.)0 10 0o r r)'4 Cl� �, ., m m atom e' '4�///i/ i 01-1rti I. ao Cl �z am CN- ,INg z i:�ii. o '•rim o 2-4 o za) n� vaao• `m N. 4%%3.i/// \ ti aana pA b 0 ',A • m �cn dill' Q 3 nn1 b 0 r ti, a 3 Cl b 5,, - La ^ D i * g Z _ b�>tn c~1 u• ti Al Cp • a .: Cti0.3 Ma A -4-4 Fr _ cn 'A 2rrA Cla --, < z V/ -,' rn 2 0 Cl 2 a co z cn r N- ao no C) co CSD C r ~ r b 31 2 A CO° 1'1(.1 W p n Z O O pn Z Z ti Chin nam o� �„ TM-Y CO Com- r0r0 2- �O� ... 01pa o DIzro pcoo2�zyz �' ,,, pao -IT) c)(1-E) Crn '"" p �tw 2�a�c��r)Crn KK ' gym- rnao2� 2 Crri a -I o _- L 3 � D � o �02 € , ILL `„O �, v, o� C-IRI pa' 21n��-'2- � cb 1 O z Or i 0 �-').„a.:. -�,., O O \ m n? �a�a2~o0rn� � �" Op p rn�a ni 2 r,0 � O a• oSfr ,�rO p�2-COpc2jp ~O t n O C -0 O 7 N SSI -g--'."'1,..,,w � " • 220� uo rnrr,rn2 " r iaaA0-r1 ISE ,, r1 LI 2 Opp�_2t�m £ 714 �` Z1.o O � " ''',,,,_r, " R < "° �I ` ' 1 P i � ^ w l ¢ i \^ `/ ..,.•. r p P ,, , , i' •• , , yrs, C "le li K ° 7 ti' i ; '6'. - TT g \ ' PO 0 5tk iE Ceti 0 t�•'£ r ,.,w 3' � Aqui �+ , :6'.., .._ 0 O f i t°i % Y... :,:::,-1-1-':,I;1- 0100 'tC WO v 03C) Ir02 � R) r �� n cr .....„,_ ? -o6 "' °c z� £ �vrn O r V © 3 rn=ate v --h F.,^1ti l € rri,00,, rn p Q -, C ( E o- a "�0 wp t,a R- g i y aA� 4r3 ?Z,nA z Ca N o No�p ic 2 rt " ,200 Z O ... y2 2 _ %."rct (N i .mow \L. '''ir"e"/ -' "-----,v v' s 4.' i '^. BeAMIto. Co kr.). � �Z 70 P) idi getn ry H flP �� -0�� GH zk m � o °CO- wc. o CI) m 1/iyt �� \ o N CO ��17 a �r NN9/4------.... / ''���i ro L7 m tzi �_ �nm0 0t a Vim=S. OSI),t - 2 � x 'c r�*ln0 X\DC7 y'q �iii y rn x x f m mo-1ti �Nrn mop ar2� n o 0 C A vim = SPk,��y w a r0=o �rt ao mown —v M 2 o i70 f�Am ep. ,yqr v n n OA O G7rn- a 2 2 2 ODt0 r • I �� o -i to R° a x a �' r��2� ��o oa ��o� ro O �� c) O.0 • ,\`.. %• Z v, p c: 3 0 o a ��2n 2y-r, u,� yy� vn y p�7C ��^7 I% `° c o 11 F �O-~ 2 -4 r„m m ra m a \ p �. // '� �. co II y . .. r'1 .r 1 0 2 .c C n rp n1 mR 0 7j6 /// d K N 2 OAC C 7Crlrnp, z Tl m ,• s,, �, /// o rn .A w '-' o, a .a . 2 -i cn O n < pr� m :2 13 O r\ m .�F r/// (. o o,O o n 0 ,r° a iz o z) y Wr 33 2 t 4,• z 1 Nr/r/ r R 6, r ig crc y cro : _ n i i 2 2 rr o O O a_ -< `�° Z 2 r�* ��*�/// --� �° a a 2 ���k kms_ 2 c 20-I r n m * 'I o r o • //j%�///// ce° tao,- 0 0 0 o 1'0-0 o r rn V Z Do� I' -o ?- rnr'l or 2�2 0 �= 0 MIO H O ` L',. � 22� �� A2 2�m Acca •n._a• ' :�i n�� �� _� r%-< o O a o mr'l o O N o O �J " , ~OO O 2 0 o Z C/3 r0 �� --Io F • R .6- NORTHWESTERN TERRITORIES, INC, DST l 717 SOUTH PEABODY STREET,PORT ANGELES,WA 98362 ��— Engineers■Land Surveyors■GeologistsJe` 2015 f ? � Construction Inspection Ch Materials Testing V•iron ers 0h `o (360)452-8491 1-800-654-5545 FAX 452-8498 E-Mail:info@nti4u.com menta/Linty NT/ Nea�th www.ntiducom October 2, 2015 Jefferson County Health Department 