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HomeMy WebLinkAboutSEP2015-00059 111 Jefferson County Department of Community Development 621 Sheridan St., Port Townsend WA 98368, (360) 379-4450 SCEPTIC//PERMIT APPLICATION/ J '�iq� PROPERTY OWNER Ga r ti / , J',i I fn i 444((.en A. �(/O / cM 1 MAILING ADDRESS /6-300 /4o/�ac,- Lr/ ✓e c33 Anc4ora ft z, //W 995/,6 PHONE ( 907 ) 395-496 , cN/: OD6)-.5'29 -.289/ 141ork :(907)6”- z.181 SYSTEM DESIGNER E g i C.,S E N bE S 1 C-a N Designer Phone# ?. (r 6- JO I - ©3.11+ LEGAL DESCRIPTION: Section 34 Township 30N Range t W PARCEL# CI9130000I Subdivision Name SWALLOW GONE PLAT Division Block Lot(s) 11A Site address/Directions to site 18 OA R D WA L-1( A\L L PORT TOWN$E N D 1 'VSA SOURCE OF SEWAGE/USE TYPE OF WORK WATER SOURCE Residential V. New Tank/s only Private Residential ADU Modification Public A Commercial Expansion )4 Community Upgrade Repair SITE SIZE 1.5.6 ASS SYSTEM TYPE Partial Repair- (tank) (drainfield) Previous Evaluation Conventional % Designate Reserve Area Yes# SC? 94- £U.4. Alternative . Redesign No SYSTEM DETAILS Number of Gallons/day 460 Soil type 4 (attach soil eval.) Application Rate . 55 5 gal./sq.ft./day Drainfield Length .3GO ft. Trench Width 3 ft. Trench/Bed Depth i$ in. Septic Tank size 1000 gal. Pump Chamber size -- g TYPE of system gRAYITY CBhi�QENT ( A11 A DP add. s-r) 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 separately judged by the rules and laws in effect at that time. (PS -6? l —2Z?IS- / Property Owner Signature Date I/mo^, // FOR OFFICE USE ONLY nn l///6--- 1 0 1) KJ l` PARTIAL OA ( ASB ILTU�Q � fI!=� � � U '� FIN /{ APPROVE S INSP/PUMP TEST P, " (Of/tlt,f ALL HOLD REQ. MET Date /�( Fee Rec# ` � C(J7/9 Check# Case#SEP / > �J S 1 H:\WEB\PDFs4ep4cpptic_permitapp_2008.DOC / S`,' -7 3 2, I S(L1 �tt t () 53. `) / U JEFFERSON COUNTY PUBLIC HEALTH r 615 Sheridan Street•Port Townsend•Washington •98368 www.jeffersoncountypublichealth.org Phone 3bU-313b-Y444 Fax MU-3/9-4481 ON-SITE SEWAGE DISPOSAL PERMIT PERMIT #: SEP15-00059 Date Received: 05/07/15 SITE ADDRESS: 183 BOARDWALK AVE Date Issued: 06/26/15 PORT TOWNSEND, WA 98368 Date Expires: 09/26/15 APPLICANT: GARY SMITH PHONE: 15300 POLLOCK DR ANCHORAGE AK 99516-4947 LEGAL DESCRIPTION: SWALLOW LONG PLAT LOT 11A PARCEL#: 997300001 Section: 34 Township: 30N Range: 1W DESIGNER: BERNT ERICSEN PHONE: 360-301-0324 293 PINECREST DRIVE PORT TOWNSEND WA 98368 SYSTEM DESCRIPTION: CONVENTIONAL TRENCH No. of Gallons per Day: 600 Type of work: EXP Drainfield Trench Septic Tank Length: 360 feet Width: 3 feet Depth: 18 inches Size: 1,000 gallons DISCLAIMER-This approval is for an on-site sewage system that meets the state and county standards in effect on the date of application. This approval for an on-site sewage system DOES NOT assure you of any other County approvals. For example, it DOES NOT GUARANTEE that you will later obtain permission to build a permanent residence or other structure on this parcel. Any future application will be separately judged by the rules and laws in effect at that time. All construction and development activities must comply with all permit conditions, state and local codes, and Recommended Standards and Guidance documents in effect when the permit is issued. The property owner is responsible for the accurate location of all property lines.Any removal of or major disturbance of soil in the primary or reserve drainfield area may create site conditions that are unacceptable for the installation of a sewage disposal system. Any change in drainfield or tank location may invalidate this permit unless prior approval is obtained from the Jefferson County Environmental Health Division. If during excavation or development of the site an area of potential archeological significance is uncovered, all activity in the immediate area shall be halted, and the UDC Administrator shall be notified at once. Permit issued to CONSTRUCT, ALTER, REPAIR OR MODIFY AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM IN JEFFERSON COUNTY, WASHINGTON This permit is issued for a period of three years (unless otherwise stated above) in accordance with Jefferson County Rules and Regulations for On-Site Sewage Systems, codified in JCC 8.15 as amended. This permit may not be renewed. Jefferson County vironmental Health Specialist This permit with conditions must be onsite during all phases of construction HEALTH DEPARTMENT MUST BE CONTACTED FOR FINAL INSPECTION. SPECIAL CONDITIONS APPLY - SEE ADDITIONAL PAGES CONDITIONS OF APPROVAL- PERMIT NO.: SEP15-00059 1.) This permit was issued to correct a violation of WAC 246-272A for a pond constructed over the drainfield and the addition of an ADU. The permit must be completed within 90 days of the date of issuance. 2.) H - The existing water line into the shop must be located and be made to meet the 10 foot separation to any septic component. Must be verrified and shown on the "Record Drawing" 3.) H - Existing DRAINFIELD shall be properly abandoned. Documentation to be provided to Health Dept. prior to final. 4.) 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. 5.) H - AS PER WAC 246-272A AND 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 6.) Designer must be contacted prior to start of construction and for inspections during installation. DESIGNER IS REQUIRED TO DO A PRECOVER INSPECTION ON ALL TYPES OF SYSTEMS. 7.) Notification of the start of construction shall be faxed or emailed to Jefferson County Public Health ONE WORKING DAY prior to start. 8.) H - An asbuilt drawing and certification of completion by the Designer is required prior to final approval. 9.) Before final approval is given, the designer shall provide an operations and maintenance manual to the property owner and the Health Department. The manual must instruct the owner of the on site sewage system on the ways to properly operate and maintain all components of the system. 10.) 10' separation required between a Water line and all portions of the onsite sewage system; effluent transport line, tanks, treatment and disposal components. 11.) 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. 12.) Approval of this sewage disposal permit does not preclude the permit holder from complying with the Unified Development Code for other/future development on the site. 13.) 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. 