615 Sheridan Street Port Townsend, WA 98368 Subject: Glendon Biofilter M32 Elevated Containment Vessel for Parcel Number 963900023 Gentlemen, This letter updates the criteria established for the septic system approved under SEP13-00116 for placement of fill inside and outside of the Glendon Technologies Inc. M32 Biofilter elevated Containment Vessel (hereinafter referred to as M32) and reflects the manner in which the system was actually installed with a 30 mil PVC liner using a containment vessel as specified in the Glendon Biofilter Containment Vessel Plan, Section & Notes signed July 21, 2015, by Ryan A. Long, Jones Engineers, (see attached), and installed as shown on Sheets 3 and 6 of the septic system design for Parcel Number 963900023 signed September 18, 2013, by Michael S. Deeney, Creative Design Solutions, Inc. (except a 45° maximum angle of repose was used for the exterior sand backfill). Backfill around the elevated M32 Containment Vessel shall be considered satisfactory for meeting the requirements of Jefferson County Health & Human Services Environmental Health Division Policy Statement Number 01-01 (see attached): 1. Natural grade shall not exceed 45% cross slope for the area of placement of the M32 Containment Vessel and required surrounding fill. 2. All organic material shall be removed from the existing grade prior to placing fill outside the M32 Containment Vessel. 3. For any portion of the bottom of the M32 Containment Vessel to be above grade, a leveling grade of ASTM C33 sand shall be placed on the native grade (after removal of organic material) and water settled. 4. Fill outside the M32 Containment Vessel shall consist of"Cover Sand" as specified by Glendon Technologies, Inc. and shall be placed with a finished grade not to exceed 1 foot of height (vertical) for every 1 feet of run (horizontal). This 1:1 slope (45°) may commence at a point 1 foot above and 1 foot outside of r ® I Jefferson County Health Department JeF� '�20/ October 2, 2015 itb/7/ �tr Cat Page 2 nta� �tY death the outside edge of the Containment Vessel as specified by Glendon Technologies, Inc. At a minimum, this fill shall be placed in 8" to 6" lifts compacted to 80 - 85% of optimum density (equivalent to "walking-in"the fill). 5. Material shall be place inside and outside the M32 Containment Vessel at the same rate (maintain equal elevations) in order to evenly distribute the loading on the Containment Vessel. Monitor compaction activities to avoid deflection of or damage to the containment vessel. 6. The top of the Containment Vessel shall not exceed 6 feet above natural grade at any point around the Containment Vessel. 