14.) The project shall adhere to the Best Management Practices (BMPs) to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. SEP15-00059 Page 2 of 2 \\tidemark\data\forms\F_SEP_Permitmod.rpt 6/26/2015 coNVENTIONAL SYSTEM ASBUILT INSPECTION REPORT INSTALLER £1?JCSEN EX (TCWY K(LIA ". ) PARCEL# qg 73 O OO p 1 Permit Owner & k-KY C1 t TF Permit # 6E1' (5 cq ABSORPTION AREA: DRAINFIELD TRENCH TRENCH TANK #OF #GAL/ LENGTH 3foo WIDTH 3 DEPTH 12—.2tt- SIZE 100t3 BEDRMS DAY �OO Tank Shroud/ IF PUMP AND PUMP CHAMBER REQUIRED: Size Screen Float Arrangement High water float—distance to top of tank/emergency storage — Dose drawdown (#of inches) #Gallons/Dose Timer/Dose Counter info Pump Size/Manufacturer I CERTIFY THIS ONSITE SEWAGE SYSTEM WAS INSTALLED AS DESIGNED, PER PLAN APPROVED DATE APPROVED 1W-t`GAiew SIGNATURE DATE NGw rAAK C sI{QL1)) ji -ci It rt-srEt of to-i&-,s kI7LET 3A5n.E rtt,1'5/ t Dizcc-- JT'iT 00.4) INsrpru.t K►J -tvtt.1 to Ks se E l-T rike t•f Cb TEccie.D .DRAktaq61 J '* c/ ,,P h ' ��� �3 © ch m y m co co et is �tt a) 0 ..' . w W w — cMM<0etU3 j.. La Zo et 0) N ! 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U Q a y O` N M V in c 2�b£.LEo I N X-Fence-X < > u a) 0' .00'LEE a) -Q 5 O 10 U To c aa., ,,000 r= }r.a y.4f��. lL .1.4. 4!",0' JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 SHERIDAN ST., PORT TOWNSEND ,WA 98368, (360) 379-4450 SOIL EVALUATION PROPERTY OWNER 6 A- y 511 i T 11 SYSTEM DESIGNER L F I GS LL N. D ES i C A.) LEGAL DESCRIPTION: Section >39- Township•O.) Range \Vi Parcel # a q 7300061 Subdivision NameSWA LLD VV LOP. ?L/} 'Division Block Lots) i i A Date Logged: 4-.11 - /5 Logged By: -5 E R MT ERIC-5E IJ 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 to 14 in.�k iRN '8RN i,.� 1 � d to ,Zp in. �DK 'BRAS LS iq to 33 in. * —.7.1..� . ('1 to 0�.4 .35i in. TA) V. F 1 .5 33 to 4Q in 6 i LT SAJ'► I a a 0$ to 57 ink 11.10 40 to 64 in. T 'ATI S N b 1/16), i • to 66 in. Vi`•ll" . 1 S N.D Anticipated water table in. ri(Fj ' Anti.'.ated water table in. Roots to inches I ` . (o '$ / Ro, s ,, inches Health Dept. Com ents ` /MOIL HA/ 4;./, Dept. Comm nit tt SOIL LOG #3 SOIL LOG #4 © to 14 in.DK, `BRN /Bizto Ls. _____a_to 16, in. 'D , $R Al f 8R N (,S15 . to b 3 in. Tiv Fm N'i) /i x,11 Ho to 39 in. l iJ, V. F kJ 51%)b to in. i. • . •11 39 to ( y in. V. F A) S A)b to in. )P . w .. ti.+, to in. Anticipated water table5(v3in. A� 0.v>wl . he- ' r ��� t7 Anticipated water table'76S in. Roots to ?j() inches s apt it f+ Roots to II-0 inches Health Dept. mments „fr5ioo25s/O .BERNT PAUL ERICSAEN. II.Health Dept. Corn nts .i„ LICENSED DE I P P IA � � ���®ma ���►soswow�.�.�a� , SOIL LOG #5 EXPIR S 0 11 _�_I SOIL LOG #6 0 to /4,, _in. bK 'BRIO/1310Q h) L'. to in. Uri to 'J-7 in.-TA) FN--H SIU to in. 47 to 61-5 in. V. b-A.) .510) to in. to in. t0 in. Anticipated water table>65 in. Anticipated water table in. Roots to inches Roots to inches Health Dept. Comments Health Dept. Comments H:IINFOHLTHISOIL.FRM1/00 G{;rct' Sit cro q973occc - EfirlIRED LID.Willi ReDZAIRE'rER \ ACCESS!USER M GRADE —� - �-- J -7"- --11 1-t-b i Li 4 .TO - .14F 1111 FROM € ,......_.... k..... ri / c ma 1r I Umei 4( SOURCE FLOAIING KAT APPROVED — EFFLUENT 4I �" ER 0. ..Ai SEDZIAIEWIS ' `if s ' it4 ,. Flo J ' SEPTIC TANK AIVV.BERNT PAUL ERICSEN , (TYPICAL) EXPIR S 0 11/ L 5-7-14-1 Trench Profile ( No Scale ) (See Notes For Details ) Finish Grade Geotextile Filter Fabric Native Backfin Inspection Port — III 4"ASTM D2729"Perp -.....:-................4.4.4.4.4.4.4.4,..:4:4.4.4.4:•:1111:.. End Trench - "D" Box 4"ASTM D2729 4:" A S TM 3o3qTo Drainfield Ilia From 5,T (Solid) 1 '~ '... YK y r r r! Clean Drainrock •. ::•%•. •4-;•x:,- ••-. 6"Min. Under Pipe ES\�' �•��f4 G� 5 t1/4CCP�' ea • ?