7. All finished grades to the sides and over the top of the M32 Containment Vessel shall be planted with drought resistant non-intrusive grass or other shallow rooted, non-intrusive drought resistant vegetation (see www.glendon.com for lists of acceptable vegetation for M32's). This letter has been prepared exclusively for Creative Design Solutions, Inc. for their use in the septic system design incorporating an M32 Containment Vessel for Parcel Number 963900023 and as specified on Sheets 3 and 6 of the above described septic system design. Our services have been executed in accordance with generally accepted professional engineering principles and practice. NTI Engineering & Land Surveying 09"/a , /1/4„;,4- Opo\ 1 //, .04 'gib✓ . •Robert A. Leach, PE, MBA 4F 13772„ 0 _� Project Engineer Fss onra�E ,_44<k; 10-02-15 attachment: Policy Statement No. 01-01 CN Work Files\CDS-MatsunamilAbove Ground Containment Vessel's,SF&M32 -2015 CDS,Matsunami project-rev slope final wpd OCj fv_.,&",00 ae Is 2045' 1r n tai,tied th GLENDON& BIOFJLTER TECHNOLOGIES,INC. October 13, 2015 Attn Mike Deeney/Jefferson Co HD RE:Glendon wick slopes(also known as side slopes) This note is to clarify that the minimum angle of repose for Glendon wicks is 352. Steeper wicks promote aerobic treatment,however,increases erosion concerns. A wick slope of 452 is considered optimal for aerobic treatment while maintaining adequate slope stability. Please contact me with any questions. Sincerely Paul Vandervelde President, • Glendon Biofilter (206) 819-8803 PO Box 2585, Gig Harbor WA 98335 Glendon®and the stylized "V"are trademarks of Glendon®BioFilter Technologies, Inc. ©Glendon®BioFilter 2010. All rights reserved. ice$' 0 0c $+, 9i r 0e's0•lfic �CO,S JEFFERSON COUNTY HEALTH&HUMAN SERVICES ei ENVIRONMENTLA HEALTH DIVISION h'ed/ 65 POLICY STATEMENT NUMBER 01-01 PROGRAM: Wastewater SUBJECT: Design Standards for Site Constructed Elevated Fixed Media Filter Vessels PURPOSE: Elevated Containment vessels are subject to significant internal loads and stresses. Internal loading must be considered in the system design in order to assure the structural integrity of the vessel and to minimize the risk of vessel failure with consequent treatment system malfunction. APPLICABILITY: This policy applies to any fixed media filter containment vessel intended to be installed above natural grade that is site designed and constructed,including but not limited to elevated sand filters and Glendon Biolfiltors. POLICY STATEMENT: Site designed and onsite constructed containment vessels for elevated fixed media filters shall be designed and constructed so that the vessel will remain within original design tolerances and vessel failure will not be a limiting factor in the useful life of the onsite sewage system. Designs for elevated containment vessels shall be prepared by a professional engineer licensed to practice in Washington State and shall bear the stamp of the design engineer. In the absence of any other longer standard,the useful life of the system shall mean a minimum of twenty(20)years in use. This policy shall become effective on the date of adoption by the Jefferson county Board of Health and shall remain in effect unless modified or repealed by the Board. Health Officer Date Chairperson,Board of Health Date G:1EnvHealth\adminLOSS Web Page\Numbor OI-01.doc 6/3/04 "--" 31va '3•d•9No1 NVAa ,.. N -� sum'a Aim 94Z96 'DM 'waybullla9• 40f a}!ng . }aal}S uu!puayF 49t4 73993A l/♦../I SNI VIN00 / o N �a31si� srcslaewBuasauahMAIM •8988-ffL-09£auoyd • zssas 6, ► r S )3 3 3 N I 9 N 3 'NOlONISYM JO 311/1.5 1H.1. 3r, MHLVA 3.111.3)/W JO 50NVONVIS 03OY 1d3OATVF13)HL �1.�17/�O18 NOON37J 3FLL S133W 0NV F000 SIHda5 lVNO5N3d AW 3213H I 03NVd3tld SVM SNOLLYOLfg3dS ONY SNOI530'stand (.0/�'5L ...�4, 8:. JO 031Ph1SNOO'1N3Wa LIV SIH1 1YH1 AJ NOIS 0'stall I 'YO iNB i0,a gm d� /YCL VOL1 80 /Y/1{J7a7X7 00 aiui ,� r V) CJ Z O O O LAJ CL ¢ G Nj v \FR LAJ Y Z CC IN O O z �Z • cn U CC O NCD CC W \ w CC r.") N Q O "7w �3 0Lo � O � 0 O czi O OW CMO CCA I= F- J CD .cf 4.N W X W = 00 Cn t U ♦- Cw.') w Z ... -J Y ¢ cn -V°O N Z N LU cn � f Z Z NU v- cf) (/) — Op wm ¢ C.D — — x p J O CC X Y Q w C) a --. O m J w z CV i-- 00 O ° 02 Z U Q �� N J CC C�j - . Z N CO CL �F- GO O I .14,,,,,4 J >� Q O N ..,i .r::.,: ___._. Z � J d J CD N x ` � 2 `i O� Q W F- C.D F- J I— iQ O o J w La-1 =-_, H _ O • > • O �::: + N J II fX .1i • a. w rii P I o COQ Of CO • C) O 0 IN O . XiO CZD C - Z C9 V7 r2 Li o 13- .F._ . / Q I N� N U O W CO : I- O . .- W I : up ' OCL cWn (n DO Cl) CC CC X . / /J CL �-. - U c...1 O w ¢ F- w O CD co c0 0 ': Ul O ¢• WC41 CD ((��77 = 3 d Z -o C F- Z w j ' N- O co • O �p ca N CD O z N cn t•:: \ CL\U ,. I .4,. CC Qrr %= N • OwO n � V) V) O F- w < WF- eO W (i)C U) Q I..,. ¢ U O c,,\ _J LLJ 2• rn CO e v) N F- N .:.• C7 O d i 1 ' CY a. 1..' ,_ V) ' !l: Cr) : � 'tet LL� 17 r/if , 1 .,..,...•:,...,... x0 • 1 N W 0 'S M � SII r y, LLD .-", ••:".1 %•¢ O w 't ._... - S W �. `'':n- try O:,•. .;l O C ,12) CC U cD a F- (Y I i O ....':�._..__.- CL x I- -o �S):.'.", CC .'i F ,_ U F- cV U .:••.1- - N V) \ ® a a i.---- CD O x W ; � L_.51- .c,O I I I ; 1I- Z V) CC \ N Li) U O (D i cn CC Z U Oj N IO= c0 c.0 N (i) ¢: x ''''t N •X I- W U'' ! F- Q V) __ WI CL M M [C W (n J m V) W FS- O CC O W O O Z,CDI -J I-- Ul' L J OW ¢ � Z J -J W O ¢ > ¢ LiJ C'� on J C) ----.¢ CJ.7 Ld 1- F- W 5 WW Cwj ¢ W CC Cl) CC `2 Cl) J C) O F— W mJ I- Z � J W ¢ W Z W a ' > zcn 2 C-)Ld OmEwcwnm ( o o = oe 2 O F- ¢ Q W CCI 01 J O Q N_ (n C9 �' W z CCO J >.J J Z CC Z CC w' Z F- F- CC 2 2 WI LAJ z `-1 - ; W W W C.7 co W ¢ Q F=- •D J W M W Z O J CO - > D w O JU, J CnN N F.