�,e Q is 11V 4 Gary Smith 997300001 •gyp BERNT PAUL ER ,�1 ICSEN' � 1111b %% R ±i� 11 �% Project Description EXPIRES 02111/ 71,�' Expand existing 3 bedroom septic system ( SEP94 — 466 ) to 5 bedrooms by adding an additional septic tank, transport lines, new drain field and new reserve area. Existing Septic Tank Existing 1000 Gal. septic tank with existing risers to remain. Install outlet baffle filter ( Orenco FTiP 0418 — W )Abandon existing transport line by cutting pipe and gluing cap. mAjtot/P New Septic Tank Install 1000 gallon two compartment septic tank for existing shop /ADU. �� Int t „„)); water tight risers to grade on all tank lid openings. Install outlet baffle filter( "" ( Orenco FTiP 0418 — W ) or equivalent. Tank to be set on 6" of "Pea Gravel". Fill with water prior to "Designers" inspection. Transport Lines Install 4" ASTM 3034 sewer pipe from building stub out to septic tank @ 2% minimum grade and from tank to "D" box @ 1% min. Install C.O. at stub out at ADU. Install new 4" ASTM 3034 from existing septic tank to new "D" box @ 1% minimum grade. "D" Box Install 9 hole "D" box on poured in place concrete pad on undisturbed soil with 24" Diameter riser to grade. Install speed-levelers and water level prior to designers "as built" inspection. Drain field Install 6 ( 60 x 3') laterals as shown on plans. Install inspection ports ( inside 6" round valve boxes ) with risers to grade within 5' of each end of lateral when using " Gravel less Chambers ". Install straight tees 10' from beginning and at end of each lateral when using " Gravel Trenches ". If Gravel less Chambers used install Digger's 20 Gauge, Hot dipped galvanized wire mesh with 3/4" hexagonal openings over entire trench bottom under chambers. Trench depth 18". ISPOSESIGN AGE p ��� Water Lines S Approver, fo; ��structian pate ' \ , +m«Cw. \ < <: . . , . .�. . . :�. . . ,. .� Maintain a minimum of 10' separation from septic components. No crossings allowed. Water line route to ADU is not known. May require moving to satisfy 10' minimum separation. Inspections Designer needs to be contacted for a pre - construction meeting prior to construction to discuss details and to set up schedule for inspections. Designer is responsible for submitting "Record" drawing, and must be called prior to back filling system. General Construction Notes 1 . The work described herein consists of construction of an on-site waste water system. 2. The contractor shall be knowledgeable and experienced in the construction of this type of waste water system and shall hold a valid certificate from Jefferson County Division of Environmental Health. "Approved" septic plans must be on site during construction. 3. If during the installation of the system the contractor finds soil conditions that may lead to premature failure of the system, construction shall be terminated immediately and the designer notified. Such soil conditions may include groundwater, fill, clay, highly compacted soil, bedrock or excessively permeable soils. 1. Any inconsistencies, errors, or omissions that, in the opinion of the installer, would compromise the quality of the waste water system shall be reported to the designer prior to construction. 1. Back fill in traffic areas shall be pit run gravel and compacted. All gravity pipe shall conform to ASTM D 3034. All gravity and transport pipe shall be bedded, using native or imported material free of rocks, debris and sharp objects. 