- V) O ..,:c 0_ <n F' 0 W ! �I Q W ¢ ¢ W F- cr) m Z W CL U) Z u0 ?i Q 0 0 C L Z CC OZ2OCW CC OW = 1 F--- I-- W Can C) Cl)I WUQ F- C CC F- > 2 - - J z W W W p LU CC Z U I O O 00 cv Q wO OM CC I, � ~O LLQ. F- U O m W W = V) C/7 Z CCU 73 V) S p Cb 1- Z W W W >W CL I Z J - W - •' J ¢ CL (1.) W N OU -;:Hi m Ill!I� f! LSF- ¢ � F- NCO O M 00 8 CC � > L.� W O U)c; W1''1O WOLd CC ¢ J w ¢ m 0 I-CC • IL �_. '-I N_ J CO z H J W V7 O 0 0 C) ,t V) V) W ~ W W =E oe W W O W J Z J U I-- z V) F2-• LU Voc V)) IF- Fcp F- O - ¢ C' ¢ U ¢ O X Q Z X '^ U 2Y Z o I Inw h ko ^ c c" o x a. w0 w M v a°� Q� I may= m � -7.-- J c ow x O ed z -y R w S g O I J o E w c�'~ >L x O CC O- W 2 a w c+i cn Z.L® ( CL. >. QJ y �m y Q 2° e0. p �� CO t° a Ls, I w j I 0.0. Q y r- ii -- i mwp -- CO2WW i O/JO0 O'i - LOmWW2 QV CO4.i CC Z . CO CVJ0 p 1 ° as v Li Q jCt 1.0' I o e a --I l o p0 i flu 110.° w -. Uj �j O i Q V) O, c. (h Q I i ...:1 '� z. J W N ¢ 14- • • c. �(J i it 20 �`_ ////lplItk W n ` .7_ y x CD / k a� I U —% d Rkao c � "� o aoti ` zol o —����M. .,e-, Q AkcL v' 47:-, i ''s .-4.I 0 -oUe z �. ,S , . co 1 C. 1 5 (/'L.L., i Q.. o O "kr.-. co I I 3 co 1 I n i 1 A 1 11 i l ti 00� �m J 2vgZNZw�i w v, w 4 J 1 0.2 Inw �L W O e Z2(/j0�0 0 I k 1 p 2 04°2wtioWoOZ. I, e 2 ti00 0 (�j LJ3 �2mcc � ,.i eWh I 1.0 I 0 iNI0 (n0,0 .41:1.0....:(%, .1 Pd ° (,) �I I 2. Q w y W J(4 J y h Z¢ 2rn o ��Q i k WZ makz�Y>.�0 4Wicn2 32aJ40 O I w ce��0 N-i-.� �I�w� N.Oq� -.1 WOO '` r °ow �Y, NWew°~i 2� y0-030 e z 1w 20 0 �2^� 4i Lict W. -fie ¢0W(wu(wii e I O� j�� �w�J 0Q(Q2� J°p f7C. 22 i W lii e,02w0 0 Q 4.1 OZ 'Cr 11 �. I'. J NQ C.1 0 O ki ujj t? Q Q O WLli Q O . ,,Z l L-Zl Z9'Zl•.;::•:..,:;`:,;.::;:.r,r.;;::�:rr..'.r::..,'•:.•:;;:.;•:•;::::'::;.:•:•:.:;..::.:::•;::::'.:.:.:�::::•.::r,::.::..:.::..:.:. V Q LL i .;'77:� r• CL,*) ,is*i;,:;::'::'..;•:._'::':::::::`:`:: oo•t;:•.:: -: ?:':;.'::;;. : :•' l •/r s->s1•,ir' li-1 NI }':7 0 1-- CN! CJ ig Ch 214.1 .. 0 41 I 3 a.° Ci i''•''�l oftz,y Ca 2 N N 0 p 1' CO 1,,:c0... * C m Z a N aa 2g(-) c, m Q N SOIL HOLE LOGS Page / of /- Designer /`"7//cL D&-E '& P Date 3— Z�- I -3 Property Owner/Buyer /4/ " ' 4t---i/9>-s0./4/7/ Parcel # q 6,3 �1x:, 02 a c Project R -- 7. --/c/� D7-/ sl-/-- .S4E.P~ ��!G Sec(Twp-Rng) s f� I 3(? 2v/ 1 HOLE NO. w 0 z TYPE w 0CT ', co �- vi OF DEPTH O o' 2013 m w , z SYSTEM (Inches) li Fes- APPL. Q ' a H F-- C TEXTURE RATE c UJ v O DATE 0 cc c OBSERVED co (gpd/sq.ft.) C _- Q cr UO O H c z Q l/1 31 & 5'/-- ead , 1 g >- ¢o "ecC �c,«i-7 ( sL :•4— 1 4-d /mac,cL z S L )`D 5 D< 3 d kJ 4-7 13GUX45- L S•'4 ,2-lZ SD r`zc,«c .- o- 3 Z.4 z (P _s---1-- O.lo 15. > 3 / 3I -Porgy P 5L 1--c) VF 5L a,4-S- Z12 p,2 n- 13Le,t_ 1-4/1--_ G 72 -5,,t___ p,2-/Z AU V \ : W l