2. All exposed soil shall be seeded and mulched prior to the final inspection. Seed shall be spread at an approximate rate of 10 lbs. per 5,000 sq. ft. 3. The installer shall be responsible for constructing the system according to plans and conditions of permit and shall be responsible for its proper operation and function for one year. The owner shall be responsible for operating and maintaining the waste water system in accordance with WAC 246-272A-0270. 4. Any changes, substitutions, or deviation from these plans shall be approved by the designer and by the Jefferson County Environmental Health Department. 5. The installer shall grade to divert all surface water runoff away from tanks and drain field/reserve areas. 6. The bottom of the trench or bed may be inspected by the designer prior to placing drain rock and shall not exceed +/- 1/2" from level. Place filter fabric over drain rock prior to back filling. 7. Setbacks to all known water lines shall be a minimum of 10'. No crossing of water lines with any septic component shall be allowed, except as included in septic design approved by Jefferson County Health Department. 8. Setback from the house foundation wall shall be 10' minimum to drain field, 5' minimum to tanks and 2' minimum to non-perforated sewer pipes. Water saving appliances, fixtures, and practices are to be used. 9. The septic and pump tanks, drain field and reserve areas are to be protected from vehicular traffic or mechanical disturbance. 10. The designer is to provide the as-built and letter of certification. 11. This system has been designed in accordance with WAC 246-272-A- 0270 and the most current Department of Health "Recommended Standards and Guidelines for Pressure Distribution Systems," and has been approved by the Jefferson County Health Department. Nevertheless, negligence or improper action on the part of the users could result in the premature failure or malfunction of the system or its components. ONSITE SEWAGE DISPOSAL SYSTEM DESIGN g q 7 p 0000 t Date — 15 Property Owner 6 ARL( SMI i N System Designer ER ( CSE N IDE S t ,i , Legal Description: Section 3q- Township 30k) Range i Subdivision Name SW }LLOW Lo 3& tPtIkT Division Block Lot(s) t J A I. CALCULATIONS If for residential use: Number of Bedrooms: rj x 120 G.P.D. = (O0 total G.P.D. If for non-residential use, attach calculations used to determine G.P.D. Soil texture waste water application rate ,757 G.P.D./ft. squared (see page 214 of the EPA Design Manual) DRAINFIELD SIZING: Absorption area: 103e) square feet (total G.P.D. G.P.D./ft. squared) Trench or bed width 3 feet Trench or bed length J(O lineal feet (sq. ft. ÷ trench or bed width) II. APPURTENANCESrte' 'x;11 -yt, 1. Septic Tank Size 1000 gallons ,!' °�wA �►�!', •• Pump Requirements (If Necessary) ' ` ��, Elevation difference in feet .- .14.11115100259 .,, r Q BERNT PAUL ERICSEN••. 11 NStb d NER Friction loss ��•+`EX I• 0 11/ Ii ���+,a Pump capacity should be G.P.M. at _ T.D.H. 6-7-17 Number of doses per day — Dosing volume — gallons Pump chamber size gallons Ft:'.home\pInc ntr\infohit h\sewd s HI. DRAINFIELD CROSS SECTION //7// / D ;L; a" or.;., Rork . NATIVE SOIL A f i _ PIPER?I?3L:E: SEASCNAL SA 'RATICN A. T.terah Depth i g inches .y ),;.c.. inches of drainrock below pipe iG,''yinches of vertical separation from trench bottom to impermeable rial/seasonal saturation .14).v9=:-)"(!)' inches of fill (if needed) E --- Tfehch.' dthf., inches NOTES: ATTACH DETAILED DESIGN OF SYSTEM